{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:20:53Z","timestamp":1792790453590,"version":"4.5.0"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T00:00:00Z","timestamp":1668384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Anterior temporal lobectomy (ATL) for medication\u2010resistant localized epilepsy results in ablation or reduction of seizures for most patients. However, some individuals who attain an initial extended period of postsurgical seizure freedom will experience a later seizure recurrence. In this study, we examined the prevalence and some risk factors for late recurrence in an ATL cohort with extensive regular follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Included were 449 patients who underwent ATL at Austin Health, Australia, from 1978 to 2008. Postsurgical follow\u2010up was undertaken 2\u20133 yearly. Seizure recurrence was tested using Kaplan\u2013Meier analysis, log\u2010rank test, and Cox regression. Late recurrence was qualified as a first disabling seizure &gt;2\u2009years postsurgery. We examined risks within the ATL cohort according to broad pathology groups and tested whether late recurrence differed for the ATL cohort compared to patients who had resections outside the temporal lobe (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u200998).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median post\u2010ATL follow\u2010up was 22\u2009years (range\u00a0=\u00a0.1\u201338.6), 6% were lost to follow\u2010up, and 12% had died. Probabilities for remaining completely seizure\u2010free after surgery were 51% (95% confidence interval [CI]\u00a0=\u200953\u201363) at 2 postoperative years, 36% (95% CI\u00a0=\u00a032\u201341) at 10\u2009years, 32% (95% CI\u00a0=\u00a027\u201336) at 20\u2009years, and 30% (95% CI\u00a0=\u00a025\u201334) at 25\u2009years. Recurrences were reported up to 23\u2009years postoperatively. Late seizures occurred in all major ATL pathology groups, with increased risk in the \"normal\" and \"distant lesion\" groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0\u2264\u00a0.03). Comparison between the ATL cohort and patients who underwent extratemporal resection demonstrated similar patterns of late recurrence (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.74).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Some first recurrences were very late, reported decades after ATL. Late recurrences were not unique to any broad ATL pathology group and did not differ according to whether resections were ATL or extratemporal. Reports of these events by patients with residual pathology suggest that potentially epileptogenic abnormalities outside the area of resection may be implicated as one of several possible underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.17440","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T05:59:53Z","timestamp":1666331993000},"page":"92-102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Extended follow\u2010up after anterior temporal lobectomy demonstrates seizure recurrence 20+ years postsurgery"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5020-260X","authenticated-orcid":false,"given":"Anne M.","family":"McIntosh","sequence":"first","affiliation":[{"name":"Epilepsy Research Centre, Department of Medicine (Austin Health) University of Melbourne  Melbourne Victoria Australia"},{"name":"Bladin\u2010Berkovic Comprehensive Epilepsy Program, Department of Neurology Austin Health  Melbourne Victoria Australia"},{"name":"Melbourne Brain Centre at Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex W.","family":"Wynd","sequence":"additional","affiliation":[{"name":"Epilepsy Research Centre, Department of Medicine (Austin Health) University of Melbourne  Melbourne Victoria Australia"},{"name":"Bladin\u2010Berkovic Comprehensive Epilepsy Program, Department of Neurology Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4580-841X","authenticated-orcid":false,"given":"Samuel F.","family":"Berkovic","sequence":"additional","affiliation":[{"name":"Epilepsy Research Centre, Department of Medicine (Austin Health) University of Melbourne  Melbourne Victoria Australia"},{"name":"Bladin\u2010Berkovic Comprehensive Epilepsy Program, Department of Neurology Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh449"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16893"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh221"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/2008.6.JNS17613"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0196274"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60890-8"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12341"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000242735.24539.33"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20372"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2012.03430.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.7.1358"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2007.10.011"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2010.02891.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000163998.01543.CF"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000081226.51886.5B"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2005.10.007"},{"key":"e_1_2_10_18_1","first-page":"630","article-title":"Seizure outcome after temporal lobectomy for temporal lobe epilepsy","volume":"54","author":"Foldvary N","year":"2000","journal-title":"A Kaplan\u2010Meier survival analysis. 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