Epilepsy Surgery – Outcome Data — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateEpilepsy & Seizure DisordersEpilepsy Surgery – Outcome DataSCE Neurology

A 60-year-old man with drug-resistant temporal lobe epilepsy undergoes anterior temporal lobectomy. Post-operatively, he is seizure-free at 1 year. What is the approximate probability of seizure freedom at 1 year following anterior temporal lobectomy for mesial temporal sclerosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — 60–70%

Explanation lettering: B = shown as A · A = shown as B · E = shown as D · D = shown as E

Anterior temporal lobectomy for mesial temporal lobe epilepsy (with concordant MRI, EEG, and semiology) achieves seizure freedom (Engel class I) in approximately 60–70% of patients at 1 year (some centres report up to 80%). The ERSET randomised trial (2012) demonstrated clear superiority of surgery over continued medical therapy for drug-resistant TLE. Long-term follow-up shows that ~50% remain seizure-free at 10 years. A/B: These underestimate the success rate. D: 80% is achievable in the best surgical candidates but not the average. E: 100% is not realistic.

Reference: NICE NG217 (2025); ERSET Trial (2012); Wiebe et al. NEJM (2001)