title: [The importance of amygdala removal in the surgical treatment of mesial temporal lobe epilepsy].
abstract: Even though amygdalar lesions are a known epilepsy model in laboratory animals, the role of the amygdala in mesial temporal sclerosis is not well-known. To date, most interest has been paid to the role of the hippocampal formation. The aim of this article is to emphasize the role of the amygdala in order to render a patient seizure free. Two patients are presented who were 50 and 42 years old at the time of surgery. They suffered from seizures since childhood and were diagnosed with mesial temporal sclerosis. A temporal lobectomy with hippocampectomy and partial amygdalectomy was performed on both patients in the year 2000, with one patient operated on the right side and the other one on the left side. Both patients were seizure free after surgery for 6 years, but presented again with seizures after that time. They were evaluated again for surgery, and subdural grids were placed, together with a deep electrode in the remnants of the amygdala. The amygdalar electrode showed to be the seizure onset in the two cases, and its resection rendered both patients seizure free. These two patients show that a complete amygdalar resection is necessary to render some patients seizure free. It might be the amygdala has a greater role than previously thought.
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España; Servicio de Neurocirugía, Hospital Universitario Fundación Jiménez Díaz, Madrid, España. Electronic address: jalbisua@fjd.es.
authors.forename: Julio
authors.initials: J
authors.lastname: Albisua
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
authors.forename: Anna
authors.initials: A
authors.lastname: Lo Presti-Vega
authors.affiliation: Unidad de Epilepsia, Servicio de Neurología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
authors.forename: Beatriz G
authors.initials: BG
authors.lastname: Giráldez
authors.affiliation: Servicio de Neurocirugía, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
authors.forename: Delia
authors.initials: D
authors.lastname: Viñas
authors.affiliation: Unidad de Epilepsia, Servicio de Neurología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
authors.forename: José María
authors.initials: JM
authors.lastname: Serratosa
mesh_terms: D000328:Adult; D000679:Amygdala / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019635:Neurosurgical Procedures
keywords: Amygdalohippocampal epilepsy; Cirugía; Diagnostic; Diagnóstico; Epilepsia amigdalohipocampal; Etiology; Etiología; Surgery; Therapy; Tratamiento