title: Efficacy of hippocampal transection for left temporal lobe epilepsy without hippocampal atrophy.
abstract: We describe a case of left temporal lobe epilepsy without hippocampal atrophy. A 31-year-old woman presented with typical symptoms of complex partial seizures. Magnetic resonance imaging demonstrated slightly obscure internal structures in the left hippocampus. Scalp electroencephalography revealed interictal epileptiform discharges in the left temporal lobe. A Wada test with propofol determined the language-dominant hemisphere to be the left. Intraoperative electrocorticography revealed active epileptic discharges in the hippocampus and the anterior temporal basal area. The hippocampal epileptic area was treated with multiple transection, which led to the complete cessation of epileptic discharges. After surgery, the Rey Auditory Verbal Learning Test score decreased from 12 to 9. However, it returned to the preoperative level 6months after surgery. We describe this case as a typical example demonstrating the efficacy of hippocampal transection for seizure control and the preservation of verbal memory.
authors.affiliation: Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Fuchu, Tokyo, Japan. shigeki_sunaga@tmhp.jp
authors.forename: Shigeki
authors.initials: S
authors.lastname: Sunaga
authors.forename: Michiharu
authors.initials: M
authors.lastname: Morino
authors.forename: Taro
authors.initials: T
authors.lastname: Kusakabe
authors.forename: Hidenori
authors.initials: H
authors.lastname: Sugano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007456:Iodine Isotopes; D020367:Iofetamine; D008279:Magnetic Resonance Imaging / Q000379:methods; D009493:Neurosurgery / Q000379:methods*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D007456:Iodine Isotopes; D020367:Iofetamine