Stereo-electroencephalography-guided three-dimensional radiofrequency thermocoagulation for mesial temporal lobe epilepsy with hippocampal sclerosis: A retrospective study with long-term follow-up.

OBJECTIVE: Stereo-electroencephalography-guided three-dimensional radiofrequency thermocoagulation (SEEG-3D RFTC) is a minimally invasive treatment for mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). This study aimed to investigate the long-term prognosis after SEEG-3D RFTC treatment in patients with MTLE-HS. METHODS: This single-center retrospective study included 28 patients with MTLE-HS treated with SEEG-3D RFTC from January 2016 to May 2018. Postoperative curative effects were evaluated using the Engel classification, and the patients were followed up for 5 years. RESULTS: The proportions of patients categorized as Engel I between 1 and 5 years after surgery were 72.41% (12 months after surgery), 67.86% (18 months after surgery), 62.07% (24 months after surgery), 50.00% (36 months after surgery), 42.86% (48 months after surgery), and 42.86% (60 months after surgery), respectively. Regarding long-term efficacy, based on the Engel classification, SEEG-3D RFTC showed room for improvement. SIGNIFICANCE: This was the first study to evaluate the efficacy of SEEG-3D RFTC for MTLE-HS with long-term follow-up. SEEG-3D RFTC is a promising alternative for patients with MTLE-HS. PLAIN LANGUAGE SUMMARY: This study explored the potential of stereoelectroencephalography-guided three-dimensional radiofrequency thermocoagulation, a minimally invasive approach, for treating medial temporal lobe epilepsy with hippocampal sclerosis. Involving 28 patients, the research tracked the treatment's success over five years using the Engel classification. Initial results were promising, with 72.41% of patients achieving the most favorable outcome (Engel I) at one year. While there was a gradual decrease in this proportion over time, 42.86% of patients maintained this positive outcome at five years, highlighting the treatment's potential for long-term efficacy.