Visual field disorder after surgery of temporal lobe epilepsy associated to hippocampus sclerosis

Eliseeva, N M; Pitskhelauri, D I; Serova, N K; Kudieva, Elina

doi:10.17116/neiro20198305114

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…Moreover, the results remained stable after sensitivity analysis with exclusion of each study. In addition, SAH has lower risk of VFD than ATL, which is concordant with the results of several previous articles [10][11][12].…”

Section: Discussionsupporting

confidence: 92%

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Comparisons of the seizure-free outcome and visual field deficits between anterior temporal lobectomy and selective amygdalohippocampectomy: A systematic review and meta-analysis

Wang

Guan

et al. 2020

Seizure

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The purpose of our study is to compare seizure-free outcome and the incidence of visual field deficits (VFD) between anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SAH) among patients with intractable temporal lobe epilepsy (TLE). Methods: We searched MEDLINE, Embase and Cochrane databases using keywords related to ATL, SAH and VFD. Previous studies that compared ATL and SAH with seizure-free outcome and the incidence of VFD were included. A fixed-effect model was used to conduct meta-analysis. Risk ratio with 95% confidence intervals were pooled and used to elucidate each outcome. Results: Twenty-three retrospective and three prospective studies were recruited with a total of 2930 cases (1390 cases for SAH and 1540 cases for ATL). The meta-analysis showed no significant difference in seizure freedom (SAH 63.5% vs ATL 63.8%) of these two procedures (RR 0.95, 95%CI 0.90-1.01, P = 0.102), but the odds of seizure freedom in ATL was higher than transsylvian SAH approach (RR 0.89 95% CI 0.82-0.96, P = 0.004). Comparing with ATL for TLE, SAH for TLE caused lower frequency of postoperative VFD. (RR 0.87, 95%CI 0.76-0.99, P = 0.034). Conclusions: There was no significant difference on seizure freedom between ATL and SAH procedures, while subgroup analysis demonstrated that ATL was associated with higher opportunity to achieve seizure-free than transsylvian SAH approach. Furthermore, the incidence of postoperative VFD was significantly lower in SAH than ATL. Individualized treatment achieving balance between seizure free and collateral damage should be considered in clinical practice. Well-designed randomized controlled clinical trials would be necessary to validate our findings.

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Section: Discussionsupporting

confidence: 92%

“…In terms of seizure control, no significant difference was found in most comparisons of SAH and ATL [3][4][5][6][7]. On the other hand, some studies suggested that SAH achieved better neuropsychological outcomes [8,9] and had lower risk of visual field deficits [10][11][12] (VFD) than ATL.…”

Section: Introductionmentioning

confidence: 99%