By: Andrew Yee
Temporal Lobe Resection
Temporal Lobe Resection, also called Lobectomy, is another type of surgery that treats drug-resistant Epilepsy. Drug-resistant Epilepsy occurs when seizures do not respond to antiepileptic medication. During a Temporal Lobe Resection, the doctor will remove part or all of the temporal lobe (Rath, 2021).
Temporal Lobe
The temporal lobe is a part of the most significant part of the brain, the cerebrum. The cerebrum has four sections to it, the frontal, parietal, occipital, and temporal lobes (MedicineNet). The temporal lobe is the second largest lobe and is located behind the ears. It is most commonly associated with hearing, language, and memory. For people with temporal lobe epilepsy, the temporal lobe is the focal point for their Epilepsy. Temporal Lobe Epilepsy is the most common type of Epilepsy for teenagers and adults.
Qualifications:
For a Temporal Lobe Resection to happen, the Temporal Lobe must be the focal point of the seizures. Additionally, surgery may be recommended if at least two anti-seizure medications have been tried and are unsuccessful. A patient may also qualify if the seizures are uncontrolled and pose significant physical, social, or psychological health risks (MedicineNet).
Pre-Surgical Tests:
Before undergoing a Temporal Lobe Resection, candidates must undergo pre-surgery evaluations. This evaluation determines the location of the seizures and if surgery can be done without harming other brain regions. This includes neuroimaging tests such as an EEG (Electroencephalogram), SPECT (Single Photon Emission Computerized Tomography), MRI (Magnetic Resonance Imaging), MEG (Magnetoencephalography), or a Wada test (Rath, 2021).
During Surgery:
The patient’s hair may be clipped short or shaved before surgery (Rath, 2021). Surgical procedures may differ depending on the exact location and how much of the temporal lobe needs to be taken out, but the surgery generally goes as follows (MedicineNet):
● The patient arrives at the hospital and is given general anesthesia.
● A craniotomy (cutting into the skull) is performed.
● A “window” is created, and special instruments are inserted.
● Surgical Microscopes, computer images, and an EEG are used to depict the brain. The patient may be asked during the surgery to perform counting, thinking, or talking so the surgeon can determine which areas to cut without disrupting brain function.
● The surgeon will then remove or cut the source of the seizures.
● The “window” is closed, and the removed bone is replaced.
Post Surgery:
The patient can expect to stay at the hospital for another 3 to 7 days, with the first day being in the Intensive Care unit (Rath, 2021). The patient should be able to walk and eat in a day or two. About 6 to 8 weeks after the surgery, most people can return to their daily lives, including school or work. They will remain on anti-seizure medications until their doctor is sure the seizures are under control. The patient may also undergo speech, occupational, or physical therapy to help with recovery (Barnes Jewish Hospital, 2023).
All surgeries come with side effects that may be experienced.
Side Effects include (Rath, 2021):
● Bruising and swelling on the side where the surgery was done.
● Headaches and earaches.
● A sore jaw and scalp numbness.
● Feelings of nausea, fatigue, or depression.
● Difficulty speaking and memorizing.
Risks include (MedicineNet):
● Infections or blood clotting
● Failure to relieve seizures
● Changes in personality
● Allergic reactions to medicine
Results:
About 70 to 90 percent of people see an improvement in their seizures after undergoing a temporal lobe resection. Most patients can also usually reduce medications after the surgery with the guidance of their epilepsy team. About 25% of seizure-free people can stop taking their medications altogether (MedicineNet).
Conclusion
Temporal Lobe Resection is an opportunity for those with drug-resistant seizures with a temporal lobe focal point to become seizure-free. The procedure does this by removing all or part of the temporal lobe. The surgery does come with possible health risks, but 70 to 90 percent of patients will significantly improve their control over their seizures. This makes Temporal Lobe Resection an opportunity that can significantly improve your quality of life. You should consult your doctor to see if a temporal lobe resection is right for you.
Resources:
Barnes Jewish Hospital (2023). Temporal Lobe Epilepsy Surgery. Barnes Jewish Hospital. Retrieved from: https://www.barnesjewish.org/Medical-Services/Neurology-Neurosurgery/Epilepsy/Epilepsy-Treatment/Epilepsy-Surgery/Temporal-Lobe-Epilepsy-Surgery
Rath, L. (2021, August 25). Temporal lobe resection for epilepsy. Web MD. Retrieved April 6, 2023, from: https://www.webmd.com/epilepsy/guide/temporal-lobe-resection-epilepsy
MedicineNet (n.d.). Epilepsy and Temporal Lobe Resection. MedicineNet. Retrieved from: https://www.medicinenet.com/temporal_lobe_resection/article.htm#introduction
