Impact of clinical and bioelectrical factors on surgical outcomes in focal drug-resistant epilepsy

INTRODUCTION . Focal drug-resistant epilepsy, particularly mesial temporal lobe epilepsy, often necessitates surgical intervention when pharmacological treatment is ineffective. MATERIALS AND METHODS . A retrospective analysis was conducted on 46 patients who underwent surgery for focal epilepsy at the Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre between 2015 and 2023. All patients received preoperative neuroimaging and neurophysiological monitoring. Outcomes were assessed using the ILAE classification at 1, 2, and 3 years postoperatively. Patients were grouped by surgery type and etiology (structural or posttraumatic). RESULTS . At one year post-surgery, favorable outcomes (ILAE classes 1–2) were observed in 63 % of patients; at two years – in 69 %, and at three years – in 69 %. No statistically significant differences were found in outcomes based on surgical technique, side of resection, or etiology (p>0.05). CONCLUSION . Surgical treatment of focal drug-resistant epilepsy provides stable seizure control over three years. Neither the side of the lesion nor the surgical method significantly influenced the long-term outcome, underscoring the importance of timely surgical intervention.