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  • Title: Surgical outcome in hippocampal sclerosis following selective amygdalo-hippocampectomy.
    Author: Karasu A, Kuşcu D, Ofluoğlu AE, Gül G, Kayrak N, Bayindir C, Toplamaoğlu H, Canbolat A.
    Journal: Turk Neurosurg; 2008 Oct; 18(4):374-9. PubMed ID: 19107683.
    Abstract:
    OBJECTIVES: Temporal lobe epilepsy is the most common form of intractable partial epilepsy in adults with hippocampal sclerosis accounting for the majority of cases. Selective amygdalo-hippocampectomy (SEAH) is suggested as a safe and effective surgical procedure with the advantage of a better cognitive outcome. METHODS: We prospectively documented 56 consecutive patients with medically refractory medial temporal lob epilepsy. Candidates for surgery were determined as those with characteristic clinical and imaging findings, ictal recordings, and neuropsychological evaluation. A standard SEAH was performed and hippocampal sclerosis was histologically confirmed. RESULTS: In our study 76.7% of patients were classified as Engel I and 62.2% as ILAE I at their last follow up. Overall, at the last follow-up, 51.8% of patients were seizure-free since surgery (Engel 1a and ILAE 1a), 25% had stopped antiepileptic treatment, and another 52% had decreased either the dosage or number of antiepileptic drugs. 86.3% of the patients with abnormality on neurocognitive tasks showed improvement at the end of the 6 months post surgery. CONCLUSION: SEAH is a safe and effective surgical procedure without the necessity of a larger resection and further invasive methods.
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