Hippocampal transection for treatment of left temporal lobe epilepsy with preservation of verbal memory

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Hiroyuki ShimizuTakatoshi Yamada

Abstract

Despite good seizure outcome with temporal lobectomy, postoperative impairment of verbal memory remains unsolved. To address this problem we developed a new method, applying the rationale of multiple subpial transection (MST) to the hippocampus. The inferior ventricle is accessed without disrupting the neuronal pathways related to verbal memory. Intraoperative electrocorticography is recorded over the hippocampus and amygdala. After the extent of the epileptic area is determined, multiple transections of the pyramidal layer under the alveus is performed using specially designed ring transectors. After this procedure, epileptic discharges from the hippocampus can be completely abolished. Of 21 cases undergoing this operation, 12 left-sided and nine right-sided, 17 were followed up for more than one year. Fourteen (82%) are seizure free, two (12%) have rare seizures, and one (6%) has significantly improved. Of eight patients who underwent a battery of neuropsychometric tests both before and after left hippocampal transection, postoperative verbal memory was completely preserved in seven cases, and one transiently worsened patient recovered within 6 months. However, these results are still preliminary as the number of patients is ...Continue Reading

References

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Citations

Apr 2, 2008·Journal of Neurosurgery·Feng WangNa-Jia Liu
Sep 8, 2012·Epilepsy Research and Treatment·Faisal Al-OtaibiDavid Steven
Jul 6, 2014·Journal of Neurosurgery·Jose Juan González SánchezArnau Benet
May 4, 2010·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·A OssadtchiK Kamada
May 1, 2015·Neurologia Medico-chirurgica·Kensuke Kawai
Jun 20, 2013·Seizure : the Journal of the British Epilepsy Association·Arun Angelo Patil, Richard Andrews
Mar 28, 2018·Scientific Reports·Duk-Gyu SunSunggu Yang
Sep 16, 2008·Neurosurgery·Johannes Schramm, Hans Clusmann
Sep 17, 2014·Journal of Neurology, Neurosurgery, and Psychiatry·Noriaki MinamiImaharu Nakano
Jun 11, 2014·Nihon rinsho. Japanese journal of clinical medicine·Kensuke Kawai
Jan 1, 2016·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·V V KrylovI L Kaimovsky

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