Taner Tanriverdi1, Andre Olivier. 1. Montreal Neurological Institute, Neurosurgery, Montreal, Quebec, Canada. tanerato2000@yahoo.com
Abstract
BACKGROUND: The aim of this study was to compare neuropsychological outcome at 1-year follow-up in patients with medically refractory unilateral mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS) treated by a cortico-amygdalohippocampectomy (CAH) or a selective-amygdalohippocampectomy (SAH). METHODS: Data for a series of 72 adult patients who underwent surgery for MTLE/HS were evaluated. Thirty-six patients underwent CAH and 36 SAH. All patients underwent neuropsychological evaluation before and 1 year after surgery. RESULTS: The intelligence quotient increased postoperatively in both surgical groups. Memory evaluation in the CAH group revealed a postoperative decline in nonverbal memory after right-sided resection and a postoperative decline in verbal memory after left-sided resection. In the SAH group, there was a slight postoperative decline only in verbal memory after left-sided resection, but other memory function was well preserved. However, no significant difference was found between two approaches regarding memory. There was no also statistically significant difference between two approaches in terms of seizure outcome at 1-year follow-up. CONCLUSIONS: Our results suggest that in the clinical planning of seizure treatment, the optimal type of surgical approach is dependent on the outcome predictions, rather than on any supposed advantages to postoperative memory function.
BACKGROUND: The aim of this study was to compare neuropsychological outcome at 1-year follow-up in patients with medically refractory unilateral mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS) treated by a cortico-amygdalohippocampectomy (CAH) or a selective-amygdalohippocampectomy (SAH). METHODS: Data for a series of 72 adult patients who underwent surgery for MTLE/HS were evaluated. Thirty-six patients underwent CAH and 36 SAH. All patients underwent neuropsychological evaluation before and 1 year after surgery. RESULTS: The intelligence quotient increased postoperatively in both surgical groups. Memory evaluation in the CAH group revealed a postoperative decline in nonverbal memory after right-sided resection and a postoperative decline in verbal memory after left-sided resection. In the SAH group, there was a slight postoperative decline only in verbal memory after left-sided resection, but other memory function was well preserved. However, no significant difference was found between two approaches regarding memory. There was no also statistically significant difference between two approaches in terms of seizure outcome at 1-year follow-up. CONCLUSIONS: Our results suggest that in the clinical planning of seizure treatment, the optimal type of surgical approach is dependent on the outcome predictions, rather than on any supposed advantages to postoperative memory function.
Authors: Alireza Mansouri; Aria Fallah; Mary Pat McAndrews; Melanie Cohn; Diana Mayor; Danielle Andrade; Peter Carlen; Jose M Del Campo; Peter Tai; Richard A Wennberg; Taufik A Valiante Journal: Epilepsy Res Treat Date: 2014-10-01