uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Long-term epilepsy surgery outcomes in patients with MRI-negative temporal lobe epilepsy
Show others and affiliations
2010 (English)In: Epilepsia, ISSN 0013-9580, E-ISSN 1528-1167, Vol. 51, no 11, 2260-2269 p.Article in journal (Refereed) Published
Abstract [en]


The outcome of surgery in patients with temporal lobe epilepsy (TLE) and normal high-resolution magnetic resonance imaging (MRI) has been significantly worse than in patients with unilateral hippocampal damage upon MRI. The purpose of this study was to determine the long-term outcomes of consecutive true MRI-negative TLE patients who all underwent standardized preoperative evaluation with intracranial electroencephalography (EEG) electrodes.


In this study we present all adult MRI-negative TLE surgery candidates evaluated between January 1990 and December 2006 at Kuopio Epilepsy Center in Kuopio University Hospital, which provides a national center for epilepsy surgery in Finland. During this period altogether 146 TLE surgery candidates were evaluated with intracranial electrodes, of whom 64 patients with normal high-resolution MRI were included in this study.


Among the 38 patients who finally underwent surgery, at the latest follow-up (mean 5.8 years), 15 (40%) were free of disabling seizures (Engel class I) and 6 (16%) were seizure-free (Engel class IA). Twenty-one (55%) of 38 patients had poor outcomes (Engel class III-IV). Outcomes did not change compared to 12-month follow-up. Histopathologic examination failed to reveal any focal pathology in 68% of our MR-negative cases. Only patients with noncongruent positron emission tomography (PET) results had worse outcomes (p = 0.044).


Our results suggest that epilepsy surgery outcomes in MRI-negative TLE patients are comparable with extratemporal epilepsy surgery in general. Seizure outcomes in the long-term also remain stable. Modern imaging techniques could further improve the postsurgical seizure-free rate. However, these patients usually require chronic intracranial EEG evaluation to define epileptogenic areas.

Place, publisher, year, edition, pages
2010. Vol. 51, no 11, 2260-2269 p.
Keyword [en]
Epilepsy surgery, Temporal lobe, Nonlesional MRI, Outcomes
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-134120DOI: 10.1111/j.1528-1167.2010.02720.xISI: 000283595400006OAI: oai:DiVA.org:uu-134120DiVA: diva2:373981
Available from: 2010-12-02 Created: 2010-11-22 Last updated: 2012-05-10Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text
By organisation
Department of Genetics and Pathology
In the same journal
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 170 hits
ReferencesLink to record
Permanent link

Direct link