title: MRI-guided stereotactic amygdalohippocampectomy: a single center experience.
abstract: BACKGROUND
  This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy performed for intractable mesial temporal lobe epilepsy.
  
  
  METHODS
  The article describes the cases of 61 patients who were treated during the period from 2004 to 2010. Mean postoperative follow-up was 5.3 years. Neuropsychological results were obtained for a subset of 31 patients.
  
  
  RESULTS
  At their last postsurgical visit, 43 (70.5%) patients were Engel class I, six (9.8%) class II, nine (14.8%) class III, and three (4.9%) class IV. The surgery was complicated by four intracranial hematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae, while another caused transitory aphasia. The remaining hematomas were asymptomatic. There were two cases of meningitis which required antibiotic treatment. One patient committed suicide due to postoperative depression. After the procedure, we performed open epilepsy surgery and rethermolesions in three and two patients, respectively (8.2%). Patients showed increases in their mean full scale, verbal, and performance intelligence quotient (IQ) scores of 4, 3, and 4 IQ points, respectively (P<0.05). Five (17.2%), four (13.8%), and four (13.3%) patients improved their full scale, verbal, and performance IQ scores, respectively. No significant changes were found in memory performance, with a mean increase of 1, 3, and 0 memory quotient points in global, verbal, and visual memory, respectively (P<0.05). Global memory improved in three (10.3%) patients, verbal memory in one (3.4%), and one patient (3.3%) showed deterioration in visual memory.
  
  
  CONCLUSIONS
  Stereotactic radiofrequency amygdalohippocampectomy offers a safe, effective, and less aggressive treatment modality in cases of well-defined mesial temporal lobe epilepsy. Seizure outcome is comparable with the results of conventional epilepsy surgery and cognitive results could be even better.
authors.affiliation: Department of Neurology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Vojtěch
authors.affiliation: Department of Radiodiagnostics, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Malíková
authors.affiliation: Department of Psychology, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Krámská
authors.affiliation: Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Roman
authors.initials: R
authors.lastname: Liščák
authors.affiliation: Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Vilibald
authors.initials: V
authors.lastname: Vladyka
keywords: epilepsy surgery; hippocampal sclerosis; neuropsychology; seizure outcome; temporal lobe epilepsy