Transsylvian selective amygdalohippocampectomy in children with hippocampal sclerosis: seizure, intellectual and memory outcome.
OBJECTIVE
This study investigates the efficacy of transylvian selective amygdalohippocampectomy (TS SAH) in children with medically intractable epilepsy due to unilateral hippocampal sclerosis. Post-surgical seizure control, intellectual and memory outcomes are examined.


METHODS
This study reports on pre- and post-surgical clinical data from 10 patients who underwent TS SAH between 2002 and 2010 after 24 months follow-up. Pre- and post-operative change in seizure frequency, AED use, intellect and memory are compared.


RESULTS
At 12 months and 24 months post-surgery, 9/10 (90%) and 7/8 (87.5%) patients respectively, were seizure free (Engel I). No patients were classed as Engel III or IV. No significant improvement or decline at a group level was found on measures of intellect or verbal or visual memory. One hundred per cent improved or remained within 1 SD of their pre-operatives score on verbal and perceptual reasoning learning and reasoning measures. Significant improvement was found post-operatively for both immediate and delayed facial memory.


CONCLUSIONS
Our findings of good post-surgical seizure control and favourable cognitive outcome provides evidence against previous findings that SAH in children may not be effective.
University Hospital Southampton, Southampton SO16 6YD, UK. anne.beaton@uhs.nhs.uk
Anne E
AE
Beaton
Andrew
A
Durnford
Phillip E
PE
Heffer-Rahn
Fenella
F
Kirkham
Angela
A
Griffin
William P
WP
Gray
W L S
WL
Gray
D000293:Adolescent; D000679:Amygdala / Q000473:pathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000473:pathology* / Q000502:physiology* / Q000601:surgery; D006801:Humans; D007360:Intelligence / Q000502:physiology*; D008297:Male; D008568:Memory / Q000502:physiology*; D009483:Neuropsychological Tests; D012598:Sclerosis; D012640:Seizures / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome