The seizure outcome after amygdalohippocampectomy and temporal lobectomy

Bate, H.; Eldridge, Paul; Varma, T. R. K.; Wieshmann, Udo

doi:10.1111/j.1468-1331.2006.01565.x

Cited by 61 publications

(51 citation statements)

References 25 publications

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“…On the other hand, some investigators have recorded neocortical epileptiform spikes with cortical electrodes, 1,35 indicating that tailored resection of the temporal neocortex is Selective amygdalohippocampectomy versus anterior temporal lobectomy in the management of mesial temporal lobe epilepsy: a meta-analysis of comparative studies essential for MTLE. Other studies have suggested that better seizure outcomes were achieved in patients who underwent ATL than in those who underwent SelAH, 3,21 and that no significant differences in neuropsychological outcomes were found between the surgical strategies. 12,42 A review attempted to pool studies comparing ATL and SelAH for MTLE to test the hypothesis that the latter procedure produces similar seizure and favorable neuropsychological outcomes, and the conclusion was concordant with the hypothesis.…”

Section: ©Aans 2013mentioning

confidence: 91%

Selective amygdalohippocampectomy versus anterior temporal lobectomy in the management of mesial temporal lobe epilepsy: a meta-analysis of comparative studies

Zhang

et al. 2013

JNS

135

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Object. Whether selective amygdalohippocampectomy (SelAH) has similar seizure outcomes and better neuropsychological outcomes compared with anterior temporal lobectomy (ATL) is a matter of debate. The aim of this study was to compare the 2 types of surgery with respect to seizure outcomes and changes in IQ scores.Methods. PubMed, Embase, and the Cochrane Library were searched for relevant studies published between January 1990 and September 2012. Studies comparing SelAH and ATL with respect to seizure and intelligence outcomes were included. Two reviewers assessed the quality of the included studies and independently extracted the data. Odds ratios and standardized mean deviations with 95% confidence intervals were used to compare pooled proportions of freedom from seizures and changes in IQ scores between the SelAH and ATL groups.Results. Three prospective and 10 retrospective studies were identified involving 745 and 766 patients who underwent SelAH and ATL, respectively. The meta-analysis demonstrated a statistically significant reduction in the odds of seizure freedom for patients who underwent SelAH compared with those who underwent ATL (OR 0.65 [95% CI 0.51-0.82], p = 0.0005). The differences between the changes in all IQ scores after the 2 types of surgery were not statistically significant, regardless of the side of resection.Conclusions. Selective amygdalohippocampectomy statistically reduced the odds of being seizure free compared with ATL, but the clinical significance of this reduction needs to be further validated by well-designed randomized trials. Selective amygdalohippocampectomy did not have better outcomes than ATL with respect to intelligence. (http://thejns.org/doi/abs/10.3171/2013.8.JNS121854) Key WorDs • temporal lobe epilepsy • anterior temporal lobectomy • selective amygdalohippocampectomy • meta-analysis 1089Abbreviations used in this paper: ATL = anterior temporal lobectomy; FCD = focal cortical dysplasia; FIQ = full-scale IQ; HS = hippocampal sclerosis; MTLE = mesial temporal lobe epilepsy; NTLE = neocortical temporal lobe epilepsy; PIQ = performance IQ; SelAH = selective amygdalohippocampectomy; SMD = standardized mean deviation; VIQ = verbal IQ.See the corresponding editorial in this issue, pp 1087-1088.

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Section: ©Aans 2013mentioning

confidence: 91%

Selective amygdalohippocampectomy versus anterior temporal lobectomy in the management of mesial temporal lobe epilepsy: a meta-analysis of comparative studies

Zhang

et al. 2013

JNS

135

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“…It has been described by most major series that postoperative seizure control does not differ significantly between the two approaches 7,13,14,15,16,17,18,19,20,21 . Nonetheless, three studies have found better seizure-control in patients submitted to ATL 4,22,23 . Similarly, two recent systematic reviews concluded that ATL is associated with a reduced rate of seizure recurrence compared to SelAH 24,25 .…”

Section: Discussionmentioning

confidence: 99%

“…Further, ATL and SelAH groups usually have unequal number of patients. Also an issue, follow-up periods are frequently of just a couple of years 4,18 . Finally, most studies include individuals with TLE due to several different pathologies, such as tumors, malformations of cortical development, MTS, etc.…”

Section: Discussionmentioning

confidence: 99%

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Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy

Nascimento

Gatto

Silvado

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective To contribute our experience with surgical treatment of patients with mesial temporal lobe epilepsy (mTLE) undergoing anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SelAH). Method This is a retrospective observational study. The sample included patients with medically refractory mTLE due to unilateral mesial temporal sclerosis who underwent either ATL or SelAH, at Hospital de Clinicas – UFPR, from 2005 to 2012. We report seizure outcomes, using Engel classification, cognitive outcomes, using measurements of verbal and visuospatial memories, as well as operative complications. Result Sixty-seven patients (33 ATL, 34 SelAH) were studied; median follow-up was 64 months. There was no statistically significant difference in seizure or neuropsychological outcomes, although verbal memory was more negatively affected in ATL operations on patients’ dominant hemispheres. Higher number of major complications was observed in the ATL group (p = 0.004). Conclusion Seizure and neuropsychological outcomes did not differ. ATL appeared to be associated with higher risk of complications.

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“…We prefer to use "corticoamygdalohippocampectomy", which describes the technique more accurately. However, studies comparing SAH and CAH by Ozkara et al (12,(14)(15)(16). There is also still no consensus on the extent of resection.…”

Section: Discussionmentioning

confidence: 99%

Surgery for intractable temporal lobe epilepsy: experience of a single institution

Kurt¹,

Tönge²,

Çeltikçi³

et al. 2014

Turk J Med Sci

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Background/aim: In the treatment of epilepsy, encouraging results have been achieved with surgical treatment, especially for temporal lobe epilepsy (TLE). Drug resistance must be diagnosed as early as possible, because the ensuing seizures can be eliminated surgically via temporal lobe surgery in a high percentage (70%-90%) of patients. In this study we share our experience, in a single institution, of surgical treatment of intractable TLE. Materials and methods:Between March 2006 and November 2010 we performed 127 corticoamygdalohippocampectomy (CAH) procedures. All CAH surgical procedures were done as described by Niemeyer's technique. Resection lengths were 4-4.5 cm from the temporal pole.Results: At the end of 24 months, 79.7% (n = 94) patients were still on antiepileptic medications, with 55 of them on a decreased number or dose of drugs, and 20.3 (n = 24) patients were antiepileptic drug-free. Postoperative Engel's classes were 1, 2, and 3 in 87.2%, 5.08%, and 7.6%, respectively. There was no mortality in follow-up, and dysphasia in 1 patient (0.84%) was the only morbidity. Conclusion:In our series we found that the outcome of surgery is associated with careful patient selection, which requires a detailed investigation of the patients. Our final conclusion is that outcome scores are independent of age, pathology, or sex but are dependent on correct patient selection.

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The seizure outcome after amygdalohippocampectomy and temporal lobectomy

Cited by 61 publications

References 25 publications

Selective amygdalohippocampectomy versus anterior temporal lobectomy in the management of mesial temporal lobe epilepsy: a meta-analysis of comparative studies

Selective amygdalohippocampectomy versus anterior temporal lobectomy in the management of mesial temporal lobe epilepsy: a meta-analysis of comparative studies

Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy

Surgery for intractable temporal lobe epilepsy: experience of a single institution

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