• Bo Zhang, Xiongfei Wang, Jing Wang, Mengyang Wang, Yuguang Guan, Zhao Liu, Yao Zhang, Meng Zhao, Haoran Ding, Ke Xu, Jiahui Deng, Tianfu Li, Guoming Luan, and Jian Zhou.
• Department of Neurosurgery, Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Epilepsy Research, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China.
• World Neurosurg. 2024 Sep 13.

PurposeAnterior temporal lobectomy (ATL) is the most common surgical treatment for temporal lobe epilepsy (TLE), and Stereoelectroencephalography (SEEG) plays a critical role in precisely localizing the epileptogenic zone (EZ). This study aimed to explore the effect of SEEG on the long-term outcomes of different side ATL.MethodsFrom March 2012 to February 2020, a retrospective analysis was conducted on 231 TLE patients who underwent standard ATL surgery. According to the surgical sides and the utilization of SEEG during preoperative evaluation, the patients were categorized into four groups, with a follow-up period exceeding two years.ResultsAmong the 231 TLE patients, the probability of being seizure-free two years after the surgery was 80.52%, which decreased to 65.65% after five years. There was no significant difference in outcomes between SEEG and non-SEEG patients. For overall and non-SEEG patients, there was no significant difference in short-term outcomes between different surgical sides. However, the long-term outcomes of right ATL patients were significantly better than left. Interestingly, for patients who underwent SEEG, there was no significant difference in both short-term and long-term outcomes between different surgical sides.ConclusionSome TLE patients encounter challenges in localizing the EZ through non-invasive evaluation, necessitating the use of SEEG for precise localization. Furthermore, their seizure outcomes after surgery can be the same with the patients who have a clear epileptogenic zone in non-invasive evaluation. And SEEG patients can achieve a more stable long-term prognosis than non-SSEEG patients.Copyright © 2024. Published by Elsevier Inc.

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