Epilepsy surgery without lipoma removal for temporal lobe epilepsy associated with lipoma in the Sylvian fissure

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Abstract
Epileptic seizure is the common symptom associated with lipomas in the Sylvian fissure (Sylvian lipomas). Removal of these lipomas carries risks of hemorrhage and brain damage. We report a surgical strategy of not removing the lipoma in a case of intractable temporal lobe epilepsy associated with Sylvian lipoma. We performed anterior temporal lobectomy with preservation of the pia mater of the Sylvian fissure and achieved seizure freedom. Focal cortical dysplasia type 1 of the epileptic neocortex adjacent to the Sylvian lipoma was pathologically diagnosed. We recommend our surgical procedure in similar cases to avoid complications and achieve adequate seizure control.
Funding Information
  • Core Research for Evolutional Science and Technology (JPMJCR 20F1, JPMJCR 18A5)
  • Ministry of Health, Labour and Welfare (H29-nanchitou-ippan-010, 20FC1039)
  • Japan Society for the Promotion of Science (21K09160, 20H00235)