Tag: Temporal Lobe Resection

Temporal Lobe Resection

Darren Long1 Comment

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.

BRAIN…

Darren Long1 Comment

I’ve started seeing a new Neurologist recently over at Kansas University Med (KU Med). She seems very nice and seems to know what she’s talking about. I was, as per her suggestion, going to get a VNS implant into my shoulder to help with the seizures that I have had all my life and have gone through every type of Epileptic medication there is. I suggested to her that I get a MRI and EEG first just for us to see the status of my brain. So, on Valentines Day, I got to go back to KU Med to do the lovely two tests for the celebrations of the holiday 🙂 to check everything out. Few weeks later I met with the new doc and she told me that from the looks of my messed up brain (not the exact words she used), doing the VNS implant is off the table.

Now she is talking about full-on brain surgery (Temporal Lobe Resection) to cut away the “bad” parts of my brain. This is going to entail a few more tests first. The first one on March 29th, is similar to what would be called a cognitive test (forget the official name). This is an all day test up at KU Med. A week away from now. I’ll have to let you how all that went afterwards. Then after that, on April 8th I get to start a Seven-Day Video EEG. Seven days stuck in a hospital room. I’m either in the bed, in a chair or visiting the bathroom. No showers. No baths (maybe a sponge-bath done by a pretty college girl ).  Visiting the bathroom is the only time I will be without video cameras watching me all the time. Can’t sleep under sheets and have I must have the lights on while I sleep just so that the video camera will watch me constantly. Arg!

Also as part of the Video EEG is the taking me off my meds and a lack of sleep. I’m sure this will cause me to have a few seizures with those things happening (or lack of happening). I’ve read about people doing these EEG’s and the doctors are looking for the outcome from a certain type of seizure. These people were only having grand-mal seizures, and that’s not what they needed. So, they had to do the Video EEG multiple times.

One more test… SPECT Brain Imaging. This is a 2 hour test that entails the injection a radiopharmaceutical (radio-active) one hour before imaging begins. The imaging is done with me laying down and a “camera” revolving around my head taking 3D images of my brain. The injection of the radio-active stuff shows the blood flow around the brain. After seeing this, the doctors can recognize the areas of the brain that are being used the most and which is used the least

I’ve heard and read that these rooms are pretty nice with a cool TV, fridge and other things. Kinda like a hotel room. Hope I can take my cell phone so I can chat with people while I’m there and brag about what they are missing. ha ha…  I’ll take pictures later when I get in there to show everyone myself and my cool room. I’ll let everyone know how the test next Friday went.

A couple links:

SPECT: http://en.wikipedia.org/wiki/Single-photon_emission_computed_tomography

Video EEG: http://en.wikipedia.org/wiki/Long-term_video-EEG_monitoring

MRI: http://en.wikipedia.org/wiki/Magnetic_resonance_imaging