Extent of resection in anterior temporal lobe resection (ATLR) for temporal lobe epilepsy (TLE) is an independent and modifiable risk factor for postoperative cognitive decline and seizure freedom, but only for left-sided ATLR.
Why this matters
ATLR is the most common surgical approach to TLE, with a 50–80% chance of achieving seizure freedom. However, ATLR carries a risk of verbal memory decline.
It is assumed that extent of resection in ATLR is a key factor with opposing effects on seizure freedom and cognitive outcomes following surgery. Defining the optimal resection margins for balancing seizure freedom and preservation of cognition will help to improve postoperative outcomes.