Surgical outcome in hippocampal sclerosis following selective amygdalo-hippocampectomy.
OBJECTIVE
Temporal lobe epilepsy is the most common form of intractable partial epilepsy in adults with hippocampal sclerosis accounting for the majority of cases. Selective amygdalo-hippocampectomy (SEAH) is suggested as a safe and effective surgical procedure with the advantage of a better cognitive outcome.


METHODS
We prospectively documented 56 consecutive patients with medically refractory medial temporal lob epilepsy. Candidates for surgery were determined as those with characteristic clinical and imaging findings, ictal recordings, and neuropsychological evaluation. A standard SEAH was performed and hippocampal sclerosis was histologically confirmed.


RESULTS
In our study 76.7% of patients were classified as Engel I and 62.2% as ILAE I at their last follow up. Overall, at the last follow-up, 51.8% of patients were seizure-free since surgery (Engel 1a and ILAE 1a), 25% had stopped antiepileptic treatment, and another 52% had decreased either the dosage or number of antiepileptic drugs. 86.3% of the patients with abnormality on neurocognitive tasks showed improvement at the end of the 6 months post surgery.


CONCLUSIONS
SEAH is a safe and effective surgical procedure without the necessity of a larger resection and further invasive methods.
Karasu
Aykut
A
Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey.
Kuşcu
Demet
D
Ofluoğlu
A Ender
AE
Gül
Günay
G
Kayrak
Nalan
N
Bayindir
Ciçek
C
Toplamaoğlu
Halil
H
Canbolat
Ali
A
D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000601:surgery*; D002648:Child; D003071:Cognition / Q000502:physiology; D004351:Drug Resistance; D004594:Electrophysiology; D004833:Epilepsy, Temporal Lobe / Q000209:etiology / Q000601:surgery; D005260:Female; D006624:Hippocampus / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D012008:Recurrence; D012598:Sclerosis; D012640:Seizures / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult