Temporal pole epilepsy (TPE) is a poorly known and difficult to individualize subtype of temporal lobe epilepsy. Consequently, in drug‐resistant TPE, there is still a debate on the need for a large surgical removal of the temporal pole and mesial temporal structures or a limited resection of the temporal pole. We reviewed all patients who underwent presurgical evaluation for drug‐resistant epilepsy over a 17‐year period, and report here 19 patients with proven drug‐resistant temporal pole epilepsy who underwent a selective temporal pole resection with respect to mesial structures. Most (15) TPE patients exhibited seizures resembling mesiotemporal seizures, whereas the others exhibited nocturnal hyperkinetic seizures or an association of both seizure types. MRI revealed a temporal pole lesion in 58% of patients. Long‐term postoperative outcome after a conservative surgery was excellent: 63% of patients were seizure‐free (International League Against Epilepsy [ILAE] 1) at 1‐year postsurgery and 78% at 5 years. These results show that TPE has no specific electroclinical features but is a distinct type of temporal lobe epilepsy allowing a conservative surgery. Respecting the mesiotemporal structures is a valid surgical approach for drug‐resistant temporal pole epilepsy.

中文翻译：

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颞极癫痫手术——保留海马体

颞极癫痫 (TPE) 是一种鲜为人知且难以个体化的颞叶癫痫亚型。因此，在耐药性 TPE 中，关于是否需要大手术切除颞极和颞叶内侧结构或有限切除颞极仍存在争议。我们回顾了 17 年来接受过耐药性癫痫术前评估的所有患者，并在此报告了 19 名经证实的耐药性颞极癫痫患者，他们接受了近中结构的选择性颞极切除术。大多数 (15) TPE 患者表现出类似于颞叶癫痫发作的癫痫发作，而其他患者则表现出夜间多动性癫痫发作或两种癫痫发作类型的关联。MRI 显示 58% 的患者有颞极病变。保守手术后的长期术后结果非常好：63% 的患者在术后 1 年无癫痫发作（国际抗癫痫联盟 [ILAE] 1），5 年时为 78%。这些结果表明 TPE 没有特定的电临床特征，但它是一种独特的颞叶癫痫类型，允许进行保守手术。尊重颞叶结构是治疗耐药性颞极癫痫的有效手术方法。