Seizure and memory outcome following temporal lobe surgery: selective compared with nonselective approaches for hippocampal sclerosis

Journal of Neurosurgery
Eliseu PaglioliJoão Rubião Hoeffel

Abstract

The aim of this study was to compare seizure and memory outcome in patients with medically refractory mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE/HS) treated using an anterior temporal lobectomy (ATL) or a selective amygdalohippocampectomy (SA). Surgical outcome data were prospectively collected for 2 to 11 years in 161 consecutive patients with MTLE/ HS. Eighty patients underwent an ATL and 81 an SA. Seizure control achieved with each technique was compared using the Engel classification scheme. Postoperative memory testing was performed in 86 patients (53%). At the last follow up, 72% of the patients who had undergone an ATL (mean follow up 6.7 years) and 71% of those who had undergone an SA (mean follow up 4.5 years) were seizure free (Engle Class IA). Estimated survival in patients in Engel Classes I, IA, and I and II combined did not differ between the two surgical techniques. Preoperatively, 58% of the patients had verbal memory scores one standard deviation (SD) below the normal mean. One third of the patients with preoperative scores in the normal range worsened after surgery, although this outcome was not related to the surgical technique. In contrast, one third of those whose preoperative scores w...Continue Reading

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Citations

Sep 16, 2008·Brain : a Journal of Neurology·Shigetoshi TakayaHidenao Fukuyama
Sep 4, 2009·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·T MengeshaB W Abou-Khalil
Nov 5, 2011·Epilepsia·Leonardo BonilhaJonathan C Edwards
Sep 8, 2012·Epilepsy Research and Treatment·David Spencer, Kim Burchiel
Jul 7, 2009·Journal of Neurosurgery·M Gazi YaşargilDianne C H Yaşargil
Mar 3, 2012·Neurosurgical Focus·Fernando L ValeSelim R Benbadis
Sep 2, 2008·Neurosurgical Focus·Badih Adada
Apr 2, 2008·Journal of Neurosurgery·Nobuhiro TanakaMichiyasu Suzuki
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Aug 19, 2015·Neurosurgical Review·Peng-Fan YangZhi-Yong Zheng
Aug 14, 2009·Epilepsy & Behavior : E&B·Dawn Mechanic-HamiltonJohn A Detre
Dec 18, 2013·Epilepsia·André PalminiVinicius Duval Silva
Nov 29, 2015·Neurosurgery Clinics of North America·Alastair T Hoyt, Kris A Smith
Jul 29, 2006·Trends in Neurosciences·Iván IzquierdoMartín Cammarota
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Mar 27, 2012·Seizure : the Journal of the British Epilepsy Association·Zdeněk VojtěchRoman Liščák
Nov 16, 2010·Epilepsy & Behavior : E&B·Saint V OkonmaRobert E Gross

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