Of the 259 patients who formed the study population, 46% were women. The duration of follow-up ranged from 10 to 21years. The average age at surgery was 25.80 ± 11.32 yrs; 49% had an aura,  61% had only hypomotor seizures and 38% had psychiatric co-morbidity. The commonest pathology was hippocampal sclerosis(70%) followed by tumoral lesions and focal cortical dysplasia;  9.8% had acute post- operative seizures. At latest follow-up 75.6% were seizure free of which 52% had resolution of epilepsy. Presence of an aura , hippocampal sclerosis and longer time to first post-operative seizure were strong predictors for resolution of epilepsy while acute post-operative seizures and an abnormal post- surgery EEG at 1 year were predictors of persistent seizures. On survival analysis, the time to first seizure was significantly early in patients with persistent seizures. Seizure freedom both at three and five years predicted seizure freedom at 10 years.

Resective surgery for drug resistant lesional TLE was associated with higher rate of seizure-freedom in ~75% and resolution of epilepsy in 52.15% even at long term follow- up. Longer time to first seizure, presence of aura at presentation and hippocampal sclerosis are strong predictors for resolution of epilepsy. APOS and abnormal Post-Surgery inter-ictal EEG are predictors of unfavourable outcome.