*Result*: Long-term seizure outcomes of epilepsy surgery in patients with mesial temporal lobe epilepsy caused by hippocampal sclerosis based on preoperative ictal versus non-ictal video-EEG: A 10-year follow-up.

Title:
Long-term seizure outcomes of epilepsy surgery in patients with mesial temporal lobe epilepsy caused by hippocampal sclerosis based on preoperative ictal versus non-ictal video-EEG: A 10-year follow-up.
Authors:
Martínez-Medina S; Neurology Residency Program. National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez', Mexico City, Mexico., Gonzalez-Salido J; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Marin-Castañeda LA; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Robles-Lomelín P; Neurology Residency Program. National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez', Mexico City, Mexico., Colado-Martinez J; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Fuentes-Calvo I; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Vasquez-Lopez F; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Vázquez-Cruz BC; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Villamil-Osorio LV; University of Tolima Faculty of Health Sciences, Ibague, Colombia., Gómez-Arias B; CES Clinic & Salud Cerebral SAS, Medellín, Colombia., Herrera-Noguera NM; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Arellano-Reynoso A; Functional Neurosurgery Department, National Institute of Neurology and Neurosurgery, Mexico City, Mexico., Gutierrez-Aceves GA; Functional Neurosurgery Department, National Institute of Neurology and Neurosurgery, Mexico City, Mexico., Moreno-Jimenez S; Radio Neurosurgery Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico., Sotelo-Díaz F; Neurosurgery Residency Program, National Institute of Neurology and Neurosurgery, Mexico City, Mexico., Vázquez-Coria RE; Neurosurgery Residency, South Central High Specialty Hospital PEMEX, Mexico City, Mexico., González-Aragón MF; Clinical Neurophysiology and Cognition Laboratory, National Institute of Neurology and Neurosurgery, Mexico City, Mexico., Moreno Avellán Á; Clinical Neurophysiology and Cognition Laboratory, National Institute of Neurology and Neurosurgery, Mexico City, Mexico., Elizondo Pereo RA; Neurology Residency Program. Christus Muguerza High Specialty Hospital, Nuevo Leon, Mexico., Alonso-Vanegas MA; Neurosurgery Department, Epilepsy Surgery Program, HMG Coyoacán, Mexico City, Mexico., Moreno-Castellanos J; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Vera-López JC; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Salgado-Deza M; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Vázquez-Hernández OI; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico., Ramos-Sánchez R; Neuroradiology Department, National Institute of Neurology and Neurosurgery, Mexico City, Mexico., Camiro-Zuñiga A; Infectious Diseases Department, Instituto Nacional de Cancerología, Mexico City, Mexico., Burneo J; Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada., Sebastián-Díaz MA; Nephrology Department, Hospital de PEMEX de Alta Especialidad Central Sur, Mexico City, Mexico. Electronic address: mario.alberto.sebastian@pemex.com., Martínez-Juárez IE; Epilepsy Clinic & Clinical Epileptology Fellowship, National Institute of Neurology and Neurosurgery 'Manuel Velasco Suarez' & Faculty of Medicine, UNAM, Mexico City, Mexico; Clinical Neurophysiology and Cognition Laboratory, National Institute of Neurology and Neurosurgery, Mexico City, Mexico; Grupo Neurológico, Neuroquirúrgico y de Columna . Hospital Ángeles Acoxpa, Mexico City, Mexico. Electronic address: imartinez@innn.edu.mx.
Source:
Epilepsy & behavior : E&B [Epilepsy Behav] 2025 Nov; Vol. 172, pp. 110714. Date of Electronic Publication: 2025 Oct 07.
Publication Type:
Journal Article; Observational Study
Language:
English
Journal Info:
Publisher: Academic Press Country of Publication: United States NLM ID: 100892858 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-5069 (Electronic) Linking ISSN: 15255050 NLM ISO Abbreviation: Epilepsy Behav Subsets: MEDLINE
Imprint Name(s):
Original Publication: San Diego, CA : Academic Press, c2000-
MeSH Terms:
Epilepsy, Temporal Lobe*/surgery , Epilepsy, Temporal Lobe*/etiology , Epilepsy, Temporal Lobe*/physiopathology , Hippocampus*/pathology , Hippocampus*/surgery , Seizures*/surgery , Seizures*/etiology , Seizures*/physiopathology, Sclerosis/complications ; Drug Resistant Epilepsy/surgery ; Humans ; Male ; Female ; Electroencephalography ; Adult ; Follow-Up Studies ; Video Recording ; Treatment Outcome ; Middle Aged ; Anterior Temporal Lobectomy ; Longitudinal Studies ; Young Adult ; Magnetic Resonance Imaging ; Adolescent ; Retrospective Studies ; Hippocampal Sclerosis
Contributed Indexing:
Keywords: Anterior temporal lobectomy; Epilepsy; Mesial temporal lobe epilepsy with hippocampal sclerosis; Seizure freedom; Video-EEG
Entry Date(s):
Date Created: 20251008 Date Completed: 20251021 Latest Revision: 20251121
Update Code:
20260130
DOI:
10.1016/j.yebeh.2025.110714
PMID:
41061411
Database:
MEDLINE

*Further Information*

*Introduction: Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is a frequent cause of drug-resistant epilepsy (DRE). In these cases, anterior temporal lobectomy (ATL) is an effective treatment in well-selected patients. While ictal video-electroencephalogram (video-EEG) remains the gold standard for localizing the epileptogenic zone, some studies have suggested that non-ictal video-EEG, when concordant with MRI, may be sufficient to perform ATL.
Objective: To compare long-term outcomes in patients who underwent ATL with ictal video-EEG versus non-ictal video-EEG by presenting one of the first comprehensive 10-year follow-up analyses.
Methods: An observational, ambispective, longitudinal, and analytic cohort was used to compare the long-term seizure outcomes in patients with MTLE-HS who underwent ATL with ictal video-EEG versus non-ictal video-EEG preoperative monitoring evaluation at a neurology and neurosurgery hospital.
Results: A total of 122 patients with MTLE-HS who underwent ATL were included. Preoperative ictal video-EEG was available for 73 patients (59.8 %), and 49 patients (40.2 %) were evaluated using non-ictal video-EEG. MRI concordance was observed in 62 patients (84.9 %) of the ictal and 41 patients (83.7 %) of the non-ictal group. Overall, 78 patients (63.9 %) were seizure-free: 47 (64.4 %) in the ictal group and 31 (63.3 %) in the non-ictal group (p = 0.89). No significant difference in seizure freedom was observed between groups over a 10-year follow-up (log-rank p = 0.24).
Conclusion: In patients with MTLE-HS, ATL guided by non-ictal video-EEG with concordant clinical and MRI findings could achieve seizure freedom outcomes comparable to those obtained with ictal video-EEG. These results support the use of non-ictal evaluations in resource-limited settings.
(Copyright © 2025 Elsevier Inc. All rights reserved.)*

*Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors report there are no competing interests to declare. The authors alone are responsible for the content and writing of this article. We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.*