Compare postoperative outcomes in terms of five-year seizure freedom in patients with temporal lobe epilepsy (TLE) who underwent epilepsy surgery.

A total of 89 patients were included, 53 (59.6%) were female and had a mean age of 36.13 years (IQR: 28, 42). Anterior temporal lobectomy (ATL) was performed in 64 (71.91%) patients, amygdalohippocampectomy in 15 (16.9%) patients, parahippocampectomy in 5 (5.6%) patients, and lesionectomy in 5 (5.6%)  patients.  Mean number of preoperative seizures was 11.0 ± 10.02 (1-60), and postoperative seizures were 1.2 ± 2.97 ( 0-19), with significant differences between them (p>0.001). There was a significant reduction (p>0.001) in the number of antiseizure medications (ASM).  Regarding seizure freedom, 59 (66.29%) patients were in Engel class I during the first and second years, 60 (67.4%) in the third year, and 58 (65.1%) in the fourth and fifth years.  Considering the type of surgery and seizure freedom, it was found that during the 1-3 year follow-up period, there was no significant difference (p=0.06), but in the 4th and 5th years, patients who underwent amygdalohippocampectomy and ATL had a lower recurrence of seizures (p=0.041). 

Surgical resection in patients with TLE was associated with greater seizure freedom that did not vary over time. ATL had a lower risk of seizure recurrence over the five-year follow-up period.