{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T05:11:01Z","timestamp":1691212261226},"reference-count":15,"publisher":"Scientific Scholar","license":[{"start":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T00:00:00Z","timestamp":1604448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ruralneuropractice.com"],"crossmark-restriction":true},"short-container-title":["JNRP"],"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p>\n<jats:bold>Background<\/jats:bold>\u2003Among the patients of drug-resistant epilepsy, a subset which has focal impaired seizures localizes to the temporal lobe region (TLE). A majority of these cases are surgically amenable with anterior-medial temporal lobe resection or \u201clesionectomy.\u201d<\/jats:p>\n<jats:p>\n<jats:bold>Objective<\/jats:bold>\u2003In India, there is scarcity of \u201cspecialized centers\u201d providing \u201ccomprehensive epilepsy care\u201d and this dearth is further worse in populous states. In this article, we share our single center, observational, and retrospective experience of TLE in background of limited resources and utmost requirement.<\/jats:p>\n<jats:p>\n<jats:bold>Methodology<\/jats:bold>\u2003Our study is a retrospective analysis medically refractory epilepsy patients (2016\u20132019). Patients with medically refractory epilepsy were selected based upon our noninvasive protocol (clinical semiology, interictal scalp electroencephalography (EEG), long-term video EEG monitoring data, and magnetic resonance injury [MRI]). The follow-up was noted from the last out-patient visit record or through telephonic conversation (International League Against Epilepsy score).<\/jats:p>\n<jats:p>\n<jats:bold>Results<\/jats:bold>\u2003Of 23 cases of TLE (<jats:italic>n<\/jats:italic> = 7, mesial temporal sclerosis; <jats:italic>n<\/jats:italic> = 16 temporal lobe like cavernomas, tumors, or arterio-venous malformations). Single photon emission computed tomography\/positron emission tomography (SPECT\/PET) was performed in five cases (three cases of ictal\/interictal SPECT and two cases of PET scan) where there was discordance between EEG\/clinical and MRI. The median follow-up was of 19 months with 18 cases being seizure free. Five cases were fully off the antiepileptic drug (AEDs) while in 15 cases, the AEDs dosages or the number were reduced. Average number of AEDs reduced from 2.9 in preoperative period to 1.2 postoperatively. Two cases had quadrantanopia and one case of cerebrospinal fluid leak.<\/jats:p>\n<jats:p>\n<jats:bold>Conclusion<\/jats:bold>\u2003A multidisciplinary and holistic approach is required for best patient care. The results of our initial surgical experience are encouraging.<\/jats:p>","DOI":"10.1055\/s-0040-1716796","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T23:48:59Z","timestamp":1604533739000},"page":"193-196","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Resistant Temporal Lobe Epilepsy: Initial Steps into a Bigger Epilepsy Surgery Program"],"prefix":"10.25259","volume":"12","author":[{"given":"Anant","family":"Mehrotra","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suyash","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soumen","family":"Kanjilal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gagandeep","family":"Attri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamlesh","family":"Rangari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vimal K.","family":"Paliwal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinita","family":"Mani","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawan K.","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ved Prakash","family":"Maurya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayesh","family":"Sardhara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamlesh S.","family":"Bhaisora","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuntal Kanti","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun Kumar","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Awadhesh K.","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Behari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,11,4]]},"reference":[{"issue":"21","key":"10.1055\/s-0040-1716796\/ref-1","first-page":"23","article-title":"Trends in mortality and hospital admissions associated with epilepsy in England and Wales during the 1990s","volume":"21","author":"Bruce","year":"2004","journal-title":"Health Stat Q"},{"issue":"10","key":"10.1055\/s-0040-1716796\/ref-2","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1590\/0004-282x20170125","article-title":"Implementing an epilepsy surgery center. 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