Outcomes of hippocampus-sparing lesionectomy for temporal lobe epilepsy and the significance of intraoperative hippocampography

Yu, Hsiang‐Yu; Lin, Chun‐Fu; Chou, Chien‐Chen; Lu, Yi-Jiun; Hsu, Sanford P.C.; Lee, Cheng‐Chia; Chen, Chien

doi:10.1016/j.clinph.2020.12.008

Cited by 11 publications

(11 citation statements)

References 44 publications

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“…Our study showed different results from Yu et al (2021) ( 32 ), who observed a good outcome in 90% of patients who underwent a lesionectomy in TLE with intact mesial structures and found that ioECoG did not add any useful information. In our study, only the 67% of our cohort had good outcome after the neocortical temporal resection, and post-ioECoG was useful to predict postsurgical seizure outcome and to possibly lead the neurosurgical team to extend the resection when necessary.…”

Section: Discussioncontrasting

confidence: 99%

“…In our study, only the 67% of our cohort had good outcome after the neocortical temporal resection, and post-ioECoG was useful to predict postsurgical seizure outcome and to possibly lead the neurosurgical team to extend the resection when necessary. The difference between the Korean results and ours partly depends on the different categorization of outcome groups: Yu et al (32) included in the seizure-free group patients belonging to Engel 1A-1B, while we included the Engel 1As only. Also, we performed intraoperative ECoG in patients in whom we did not doubt the surgical plan and thus we anticipated a good outcome.…”

Section: Discussionmentioning

confidence: 68%

“…This finding, although based on small numbers, suggests that the presence or absence of FRs may have a good predictive power in lesional-free hippocampi of lateral neocortical patients with TLE. Yu et al (2021) recently studied the presence of spikes and HFOs in lesion-free hippocampi of neocortical patients with TLE and found no relation between events and seizure outcome (32). No other study has examined HFOs in detail in this specific cohort of patients.…”

Section: Introductionmentioning

confidence: 99%

“…Yu et al (2021) recently studied the presence of spikes and HFOs in lesion-free hippocampi of neocortical patients with TLE and found no relation between events and seizure outcome ( 32 ). No other study has examined HFOs in detail in this specific cohort of patients.…”

Section: Introductionmentioning

confidence: 99%

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Spikes and High Frequency Oscillations in Lateral Neocortical Temporal Lobe Epilepsy: Can They Predict the Success Chance of Hippocampus-Sparing Resections?

et al. 2022

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PurposeWe investigated the distribution of spikes and HFOs recorded during intraoperative electrocorticography (ioECoG) and tried to elaborate a predictive model for postsurgical outcomes of patients with lateral neocortical temporal lobe epilepsy (TLE) whose mesiotemporal structures are left in situ.MethodsWe selected patients with temporal lateral neocortical epilepsy focus who underwent ioECoG-tailored resections without amygdalo–hippocampectomies. We visually marked spikes, ripples (80–250 Hz), and fast ripples (FRs; 250–500 Hz) on neocortical and mesiotemporal channels before and after resections. We looked for differences in event rates and resection ratios between good (Engel 1A) and poor outcome groups and performed logistic regression analysis to identify outcome predictors.ResultsFourteen out of 24 included patients had a good outcome. The poor-outcome patients showed higher rates of ripples on neocortical channels distant from the resection in pre- and post-ioECoG than people with good outcomes (ppre = 0.04, ppost = 0.05). Post-ioECoG FRs were found only in poor-outcome patients (N = 3). A prediction model based on regression analysis showed low rates of mesiotemporal post-ioECoG ripples (ORmesio = 0.13, pmesio = 0.04) and older age at epilepsy onset (OR = 1.76, p = 0.04) to be predictors of good seizure outcome.ConclusionHFOs in ioECoG may help to inform the neurosurgeon of the hippocampus-sparing resection success chance in patients with lateral neocortical TLE.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spikes and High Frequency Oscillations in Lateral Neocortical Temporal Lobe Epilepsy: Can They Predict the Success Chance of Hippocampus-Sparing Resections?

et al. 2022

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“…In contrast, half of patients with a tumor located medial to the collateral sulcus underwent hippocampal resection. Yu et al investigated temporal lobe epilepsy (TLE) patients with a normal hippocampus and concluded that the distance between the tumor and hippocampus was not a factor responsible for achieving seizure freedom [ 20 ]. The hippocampus is not necessarily epileptogenic, even if the tumor is located close to it.…”

Section: Discussionmentioning

confidence: 99%

Is Hippocampal Resection Necessary for Low-Grade Epilepsy-Associated Tumors in the Temporal Lobe?

et al. 2022

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Low-grade epilepsy-associated tumors (LEATs) are common in the temporal lobe and can cause drug-resistant epilepsy. Complete resection of LEATs is sufficient for seizure relief. However, hippocampal resection might result in postoperative cognitive impairment. This study aimed to clarify the necessity of hippocampal resection for seizure and cognitive outcomes in patients with temporal lobe LEATs and a normal hippocampus. The study included 32 patients with temporal lobe LEATs and without hippocampal abnormalities. All patients underwent gross total resection as treatment for drug-resistant epilepsy at our tertiary epilepsy center from 2005 to 2020, followed by at least a 12-month follow-up period. Seizure and cognitive outcomes were compared between patients who underwent additional hippocampal resection (Resected group) and those who did not (Preserved group). Among the participants, 14 underwent additional hippocampal resection and 28 (87.5%) achieved seizure freedom irrespective of hippocampal resection. The seizure-free periods were not different between the two groups. Additional hippocampal resection resulted in a significantly negative impact on the postoperative verbal index. In conclusion, additional hippocampal resection in patients with temporal lobe LEATs without hippocampal abnormalities is unnecessary because lesionectomy alone results in good seizure control. Additional hippocampal resection may instead adversely affect the postoperative language function.

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Location-based selection of the surgical approach to preserve the hippocampus in lesion-associated temporal lobe epilepsy

Nishijima,

Uda,

Yindeedej

et al. 2024

Clinical Neurology and Neurosurgery

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Outcomes of hippocampus-sparing lesionectomy for temporal lobe epilepsy and the significance of intraoperative hippocampography

Cited by 11 publications

References 44 publications

Spikes and High Frequency Oscillations in Lateral Neocortical Temporal Lobe Epilepsy: Can They Predict the Success Chance of Hippocampus-Sparing Resections?

Spikes and High Frequency Oscillations in Lateral Neocortical Temporal Lobe Epilepsy: Can They Predict the Success Chance of Hippocampus-Sparing Resections?

Is Hippocampal Resection Necessary for Low-Grade Epilepsy-Associated Tumors in the Temporal Lobe?

Location-based selection of the surgical approach to preserve the hippocampus in lesion-associated temporal lobe epilepsy

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