Shrinkage of the hippocampal remnant after surgery for temporal lobe epilepsy: impact on seizure and neuropsychological outcomes.
The aim of this study was to investigate the influence of the postoperative hippocampal remnant on postoperative seizure and neuropsychological outcome in temporal lobe epilepsy (TLE). Postoperative volumetric MRI measurements of 53 patients surgically treated for TLE revealed a postoperative volume loss of the hippocampal remnant compared with the respective preoperative segment in all patients. Extent of preoperative hippocampal pathology, remnant shrinkage, resection volume, and postoperative volume of the hippocampal remnant did not correlate with seizure outcome 1 year after surgery. With respect to neuropsychological outcome, performance on tasks assessing verbal memory and language-related functions was impaired in patients with left-sided pathology after surgery. Performance of patients with right-sided pathology (n=26) demonstrated no significant correlation with hippocampal measures or with neuropsychological data. Degree of hippocampal remnant shrinkage seems to be associated with decreased verbal memory performance in patients with left-sided TLE.
Mueller
Christian-Andreas
CA
Department of Neurosurgery, University of Bonn, Bonn, Germany. Christian-Andreas.Mueller@ukb.uni-bonn.de
Kaaden
Sabine
S
Scorzin
Jasmin
J
Urbach
Horst
H
Fimmers
Rolf
R
Helmstaedter
Christoph
C
Zentner
Josef
J
Lehmann
Thomas-Nicolas
TN
Schramm
Johannes
J
D000328:Adult; D004833:Epilepsy, Temporal Lobe / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D007839:Functional Laterality; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014705:Verbal Behavior / Q000502:physiology*