Anterior temporal lobectomy combined with anterior corpus callosotomy in patients with temporal lobe epilepsy and mental retardation

Aims: To investigate the surgical outcomes of anterior corpus callosotomy (aCCT) combined with anterior temporal lobectomy (ATL) in patients with intractable temporal lobe epilepsy (TLE) and mental retardation (MR). Methods: Sixty patients with TLE and MR were carefully selected and randomly divided into two equal groups: ATL and aCCT, in which they were treated with ATL or ATL combined with aCCT, respectively. Surgical outcomes, including seizure control, IQ and quality of life (QOL) changes, as well as complications were recorded and analyzed 2 years after operation. Results: Seizure-free status had been achieved in 66.7% of all patients. The aCCT group had higher percentage in Engle Classes I-II than the ATL group (96.7% vs. 80.0%, P < 0.05). 56.7% of patients in ATL group and 63.3% in aCCT group had improved full scale IQ (FIQ) after surgery, while the decline of FIQ in aCCT group was less than that of ATL group (3.3% vs. 30.0%). Compared with pre-operative score, the mean post-operative score of performance IQ in aCCT group had improved. Significant difference in QOL change had been found between two groups (P < 0.001). 73.7% of patients in aCCT group had their QOL improved with no long-term complications. Conclusions: ATL combined with aCCT can improve QOL and performance IQ in patients with TLE and MR. (C) 2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.