*5.4.1 Temporal lobe epilepsy (TLE)*

TLE is the most common focal seizure disorder in adults with mesial temporal sclerosis being the most common pathological entity (10). Several varieties of techniques have been described, including tailored temporal lobectomy, anteromesial temporal lobectomy, trans-Sylvian amygdalohippocampectomy, and temporal lobe lesionectomy [53]. The overall seizure freedom following temporal lobectomy for epilepsy has been reported to be between 74 and 82%, with best outcome for temporal lobe neoplasm (88–92%), followed by patients with MTS (70%), and the poorest control for cortical dysplasia [54].

Resection of the anterior temporal lobe, the amygdala, and part of the hippocampus is the most commonly performed resective epilepsy surgery [55]. The posterior margin of resection is 4.0–4.5 cm in the dominant side, and 5.0–5.5 cm in the non-dominant hemisphere, in order to minimize the speech and visual deficits

**Figure 3.**

*Brain MRI T1-weighted image, axial slide showing postsurgical temporal lobectomy and amygdalohypocampectomy.*

and an en bloc resection of the amygdala, hippocampus, uncus, and fusiform gyrus [56]. Schram et al. [57], in a review study of 53 scientific papers, showed no differences between temporal lobectomy and selective amygdala hippocampectomy. Nevertheless, neurophysiological outcome was significantly better in selective amygdalohippocampectomy [57]. Approximately 25% of patients will develop some degree of memory impairment after temporal lobe lobectomy (**Figure 3**) [55].
