{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T12:48:28Z","timestamp":1782132508234,"version":"3.54.5"},"reference-count":15,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"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"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Balancing seizure outcomes and cognitive deficits is always a challenge in both mesial and neocortical temporal lobe epilepsy cohorts. The present study evaluated the long\u2010term seizure outcomes and perceived quality of life (QOL) in both of these groups, along with factors predictive of these outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis of patients undergoing temporal lobe epilepsy (TLE) surgery from 2015 to 2023, with at least 1\u2009year of follow\u2010up (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009175), is presented. Patients were grouped as MTLE (mesial temporal sclerosis only) and NTLE (neocortical) based on neuroimaging. Surgical approaches included standard anterior temporal lobectomy with amygdalohippocampectomy (ATL\u2009+\u2009AH) and hippocampal\u2010sparing resections. Seizure outcomes were classified using Engel's scale; QOL was assessed telephonically using a questionnaire adopted from QOLIE\u201010\u2010P. Predictors for seizure freedom and perceived QOL outcomes were studied in both groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At a mean follow\u2010up of 55\u2009months, 83.5% of patients achieved seizure freedom, MTLE (85%), and NTLE (81%) patients. Of the entire TLE cohort, 38% were free from drugs at the last follow\u2010up. In MTLE, the presence of red flags significantly lowers the chances of complete seizure freedom (59% vs. 93%.) (OR 0.11, 95% CI 0.03\u20130.37;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Preserving the hippocampus in NTLE is associated with a lower the seizure freedom rate (68% vs. 86%) (OR 0.34, 95% CI 0.10\u20131.08). In NTLE, the odds of perceived memory decline were marginally higher in the standard ATL\u2009+\u2009AH group (OR 1.48, 95% CI 0.37\u20135.87) compared to hippocampus\u2010preserving resection (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7). Approx. 75% patients reported improvement in all QOL parameters in the entire TLE cohort. No mortality or permanent neurological deficits recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TLE surgery provides robust seizure control and significant perceived QOL improvements for most patients in the long term. Hippocampal sparing surgery in NTLE did not seem to affect perceived memory difficulties but was more likely to be associated with suboptimal seizure outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70313","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T12:00:36Z","timestamp":1782129636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of long\u2010term seizure outcomes and perceived quality of life outcomes after temporal lobe epilepsy surgery"],"prefix":"10.1002","author":[{"given":"Nilesh S.","family":"Kurwale","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarthak","family":"Jain","sequence":"additional","affiliation":[{"name":"NHS foundation trust University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujit A.","family":"Jagtap","sequence":"additional","affiliation":[{"name":"Department of Neurology Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandip B.","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogeshwari","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Department of Radiology Star Imaging Center  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniruddha","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Radiology Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujit","family":"Nilegaonkar","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Bapat","sequence":"additional","affiliation":[{"name":"Department of Neuropsychology Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antara","family":"Sapre","sequence":"additional","affiliation":[{"name":"Department of Neuropsychology Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5835-2952","authenticated-orcid":false,"given":"Rangaswami Thiruvengadam","family":"Rajeswarie","sequence":"additional","affiliation":[{"name":"Department of Neuropathology NIMHANS  Bengaluru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonal","family":"Chitnis","sequence":"additional","affiliation":[{"name":"Department of Speech Pathology and Language Deenanath Mangeshkar Hospital  Pune India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"issue":"1","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/epi.16772","article-title":"Temporal lobe epilepsy surgery in children and adults: a multicenter study","volume":"62","author":"Barba C","year":"2021","journal-title":"Epilepsia"},{"issue":"6","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1227\/neu.0000000000002358","article-title":"Long\u2010term seizure freedom, resolution of epilepsy and perceived life changes in drug resistant temporal lobe epilepsy with hippocampal sclerosis: comparison of surgical versus medical management","volume":"92","author":"Jayalakshmi S","year":"2023","journal-title":"Neurosurgery"},{"issue":"1","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"174","DOI":"10.3171\/2017.4.JNS162699","article-title":"Mesial temporal lobe epilepsy: long\u2010term seizure outcome of patients primarily treated with transsylvian selective amygdalohippocampectomy","volume":"129","author":"Dorfer C","year":"2018","journal-title":"J Neurosurg"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.seizure.2014.10.006","article-title":"Long\u2010term seizure outcome for international consensus classification of hippocampal sclerosis: a survival analysis","volume":"25","author":"Na M","year":"2015","journal-title":"Seizure"},{"issue":"4","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.yebeh.2011.05.005","article-title":"Determinants of quality of life after epilepsy surgery: systematic review and evidence summary","volume":"21","author":"Seiam AHR","year":"2011","journal-title":"Epilepsy Behav"},{"issue":"8","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1111\/j.1528-1167.2008.01604.x","article-title":"Temporal lobe epilepsy surgery and the quest for optimal extent of resection: a review","volume":"49","author":"Schramm J","year":"2008","journal-title":"Epilepsia"},{"issue":"3","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1684\/epd.2013.0587","article-title":"Cognitive outcomes of different surgical approaches in temporal lobe epilepsy","volume":"15","author":"Helmstaedter C","year":"2013","journal-title":"Epileptic Disord"},{"issue":"11","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1080\/01616412.2021.1942407","article-title":"Operative variations in temporal lobe epilepsy surgery and seizure and memory outcome in 226 patients suffering from hippocampal sclerosis","volume":"43","author":"Roessler K","year":"2021","journal-title":"Neurol Res"},{"issue":"8","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1111\/epi.13831","article-title":"Predictive factors of long\u2010term outcomes of surgery for mesial temporal lobe epilepsy associated with hippocampal sclerosis","volume":"58","author":"Mathon B","year":"2017","journal-title":"Epilepsia"},{"issue":"2","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1093\/brain\/awv372","article-title":"Temporal plus epilepsy is a major determinant of temporal lobe surgery failures","volume":"139","author":"Barba C","year":"2016","journal-title":"Brain J Neurol"},{"issue":"1","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.yebeh.2008.02.015","article-title":"When should a resection sparing mesial structures be considered for temporal lobe epilepsy","volume":"13","author":"Mintzer S","year":"2008","journal-title":"Epilepsy Behav"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.yebeh.2020.107642","article-title":"Consequences of mesial temporal sparing temporal lobe surgery in medically refractory epilepsy","volume":"115","author":"Goldstein L","year":"2021","journal-title":"Epilepsy Behav"},{"issue":"2","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1111\/j.0013-9580.2005.28004.x","article-title":"Antiepileptic drug withdrawal after successful surgery for intractable temporal lobe epilepsy","volume":"46","author":"Kim YD","year":"2005","journal-title":"Epilepsia"},{"issue":"2","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1097\/WCO.0000000000000905","article-title":"Visual field defects in temporal lobe epilepsy surgery","volume":"34","author":"Vakharia VN","year":"2021","journal-title":"Curr Opin Neurol"},{"issue":"2","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/j.1528-1167.2011.03343.x","article-title":"Mortality after temporal lobe epilepsy surgery","volume":"53","author":"Seymour N","year":"2012","journal-title":"Epilepsia"}],"container-title":["Epileptic Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epd2.70313","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/epd2.70313","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epd2.70313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T12:00:39Z","timestamp":1782129639000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epd2.70313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":15,"alternative-id":["10.1002\/epd2.70313"],"URL":"https:\/\/doi.org\/10.1002\/epd2.70313","archive":["Portico"],"relation":{},"ISSN":["1294-9361","1950-6945"],"issn-type":[{"value":"1294-9361","type":"print"},{"value":"1950-6945","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"assertion":[{"value":"2026-01-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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