• World Neurosurg · May 2022

    Aura Type and Outcome Following Anterior Temporal Lobectomy.

    • Luis F Rendon, Sarah K Bick, Sydney S Cash, Andrew J Cole, Emad N Eskandar, and Ziv M Williams.
    • Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Neurosurgery, Boston University School of Medicine, Boston, Massachusetts, USA. Electronic address: lrendon@bu.edu.
    • World Neurosurg. 2022 May 1; 161: e199-e209.

    ObjectiveTemporal lobe epilepsy (TLE) is one of the most common causes of medically refractory focal epilepsy. Anterior temporal lobectomy (ATL) leads to improved seizure control in patients with medically refractory TLE. Various auras are associated with TLE; however, the relationships between aura type and outcome after ATL are poorly understood. Our objective was to investigate the associations among clinical features, aura type, and seizure outcome after ATL.MethodsThe records of patients who underwent ATL between 1993 and 2016 at a single institution (N = 174) were retrospectively reviewed. Demographic and clinical variables were compared among aura types using analysis of variance and logistic regression analysis. A multiple regression analysis was conducted to determine whether aura type predicted seizure outcome after ATL.ResultsMesial temporal sclerosis (MTS) on magnetic resonance imaging inversely correlated with cephalic auras (P = 0.0090). Affective auras (P = 0.014) and somatosensory auras (P = 0.021) were correlated with findings of MTS on pathology, whereas this finding was inversely correlated with the presence of auditory auras (P = 0.0056). On multiple regression analysis, predictors of worse seizure outcome after ATL were cephalic auras (P = 0.0048), gustatory auras (P = 0.029), visual auras (P = 0.049), and tonic-clonic seizures (P = 0.047). Fewer preoperative antiepileptic medications (P = 0.0032), and presence of multiple auras (P = 0.011) were associated with better outcome.ConclusionsCephalic auras, gustatory auras, and visual auras were associated with worse seizure outcome after ATL.Copyright © 2022 Elsevier Inc. All rights reserved.

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