PURPOSE: The technique of selective amygdalohippocampectomy (SAH) was originally developed in epilepsy surgery to spare unaffected brain tissue from surgery, thus minimizing the cognitive consequences of temporal lobe surgery. The results of previous studies, however, are equivocal in this regard. This study evaluated memory after SAH in a large sample of patients with mesial temporal lobe epilepsy. METHODS: The 140 patients received material-specific memory tests before and 3 months after unilateral SAH. RESULTS: Significant declines in all aspects of verbal learning and memory were found particularly for the left resected group. With reliability-of-change indices, a high number of patients showed postoperative verbal memory declines, < or = 51% in left SAH and < or = 32% in right SAH. For left SAH, a higher preoperative verbal memory performance, a lower preoperative nonverbal memory score, an older age at surgery, and a later onset of epilepsy predicted a stronger decline in verbal memory. After right SAH, the risk for a verbal memory decline was slightly increased when patients had surgical complications or a presurgical evaluation with bilateral intrahippocampal depth electrodes. Results concerning nonverbal memory were less clear. CONCLUSIONS: The results clearly indicate, that particularly left SAH can lead to a significant decline in memory functions. Predictors of postoperative verbal memory were similar to those reported for temporal lobectomy. Postoperative deteriorations were broader and stronger in our study than in previous studies. We discuss methodologic differences (sample size, retest interval, extent of resection) and other factors as possible reasons.
PURPOSE: The technique of selective amygdalohippocampectomy (SAH) was originally developed in epilepsy surgery to spare unaffected brain tissue from surgery, thus minimizing the cognitive consequences of temporal lobe surgery. The results of previous studies, however, are equivocal in this regard. This study evaluated memory after SAH in a large sample of patients with mesial temporal lobe epilepsy. METHODS: The 140 patients received material-specific memory tests before and 3 months after unilateral SAH. RESULTS: Significant declines in all aspects of verbal learning and memory were found particularly for the left resected group. With reliability-of-change indices, a high number of patients showed postoperative verbal memory declines, < or = 51% in left SAH and < or = 32% in right SAH. For left SAH, a higher preoperative verbal memory performance, a lower preoperative nonverbal memory score, an older age at surgery, and a later onset of epilepsy predicted a stronger decline in verbal memory. After right SAH, the risk for a verbal memory decline was slightly increased when patients had surgical complications or a presurgical evaluation with bilateral intrahippocampal depth electrodes. Results concerning nonverbal memory were less clear. CONCLUSIONS: The results clearly indicate, that particularly left SAH can lead to a significant decline in memory functions. Predictors of postoperative verbal memory were similar to those reported for temporal lobectomy. Postoperative deteriorations were broader and stronger in our study than in previous studies. We discuss methodologic differences (sample size, retest interval, extent of resection) and other factors as possible reasons.
Authors: Robert E Gross; Matthew A Stern; Jon T Willie; Rebecca E Fasano; Amit M Saindane; Bruno P Soares; Nigel P Pedersen; Daniel L Drane Journal: Ann Neurol Date: 2018-03-03 Impact factor: 10.422
Authors: Franklin C Brown; Michael Westerveld; John T Langfitt; Marla Hamberger; Hamada Hamid; Shlomo Shinnar; Michael R Sperling; Orrin Devinsky; William Barr; Joseph Tracy; David Masur; Carl W Bazil; Susan S Spencer Journal: Epilepsy Behav Date: 2013-11-26 Impact factor: 2.937
Authors: S Kathleen Bandt; Nicole Werner; Jennifer Dines; Samiya Rashid; Lawrence N Eisenman; R Edward Hogan; Eric C Leuthardt; Joshua Dowling Journal: Epilepsy Behav Date: 2013-05-03 Impact factor: 2.937