Temporal Lobe Resective Surgery for Medically Intractable Epilepsy: A Review of Complications and Side Effects

Table 3

Synopsis of data of adult temporal lobe epilepsy surgical series and their reported surgical complications.

Series/year of publication	Study characteristics	Number of pts	Surgical procedure	Mortality	Mean followup	Seizure-free outcome	Complications	Cumulative complication rate*	Behavioral/; cognitive/psychiatric; complications
Wiebe et al.,; 2001 [1]	Prospective	40	ATL + AH	0%	12 months	54%	None	5%	5% memory deficits
Cohen-Gadol et al.,; 2003 [33]	Prospective	47	ATL + AH	0%	6 months	N/A	Diplopia: 19%; VFDs: 69%	88%	N/A
Oertel et al.,; 2004 [31]	Prospective	60	Transcortical selective AH	0%	N/A	N/A	Hemiparesis: 5%; Aphasia: 1.7%; C.N. palsy: 5%; Infections: 1.7%	13.4%	N/A
Grivas et al.,; 2006 [26]	Retrospective	52	AH,; lesionectomy + AH	0%	33 months	71%	Hemiparesis: 3.8%; Aphasia: 3.8%; C.N. palsy: 5.8%; VFDs: 5.8%; Hematomas: 3.8%; Pneumonia: 1.9%; Pulmonary embolism: 1.9%	53.4%	Decline in neuropsychological status: 26.5% (Verbal memory decline in 29.4%, visual memory decline in 32.4%)
Sindou et al.,; 2006 [17]	Retrospective	100	Tailored ATL + AH	0%	53 months	85%	Hemiparesis: 2%; C.N. palsy: 5%; Hydrocephalus: 2%; Meningitis: 3%; Hematomas: 3%; Pulmonary embolism: 1%	19%	Permanent neuropsychological impairment: 3%
Roberti et al.,; 2007 [15]	Retrospective	42	Tailored ATL + AH	0%	60 months	64%	Frontal branch of facial n. palsy: 2.4%; Bone flap reabsorption: 2.3%	4.7%	N/A
Acar et al.,; 2008 [24]	Retrospective	39	Transcortical selective AH	0%	25.9 months	82%	Hemiparesis: 2.6%; Dysphasia: 7.7%; VFDs: 10.3%; C.N. palsy: 2.6%; Hemotympanum: 2.6%; Frontal branch of facial n. palsy: 2.6%	33.5%	Memory difficulties: 5.1%
Elsharkawy et al.,; 2009 [25]	Retrospective	483	ATL + AH	0%	2 years	72.3%	Permanent deficits: 2.3%; Temporary deficits: 2.3%	5%	N/A
Heller et al.,; 2009 [28]	Retrospective	55	Tailored ATL + AH	0%	N/A	N/A	Hemiparesis: 1.8%; Stroke: 5.5%; VFDs: 1.8%; Hematomas/hygromas: 3.6%; Meningitis: 1.8%; Deep venous thrombosis: 1.8%	16.3%	N/A
Ipekdal et al.,; 2011 [5]	Retrospective	58	ATL + AH	0%	N/A	N/A	Stroke: 1.7%; Frontal branch of Facial n. palsy: 1.7%; Infections: 4.7%; Subdural effusion: 1.7%	14.9%	Psychosis: 1.7%; Depression: 1.7%; Anxiety disorders: 1.7%
Falowski et al.,; 2012 [4]	Retrospective	222	Tailored AH	0%	5.4 years	70%	Dysphasia: 0.9%; Infections: 1.4%; Deep venous thrombosis: 0.9%	3.2%	N/A

∗This rate includes the behavioral/cognitive/psychiatric complications. ATL: anterior temporal lobectomy; AH: amygdalohippocampectomy; VFDs: visual field deficits; C.N.: cranial nerve.