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A temporal lobectomy involves the removal of a portion of the person's temporal lobe of their brain. The surgery is the most common type of epilepsy surgery; it is also the most successful type of epilepsy surgery. There are a number of highly-skilled and qualified neurosurgeons who perform this type of surgery in india. Among people with epilepsy who have undergone this surgery. Sixty to seventy-percent become free of the seizures they experienced that caused abnormal movements, or impaired their consciousness. Some of these people still may experience things such as auras, or sensations like odors without an outside source.
Once the person who is having the surgery has both in position and asleep, the surgery starts. A patch of hair over the person's temple is shaved; fortunately it is not necessary to shave the person's entire head. Their skin is cut in a, 'C,' shaped partial circle above their ear. A number of nickel-sized holes are created in a circular pattern. The surgeon uses a saw to cut between the holes, removing a circle of bone approximately the size of the rim of a small coffee cup. Once the procedure is over, the person's bone is hard-wired back into place and eventually heals back into place in their skull. The wires that are used are non-magnetic and MRI compatible; they hold the person's bone in place and do not need to be removed.
The membrane over the brain, the dura mater, then is cut open, exposing the temporal lobe. Portions of the temporal lobe are removed by suction, since the brain has a "firm pudding" consistency. Different surgeons use different techniques and approaches, depending upon preference and training, but no one technique is proven superior to the others. The amount usually removed ranges between the size of a golf ball and a small lemon, representing well less than half the volume of the temporal lobe.
Diagnosis/Preparation
An ATL pre-surgical diagnosis requires reliable diagnostic levels classified as (1) seizure, (2) epilepsy, and (3) syndrome. The epilepsy and syndromic diagnoses are usually combined. The seizure diagnosis is determined from the physical and neurological manifestations of the condition recorded in the patient's history and from electroencephalogram (EEG) evaluations. Because seizures commonly result from cortical damage, neuroimaging techniques are used to identify and localize the damaged area.
They include : -
Magnetic resonance imaging (MRI). Brain MRI is the best structural imaging technique available. Every ATL surgical evaluation usually includes a complete MRI study.
Positron emission tomography (PET) . Unlike MRI, PET provides information on brain metabolism rather than on structure. Typically, the epileptic region's metabolism is lowered unless the scan is obtained during a seizure.
Single photon emission tomography (SPECT). SPECT scans visualize blood flow through the brain and are used as another method for localizing the epileptic site.
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