title: Trans-middle temporal gyrus selective amygdalohippocampectomy for medically intractable mesial temporal lobe epilepsy in adults: seizure response rates, complications, and neuropsychological outcomes.
abstract: OBJECTIVE
  Selective amygdalohippocampectomy (AHC) has evolved to encompass a variety of techniques to resect the mesial temporal lobe. To date, there have been few large-scale evaluations of trans-middle temporal gyrus selective AHC. The authors examine a large series of patients who have undergone the trans-middle temporal gyrus AHC and assess its clinical and neuropsychological impact.
  
  
  METHODS
  A series of 76 adult patients underwent selective AHC via the trans-middle temporal gyrus approach over a 10-year period, 19 of whom underwent pre- and postoperative neuropsychological evaluations.
  
  
  RESULTS
  Favorable seizure response rates were achieved (92% Engel class I or II), with very low surgical morbidity and no mortality. Postoperative neuropsychological assessment revealed a decline in verbal memory for the left AHC group. No postoperative memory decline was identified for the right AHC group, but rather some improvements were noted within this group.
  
  
  CONCLUSIONS
  The trans-middle temporal gyrus selective AHC is a safe and effective choice for management of medically refractory epilepsy in adults.
authors: Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO 63110, USA. bandtk@wudosis.wustl.edu
authors: S Kathleen
authors: SK
authors: Bandt
authors: Nicole
authors: N
authors: Werner
authors: Jennifer
authors: J
authors: Dines
authors: Samiya
authors: S
authors: Rashid
authors: Lawrence N
authors: LN
authors: Eisenman
authors: R Edward
authors: RE
authors: Hogan
authors: Eric C
authors: EC
authors: Leuthardt
authors: Joshua
authors: J
authors: Dowling
mesh_terms: D000328:Adult; D000368:Aged; D000679:Amygdala / Q000601:surgery*; D000704:Analysis of Variance; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D014741:Video Recording; D055815:Young Adult
references: Adv Tech Stand Neurosurg. 1985;12:93-123
references: 4084377
references: Epilepsia. 1996 Jun;37(6):526-33
references: 8641228
references: Neurosurgery. 2000 Jun;46(6):1377-82; discussion 1382-3
references: 10834642
references: Neurosurgery. 1994 Apr;34(4):567-76; discussion 576
references: 7516498
references: Epilepsy Behav. 2005 Mar;6(2):207-11
references: 15710306
references: J Neurosurg. 2008 Mar;108(3):517-24
references: 18312099
references: Acta Neurochir (Wien). 1992;115(3-4):143-8
references: 1605083
references: Neurosurgery. 1993 Jul;33(1):50-6; discussion 56-7
references: 8355847
references: Neurosurg Focus. 2008 Sep;25(3):E4
references: 18759628
references: N Engl J Med. 2008 Jan 3;358(1):18-27
references: 18172171
references: Epilepsia. 1988;29 Suppl 2:S100-13
references: 3168957
references: Eur J Neurol. 2007 Jan;14(1):90-4
references: 17222120
references: Surg Neurol. 1982 Jun;17(6):445-57
references: 7112377
references: Adv Tech Stand Neurosurg. 1986;13:39-133
references: 3510624
references: Epilepsia. 1996;37 Suppl 3:57-60
references: 8681916
references: Epilepsia. 2008 Jan;49(1):88-97
references: 17941848
references: J Neurosurg. 2009 Jun;110(6):1135-46
references: 19025359
references: J Neurosurg. 2010 May;112(5):1033-8
references: 19612976
references: N Engl J Med. 2001 Aug 2;345(5):311-8
references: 11484687
references: Epilepsia. 2002 Jan;43(1):87-95
references: 11879392
references: J Neurosurg. 1996 Dec;85(6):1172-6
references: 8929515
references: Epilepsy Res. 2009 Apr;84(2-3):194-200
references: 19264450
references: Clin Psychol Rev. 2009 Jun;29(4):354-67
references: 19346044
references: J Neurosurg. 2010 Jan;112(1):168-85
references: 19575575
references: J Neurosurg. 2007 Jan;106(1):134-41
references: 17236499
references: Can J Neurol Sci. 2000 May;27 Suppl 1:S68-76; discussion S92-6
references: 10830331
references: Neurosurgery. 2010 Mar;66(3 Suppl Operative):4-12
references: 20173571
references: Epilepsy Behav. 2009 Mar;14(3):459-64
references: 19130899
references: Epilepsia. 2004 Aug;45(8):960-2
references: 15270763
references: J Neurosurg. 2004 Nov;101(5):725-38
references: 15540909
references: J Neurosurg. 2006 Jan;104(1):70-8
references: 16509149
references: J Neurosurg. 1989 Sep;71(3):316-26
references: 2769383
references: Stereotact Funct Neurosurg. 2008;86(5):314-9
references: 18841036
references: Epilepsia. 2004 Jul;45(7):809-16
references: 15230706