Subtemporal selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy: Systematic review of seizure and neuropsychological outcomes.

In addition to standard anterior temporal lobectomy (ATL), subtemporal selective amygdalohippocampectomy (sSAH) is also a common technique for the treatment of medically intractable mesial temporal lobe epilepsy (MTLE). We conducted a systematic literature review to determine the seizure and neuropsychological outcomes in patients with MTLE who underwent sSAH. We searched PubMed and Embase using Medical Subject Headings and keywords related to sSAH, seizure outcome, and neuropsychological outcome. Titles, abstracts, and full-texts were screened in light of inclusion and exclusion criteria that were established a priori. Potential papers were reviewed by 3 reviewers, who reached a consensus on the final papers to be included. Literature review identified 208 abstracts from which a total of 29 full-text articles were reviewed. Six studies containing data from 4 countries (3 continents) met our inclusion criteria. The seizure-free rates at 12 months after sSAH ranged from 59.1% to 61.5% in 4 studies. Four studies showed that seizure-free rates ranged from 56% to 82.6% at 24 months after surgery. Six studies evaluated the neuropsychological changes of patients with MTLE after sSAH, including intelligence, verbal memory, nonverbal memory, language function, and so on. In terms of neuropsychological outcomes, there are some differences among the 6 studies. Taken together, sSAH can provide a considerable rate of seizure freedom. In addition, the neuropsychological outcomes of patients who underwent sSAH were slightly different among 6 studies. Therefore, large-scale case series or randomized controlled trials (RCTs) are needed to clarify the advantages and disadvantages of the sSAH.