Temporal Lobe Resection

I think today that I’m going to come across and explain this operation the best I can. The Temporal Lobe Resection is the removal of a portion of the temporal lobe, or temporal lobectomy. These brain structures play an important role in the generation or propagation of the majority of temporal lobe seizures. In most cases, a modest portion of the brain measuring about 2 inches long is removed. The temporal lobes are important in memory, emotion and language comprehension. However, the extensive tests that I have been doing ensure that removal of the area causing seizures will hopefully not disrupt any of these critical functions.

Risks? Permanent complications associated with temporal lobe resection surgery are very low. Mortality is less than 0.1% and permanent unexpected morbidity less then 1%. In dominant hemisphere resections, temporary language difficulties are seen in 10% of the cases although these usually resolve. An upper quadrantanopsia (partial upper peripheral vision loss) is expected in large temporal resections, but seen in less than 25% of the patients. Memory impairment rarely occurs from temporal lobectomies because of extensive preoperative testing of language and memory functions.

Success Rates? Seizure control in temporal lobectomy varies:

  • 60%-70% of patients are free of seizures that impair consciousness or cause abnormal movements, but some still experience auras
  • 20%-25% of patients have some seizures but are significantly improved (greater than 85% reduction of complex partial and tonic-clonic seizures)
  • 10%-15% of patients have no worthwhile improvement

Therefore, over 85% of patients enjoy a marked improvement in seizure control. Most of them need less medication after surgery. Approximately 25% of those who are seizure-free eventually can discontinue antiepileptic drugs.

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What does all this mean? It’s scary. Do I feel confident and want to go through with it? Yes.

But, it’s still not a sure thing as to if I qualify. The damage would be best (or I should say “safest”?) if the bruise on the brain is completely on the left side. But from what the tests have shown so far, there might be slightly on the right. I don’t exactly know what that means, but I guess it’s not a good thing as far as a surgery goes.

Medicine

Having problems with the increase of my Lamictal. Made my right arm shake like crazy, even worse than it does. I could barely hold the money from the cash register while working at Walmart. So, I’m going back to where I was with it and then getting on a new med called Zonegran. I read up on that. Drowsy… Well, that is explaining all my meds already. Few other side effects I’ll have to pay attention to.

Cognitive Testing Results

I have the results of the cognitive testing that I finished a couple weeks ago. Very long and informative evaluation. Many “big words”. Not too many things that I didn’t already know. My memory sucks. Compared to the last time I’ve had this evaluation, this one came out slightly lower. Could be because of age, or other things. They say that I should be living my life the way I already do by having a structured routine and relying on a smartphone to aid in my daily activities.

The evaluation goes on and on for 8 pages, but that’s the main things in a nut-shell.

Next??

One of the next tests is Functional magnetic resonance imaging. Functional magnetic resonance imaging or functional MRI (fMRI) is an MRI procedure that measures brain activity by detecting associated changes in blood flow. This technique relies on the fact that cerebral blood flow and neuronal activation are coupled. When an area of the brain is in use, blood flow to that region also increases.