OBJECT: Resection strategies for the treatment of temporal lobe epilepsy (TLE) are a matter of discussion, and little information is available. The aim of this study was to compare seizure outcomes at the 5-year follow-up in patients with medically refractory unilateral mesial TLE (MTLE) due to hippocampal sclerosis (HS) who were treated using a cortical amygdalohippocampectomy (CorAH) or a selective AH (SelAH). METHODS: The authors obtained data from 100 adult patients who underwent surgery for MTLE. Fifty patients underwent a CorAH and 50 underwent an SelAH. Seizure control achieved with each technique was compared using the Engel classification scheme. RESULTS: Overall, at the 5-year follow-up, favorable (Engel Classes I and II) seizure outcomes were noted in 82 and 90% of patients who had undergone CorAH and SelAH, respectively. Furthermore, 40% of the patients who had undergone a CorAH and 58% of those who had undergone an SelAH were seizure free (Engel Class Ia). There was no statistically significant difference between the 2 surgical approaches in terms of seizure outcome at the 5-year follow-up (p = 0.38). CONCLUSIONS: Both CorAH and SelAH can lead to similar favorable seizure control in patients with MTLE/HS. However, the authors suggest that the transcortical selective approach has the great advantage of minimizing or completely abolishing the impact of dividing several venous and arterial adhesions which are tedious, time consuming, and, at times, associated with some degree of cerebral swelling.
OBJECT: Resection strategies for the treatment of temporal lobe epilepsy (TLE) are a matter of discussion, and little information is available. The aim of this study was to compare seizure outcomes at the 5-year follow-up in patients with medically refractory unilateral mesial TLE (MTLE) due to hippocampal sclerosis (HS) who were treated using a cortical amygdalohippocampectomy (CorAH) or a selective AH (SelAH). METHODS: The authors obtained data from 100 adult patients who underwent surgery for MTLE. Fifty patients underwent a CorAH and 50 underwent an SelAH. Seizure control achieved with each technique was compared using the Engel classification scheme. RESULTS: Overall, at the 5-year follow-up, favorable (Engel Classes I and II) seizure outcomes were noted in 82 and 90% of patients who had undergone CorAH and SelAH, respectively. Furthermore, 40% of the patients who had undergone a CorAH and 58% of those who had undergone an SelAH were seizure free (Engel Class Ia). There was no statistically significant difference between the 2 surgical approaches in terms of seizure outcome at the 5-year follow-up (p = 0.38). CONCLUSIONS: Both CorAH and SelAH can lead to similar favorable seizure control in patients with MTLE/HS. However, the authors suggest that the transcortical selective approach has the great advantage of minimizing or completely abolishing the impact of dividing several venous and arterial adhesions which are tedious, time consuming, and, at times, associated with some degree of cerebral swelling.
Authors: Krzysztof A Bujarski; Fuyuki Hirashima; David W Roberts; Barbara C Jobst; Karen L Gilbert; Robert M Roth; Laura A Flashman; Brenna C McDonald; Andrew J Saykin; Rod C Scott; Eric Dinnerstein; Julie Preston; Peter D Williamson; Vijay M Thadani Journal: J Neurosurg Date: 2013-04-26 Impact factor: 5.115
Authors: Justin A Blanco; Matt Stead; Abba Krieger; William Stacey; Douglas Maus; Eric Marsh; Jonathan Viventi; Kendall H Lee; Richard Marsh; Brian Litt; Gregory A Worrell Journal: Brain Date: 2011-09-08 Impact factor: 13.501
Authors: Zhenxing Sun; Huancong Zuo; Dan Yuan; Yaxing Sun; Kai Zhang; Zhiqiang Cui; Jin Wang Journal: Exp Ther Med Date: 2015-09-18 Impact factor: 2.447
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