Neocortical Epilepsy

Abstract

Abstract Temporal lobe epilepsy (TLE) is the most common form of adult localization-related epilepsy. While 80% of patients have mesial temporal seizure onset, neocortical TLE encompasses a broader group of epilepsies generally characterized by an aura and contralateral clonic activity that will very often generalize. Thirty percent of these patients will remain refractory to medication. In patients whose thorough phase I and phase II evaluation has determined a neocortical seizure onset zone, anterior temporal lobectomy has been shown to be superior to medication alone in achieving seizure freedom and does so in up to 80% of these patients. Mortality in ATL is less than 1%, with morbidity rates around 5%, most commonly visual field defects. Neuropsychological performance may decline in up to 50% of cases, though it will improve in up to one-third of cases if seizure freedom is obtained.