Materials and Methods: One hundred twelve patients with drug resistant TLE underwent temporal lobectomy and had pathologically proven HS between 2004 and 2008. All patients had a minimum follow-up of five years. Seizure outcome was categorized into being seizure-free and not seizure-free.

Results: Sixty one patients (54.5%) were seizure free for the entire period after surgery. One hundred patients (89.3%) were seizure free for at least two years at the last follow-up. Forty three patients (38.4%) were able to stop antiepileptic medications. The mean follow-up was 8.1±1.9 years (range 5 to 11 years). A preoperative secondarily generalized tonic-clonic seizure was predictor for poor seizure outcome.

Conclusion: A long-term outcome (more than five years) in terms of a percentage of seizure free in TLE with HS [TLE-HS] patients remains favorable. Long-term seizure outcome is helpful for preoperative and postoperative counseling to the patients. Surgical treatment should be considered in patients with drug-resistant TLE-HS.

Keywords: Hippocampal sclerosis, Temporal lobe epilepsy, Temporal lobe surgery, Epilepsy surgery, Seizure outcomes