title: Stereotactic radiofrequency amygdalohippocampectomy for the treatment of temporal lobe epilepsy: do good neuropsychological and seizure outcomes correlate with hippocampal volume reduction?
abstract: Temporal lobe surgery bears the risk of a decline of neuropsychological functions. Stereotactic radiofrequency amygdalohippocampectomy (SAHE) represents an alternative to mesial temporal lobe epilepsy (MTLE) surgery. This study compared neuropsychological results with MRI volumetry of the residual hippocampus. We included 35 patients with drug-resistant MTLE treated by SAHE. MRI volumetry and neuropsychological examinations were performed before and 1 year after SAHE. Each year after SAHE clinical seizure outcome was assessed. One year after SAHE 77% of patients were assessed as Engel Class I, 14% of patients was classified as Engel II and in 9% of patients treatment failed. Two years after SAHE 76% of subjects were classified as Engel Class I, 15% of patients was assessed as Engel II and in 9% of patients treatment failed. Hippocampal volume reduction was 58±17% on the left and 54 ± 27% on the right side. One year after SAHE, intelligence quotients of treated patients increased. Patients showed significant improvement in verbal memory (p=0.039) and the semantic long-term memory subtest (LTM) (p=0.003). Patients treated on the right side improved in verbal memory, delayed recall and LTM. No changes in memory were found in patients treated on the left side. There was a trend between the larger extent of the hippocampal reduction and improvement in visual memory in speech-side operated.
authors.affiliation: Department of Radiology, Na Homolce Hospital, Roentgenova 2, 150 00 Prague 5, Czech Republic. hana.malikova@homolka.cz
authors.forename: Hana
authors.initials: H
authors.lastname: Malikova
authors.forename: Lenka
authors.initials: L
authors.lastname: Kramska
authors.forename: Roman
authors.initials: R
authors.lastname: Liscak
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Vojtech
authors.forename: Tomas
authors.initials: T
authors.lastname: Prochazka
authors.forename: Iva
authors.initials: I
authors.lastname: Mareckova
authors.forename: Jiri
authors.initials: J
authors.lastname: Lukavsky
authors.forename: Rastislav
authors.initials: R
authors.lastname: Druga
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000601:surgery*; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology; D004833:Epilepsy, Temporal Lobe / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D011788:Quality of Life; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult