Occult focal cortical dysplasia may predict poor outcome of surgery for drug-resistant mesial temporal lobe epilepsy

• DOI: 10.1371/journal.pone.0257678
• Publication Date: 2021-09-30T19:10:12Z
• Authors: Arkadiusz Nowak; Aleksandra Bala
• Keywords: Hippocampal sclerosis; Occult; Anterior temporal lobectomy; Lobe

Purpose The results of surgery in patients with mesial temporal lobe epilepsy (MTLE) associated hippocampal sclerosis (HS) are favorable, a success rate over 70% following resection. An association HS focal cortical dysplasia (FCD) the is one potential causes for poor surgical outcome MTLE. We aimed to analyzed seizure population MTLE and recognize role occult FCD achieving postoperative control. Methods retrospectively outcomes 82 consecutive adult syndrome due HS, who had no concomitant lesions within MRI underwent treatment years 2005–2016, correlated factors relapse. Results At latest follow-up evaluation after surgery, 59 (72%) were free disabling seizures (Engel Class I) 48 (58,5%) an Engel Ia. neocortical structures noted 33 (40%). Analyzes have shown that dual pathology was most significant negative predictive factor class I Ia outcome. Conclusions incidence seems be underestimated. incomplete epileptogenic zone resection supposed important prognostic freedom MTLE-HS patients. study indicates need improve diagnostics other pathologies, despite typical clinical radiological picture MTLE-HS.