Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Endowed Professor Jorge Gonzalez-Martinez, University of Pittsburgh
- Second opponent: Professor Bertil Rydenhag, Sahlgrenska University Hospital
- Third member and chair of the evaluation committee: Professor II Mona Kristiansen Beyer, University of Oslo
Chair of the Defence
Professor Emeritus Leif Gjerstad, University of Oslo
Principal Supervisor
Senior Consultant Pål Gunnar Larsson, Oslo University Hospital
Summary
Epilepsy is a common brain disorders characterized by seizures with or without loss of consciousness. Seizure types may be either focal (i.e., from a defined brain area) or generalized. Approximately two-thirds of all surgically treatable epilepsies arise in the temporal lobe. Albeit 70%–90% of patients with temporal lobe epilepsy (TLE) who undergo resective surgery become seizure-free, nevertheless, the average duration of epilepsy prior to surgery is approximately 20 years.
The aim of this doctoral thesis was to study the neurosurgical challenges in the decision-making process for selecting patients with pharmacoresistant TLE who would be appropriate candidates for surgical treatment.
At first, the proportion of resected positron emission tomography (PET) abnormality volume in the epileptogenic temporal lobe were examined and related to the postoperative seizure outcomes, finding that relatively small percentage of total PET abnormality volume needed to be resected to achieve seizure freedom. Moreover, the extent of resection did not influence postoperative seizure outcomes and could not predict seizure freedom.
Further, the postoperative seizure outcomes in patients with TLE who did not show structural abnormalities on MRI and had nonspecific histopathological findings on surgical specimens were assessed. These patients had a good chance of becoming seizure-free after TLE surgery. Also, typical seizure semiology and localized ictal surface electroencephalography (EEG) findings were predictors of seizure freedom.
Lastly, the effect of extended temporal lobe resection in previously operated patients with TLE in who seizures recurred were evaluated, finding that these patients rarely achieved seizure freedom, and that they had a higher risk of both surgical and neurological complications after repeated surgery.
Additional information
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