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Temporal Lobe Epilepsy Surgery

Temporal lobe epilepsy surgery, also called temporal lobectomy or resection, is a treatment for epilepsy when patients do not respond to antiepileptic medication. This procedure involves removing part of the temporal lobe of the brain.

The temporal lobes are located on either side of the brain above the ears and are involved in sensations and short-term memory. Temporal lobe epilepsy accounts for about 60-70 percent of epilepsy cases, making it the most common form of partial epilepsy, or partial seizures.

Our experts at the Washington University and Barnes-Jewish Comprehensive Epilepsy Center see hundreds of epilepsy patients every year. We use the latest technologies like iMRI, brain laser surgery and video EEG to provide our patients with the most advanced care. If you’ve been diagnosed with epilepsy, our neurology team can perform temporal lobe epilepsy surgery with precision and expertise.

Why Temporal Lobe Epilepsy Surgery is Performed

Around 60-70 percent of epilepsy patients find success with anti-seizure medications. However, about 30 percent of people with epilepsy will not respond to medical therapy. When medications fail to control seizures, epilepsy surgery may be the next step.

Epileptologists, neurosurgeons and other specialists at Barnes-Jewish work together to determine whether temporal lobe epilepsy surgery is right for you. They may recommend this surgery if you meet the following conditions:

  • You have tried at least two first-line anti-seizure medications or one combination of at least two drugs without success.
  • Your seizures are uncontrolled and posing serious physical, social or psychological risks.

Your care team will only recommend surgery if the potential benefits outweigh the risks.

What to Expect from Temporal Lobectomy

One of our highly experienced neurosurgeons will perform temporal lobe epilepsy surgery. In most cases, you will have general anesthesia. Sometimes, it may be necessary for you to be awake, but sedated, during the surgery to help your doctor evaluate your language and movement.

The surgery takes several hours and involves removing part of the temporal lobe. The goal is to remove only the tissue responsible for the seizures.

Selective Amygdalohippocampectomy (SAH)

The hippocampus and amygdala are two brain structures in the temporal lobe. When evaluation with neuroimaging and EEG studies shows that seizures arise from the amygdala and hippocampus, patients undergo evaluation for a special, minimally invasive neurosurgical procedure called selective amygdalohippocampectomy.

A type of temporal lobe epilepsy surgery, SAH is a minimally invasive procedure to remove the amygdala and hippocampus while preserving other surrounding structures. Barnes-Jewish was one of the first Comprehensive Epilepsy Centers to routinely perform this procedure to treat temporal lobe epilepsy.

Compared to other temporal lobe epilepsy surgeries, SAH provides equal seizure control and fewer side effects. As a minimally invasive procedure, neurosurgeons can offer optimal treatment without further damaging other areas. Minimally invasive surgery typically results in fewer complications after surgery and a shorter hospital stay.

Recovery After Temporal Lobe Epilepsy Surgery

You can expect to stay in the hospital for three to seven days after temporal lobe epilepsy surgery. Most people can resume their regular activities two to eight weeks after surgery. Speech therapy, physical therapy and occupational therapy can help you recover.

About 90 percent of people see an improvement in their seizures after temporal lobe epilepsy surgery. Most patients can usually reduce medications after the operation to minimize side effects and improve quality of life.

To make an appointment with a Washington University epileptologist, neurologist or neurosurgeon at Barnes-Jewish Hospital, call 855.925.0631.

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