{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:32:02Z","timestamp":1773012722662,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify long\u2010term predictors of seizure outcome after anterior temporal lobectomy (ATL) in a large, homogeneous cohort of patients with drug\u2010resistant temporal lobe epilepsy (TLE) and MRI\u2010defined unilateral hippocampal sclerosis (HS), all operated on by a single neurosurgeon with extended follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 281 consecutive patients with unilateral HS who underwent standardized ATL performed by the same senior neurosurgeon. All patients had at least two years of follow\u2010up (mean 10.8 \u00b1\u20095.79\u2009years). Clinical history, neuropsychological evaluation, long\u2010term video\u2010EEG monitoring, and 1.5T MRI constituted the preoperative dataset. Twenty\u2010one variables were assessed as potential predictors of seizure outcome. Kaplan\u2013Meier survival curves and univariate log\u2010rank tests identified candidate predictors; variables with\n                      <jats:italic>p<\/jats:italic>\n                      &lt;\u2009.10 were entered into a multivariate Cox regression model. Cognitive and quality\u2010of\u2010life outcomes were evaluated using standardized neuropsychological batteries and the ESI\u201055 questionnaire.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 10\u2009years postoperatively, 62.6% of patients remained seizure\u2010free (Engel I). Univariate analysis identified seven factors associated with seizure freedom, including history of focal\u2010to\u2010bilateral tonic\u2013clonic seizures, history of status epilepticus, presence of psychogenic non\u2010epileptic seizures, IED predominance or exclusivity in the operated lobe, ictal onset exclusively in the operated lobe, and a preoperative neuropsychological deficit confined to the operated temporal lobe. Multivariate analysis revealed three independent predictors of seizure outcome: history of status epilepticus (HR\u2009=\u20092.11;\n                      <jats:italic>p<\/jats:italic>\n                      =\u2009.002), ictal onset confined to the operated temporal lobe (HR\u2009=\u2009.57;\n                      <jats:italic>p<\/jats:italic>\n                      =\u2009.018), and preoperative neuropsychological deficit restricted to the operated temporal lobe (HR\u2009=\u2009.59;\n                      <jats:italic>p<\/jats:italic>\n                      =\u2009.040). Cognitive outcomes were generally stable; left ATL was associated with greater verbal memory decline. Quality\u2010of\u2010life improved significantly at 2\u2010year follow\u2010up (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;\u2009.001), with better outcomes among seizure\u2010free patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In this large single\u2010surgeon cohort with one of the longest follow\u2010up durations reported, most patients with unilateral HS achieved durable seizure freedom after ATL. Status epilepticus, consistent ictal localization to the operated temporal lobe, and concordant preoperative neuropsychological deficit emerged as robust long\u2010term predictors. These findings reinforce the value of detailed presurgical evaluation\u2014particularly ictal EEG concordance and neuropsychological lateralization\u2014in optimizing surgical counseling, risk stratification, and patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70139","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T12:12:36Z","timestamp":1763986356000},"page":"84-96","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term predictors of seizure outcome after anterior temporal lobectomy in unilateral hippocampal sclerosis: A\u00a0281\u2010patient cohort with mean 10\u2010year follow\u2010up"],"prefix":"10.1002","volume":"28","author":[{"given":"Thiago Pereira","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo SP 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Barreira","family":"Alonso","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrique Carrete","family":"Junior","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Helena Silva","family":"Noffs","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Otavio","family":"Caboclo","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o\u00a0Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeana Torres 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