الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Temporal lobe epilepsy is the most common form of focal epilepsy. As many patients with this condition do not achieve good seizure control with the available antiepileptic drugs, surgery has gradually become the treatment of choice for drug refractory temporal lobe epilepsy worldwide. In our study we aimed to study the safety and efficacy of the surgical resection procedures in the management of drug resistant Temporal Lobe Epilepsy and factors affecting post-operative seizure freedom. We studied 40 pharmacoresistant Temporal Lobe Epilepsy patients who were treated surgically. Mean age was 30.75 years with a range from 11 to 66 years . 60% of our patients were males . All our patients were assessed clinically, radiologically and electrophysiologically in order to ensure that they are fulfilling the criteria to be defined as pharmacoresistant epilepsy patients and to make sure that their epileptogenic activity originate from one temporal lobe. All cases were operated either by Anterior Medial Temporal Lobectomy with amygdalohippocampectomy or tailored neocortical lesionectomy for some cases where preoperative investigations reveal limited neocortical epileptogenic activity without medial structures affection. All our patients in this study were followed for at least 12 months to detect any postoperative morbidity or mortality . We used one year post-operative Engel’s classification to classify the post-operative seizure outcome in our patients . 80% of our patients were totally seizure free (Engel’s class I) after 1 year postoperatively . Engel’s Class II was achieved in 12.5% of our patients . Engel’s Class III in 5 % while no improvement in seizure frequency was in 2.5 % of our patients (Engel’s Class IV). Presence of medial structural lesion in patients’ MRI was associated with statistically significant better results . Patients operated by Anterior Medial Temporal Lobectomy were associated with a statistically significant better outcome than those operated by tailored lesionectomy. Our work demonstrated that electophysiological studies are essential in determining the extent of surgical resection , this means that if the epileptogenic activity was confined to the lesion lesionectomy will be enough but if the epileptogenic activity extended beyond the lesion affecting adjacent neocortex or mesial structures this tissue must be included in the surgical resection . No Mortality or major complications were found in our series, minor complications as wound infection or transient neurological deficit were encountered in 5 cases.