Effectiveness of surgery in temporal lobe epilepsy with hippocampal sclerosis

Abstract

Introduction. Temporal lobe epilepsy with hippocampal sclerosis is one of the most common and challenging forms of epilepsy, often accompanied by recurrent seizures and impacts on quality of life. Conventional surgical treatment shows good results in controlling seizures, while new minimally invasive approaches are being developed with the aim of further improving prognosis. Objective. To demonstrate the efficacy of surgical treatment and discuss new therapeutic techniques for patients with temporal lobe epilepsy with hippocampal sclerosis. Method. The search for scientific articles took place in the National Library of Medicine - PubMed electronic database, restricting the period of publication to the last five years. The search used a combination of descriptor and Boolean operator: (epilepsy) and (temporal lobe) and (hippocampal sclerosis) and (treatment). Results. We analyzed 18 articles from 2019 to 2024. As for the results of the papers analyzed, 66.6% showed a good prognosis after surgical treatment of temporal lobe epilepsy (TLE) with hippocampal sclerosis and 33.3% bring new therapeutic modalities. Of the 66.6%, only 11.1% advocate therapeutic measures with highly selective ablation or a smaller resection. A further 16.6% report uncertain results for the outcomes of surgical treatment, both for anterior temporal lobectomy and the more selective approach. On the other hand, 11.1% show that there is a relationship between factors for a good surgical prognosis, such as the laterality of the disease. Conclusion. Anterior temporal lobectomy showed better results for the treatment of TLE with hippocampal sclerosis. New therapies are still inconclusive and require more scientific evidence.