TEMPORAL LOBECTOMY - AN OVERVIEW OF ITS ROLE AND INDICATION IN EPILEPSY SURGERY

When a focal epilepsy proves refractory to medical therapy, surgical treatment is increasingly used. Most interventions consist in cortical resections, and by far the most common operation is a temporal lobectomy. The presurgical evaluation is a multi-disciplinary one, and includes history and examination, neuropsychological testing, neuro-imaging techniques, (functional imaging and intracarotid amobarbital procedure), and neurophysiologic data (EEG-video monitoring). When non-invasive EEG does nor succeed in localizing the epileptogenic sone with sufficient accuracy, several invasive techniques ore available. Each has its own advantages and disadvantages. In appropriately selected cases, postoperative outcome is excellent, especially in temporal lobe epilepsy. In general, outcome is slightly less successful in extra-temporal cases.