Memory outcome after temporal lobe epilepsy surgery: corticoamygdalohippocampectomy versus selective amygdalohippocampectomy

Tanrıverdi, Taner; Dudley, Roy W.R.; Hasan, Alya; Jishi, Ahmed Al; Hinai, Qasim Al; Poulin, Nicole; Colnat-Coulbois, Sophie; Olivier, André

doi:10.3171/2009.10.jns09677

Cited by 88 publications

(105 citation statements)

References 51 publications

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“…In our series, we did not observe significant decline in delayed noncontextual and contextual verbal memory after SLAH as assessed by the California verbal learning test and logical memory tests [7]. Decline in verbal memory is associated with dominant hemisphere resections [28]. Sparing lateral temporal cortex may preserve connections involved in contextual learning of information based on semantic content and syntactical structure [29].…”

Section: Mtlementioning

confidence: 46%

“…Sparing lateral temporal cortex may preserve connections involved in contextual learning of information based on semantic content and syntactical structure [29]. However, we expect that ablating mesial temporal lobe structures (hippocampus, parahippocampal gyrus) will result in decline in noncontextual memory, such as learning of unrelated series or pairs of words [28,29]. We should note that we have treated patients not yet reported in the literature who did experience verbal memory impairment after SLAH.…”

Section: Mtlementioning

confidence: 96%

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Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy

Kang

Sperling

2017

Neurotherapeutics

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Surgery is the most effective treatment for drug-resistant epilepsy. Long-term studies demonstrate that about 60% to 80% of patients become seizure-free after anterior temporal lobectomy and a majority of patients (about 95%) report significant seizure reduction after surgery. In the last few years, there has been significant advances in minimally invasive surgical techniques to treat drug-resistant epilepsy. These minimally invasive procedures have significant advantages over open surgery in that they produce less immediate discomfort and disability, while allowing for greater preservation of functional tissue. Laser interstitial thermal therapy (LiTT) is an example of such a procedure. Recent advances in imaging, surgical navigation, and real-time thermal monitoring have made LiTT safer and easier to implement, offering an effective and powerful neurosurgical tool for drug-resistant epilepsy. This article will review the technical considerations, uses, and potential future directions for LiTT in drugresistant epilepsy.

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Section: Mtlementioning

confidence: 46%

Section: Mtlementioning

confidence: 96%

Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy

Kang

Sperling

2017

Neurotherapeutics

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“…7,23,26,30,31,37,39 However, the statistical result changed to favor ATL when data were pooled from various stud- ies. The main difference between SelAH and ATL with respect to surgical technique is the resection of the anterolateral temporal neocortex.…”

Section: Discussionmentioning

confidence: 99%

Selective amygdalohippocampectomy versus anterior temporal lobectomy in the management of mesial temporal lobe epilepsy: a meta-analysis of comparative studies

Zhang

et al. 2013

JNS

132

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Object. Whether selective amygdalohippocampectomy (SelAH) has similar seizure outcomes and better neuropsychological outcomes compared with anterior temporal lobectomy (ATL) is a matter of debate. The aim of this study was to compare the 2 types of surgery with respect to seizure outcomes and changes in IQ scores.Methods. PubMed, Embase, and the Cochrane Library were searched for relevant studies published between January 1990 and September 2012. Studies comparing SelAH and ATL with respect to seizure and intelligence outcomes were included. Two reviewers assessed the quality of the included studies and independently extracted the data. Odds ratios and standardized mean deviations with 95% confidence intervals were used to compare pooled proportions of freedom from seizures and changes in IQ scores between the SelAH and ATL groups.Results. Three prospective and 10 retrospective studies were identified involving 745 and 766 patients who underwent SelAH and ATL, respectively. The meta-analysis demonstrated a statistically significant reduction in the odds of seizure freedom for patients who underwent SelAH compared with those who underwent ATL (OR 0.65 [95% CI 0.51-0.82], p = 0.0005). The differences between the changes in all IQ scores after the 2 types of surgery were not statistically significant, regardless of the side of resection.Conclusions. Selective amygdalohippocampectomy statistically reduced the odds of being seizure free compared with ATL, but the clinical significance of this reduction needs to be further validated by well-designed randomized trials. Selective amygdalohippocampectomy did not have better outcomes than ATL with respect to intelligence. (http://thejns.org/doi/abs/10.3171/2013.8.JNS121854) Key WorDs • temporal lobe epilepsy • anterior temporal lobectomy • selective amygdalohippocampectomy • meta-analysis 1089Abbreviations used in this paper: ATL = anterior temporal lobectomy; FCD = focal cortical dysplasia; FIQ = full-scale IQ; HS = hippocampal sclerosis; MTLE = mesial temporal lobe epilepsy; NTLE = neocortical temporal lobe epilepsy; PIQ = performance IQ; SelAH = selective amygdalohippocampectomy; SMD = standardized mean deviation; VIQ = verbal IQ.See the corresponding editorial in this issue, pp 1087-1088.

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“…It has been described by most major series that postoperative seizure control does not differ significantly between the two approaches 7,13,14,15,16,17,18,19,20,21 . Nonetheless, three studies have found better seizure-control in patients submitted to ATL 4,22,23 .…”

Section: Discussionmentioning

confidence: 96%

“…Numerous studies concluded that there are no differences between the two approaches, including the systematic review conducted by Hu et al 16,25,26 . Nevertheless, many other studies claim that SelAH confers lower cognitive morbidity, mostly involving language and verbal memory.…”

Section: Discussionmentioning

confidence: 99%

Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy

Nascimento

Gatto

Silvado

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective To contribute our experience with surgical treatment of patients with mesial temporal lobe epilepsy (mTLE) undergoing anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SelAH). Method This is a retrospective observational study. The sample included patients with medically refractory mTLE due to unilateral mesial temporal sclerosis who underwent either ATL or SelAH, at Hospital de Clinicas – UFPR, from 2005 to 2012. We report seizure outcomes, using Engel classification, cognitive outcomes, using measurements of verbal and visuospatial memories, as well as operative complications. Result Sixty-seven patients (33 ATL, 34 SelAH) were studied; median follow-up was 64 months. There was no statistically significant difference in seizure or neuropsychological outcomes, although verbal memory was more negatively affected in ATL operations on patients’ dominant hemispheres. Higher number of major complications was observed in the ATL group (p = 0.004). Conclusion Seizure and neuropsychological outcomes did not differ. ATL appeared to be associated with higher risk of complications.

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Memory outcome after temporal lobe epilepsy surgery: corticoamygdalohippocampectomy versus selective amygdalohippocampectomy

Abstract: Both CAH and SelAH can lead to several cognitive impairments depending on the side of the surgery. The authors suggest that the optimal type of surgical approach should be decided on a case-by-case basis.

Cited by 88 publications

References 51 publications

Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy

Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy for Treatment of Drug-Resistant Epilepsy

Selective amygdalohippocampectomy versus anterior temporal lobectomy in the management of mesial temporal lobe epilepsy: a meta-analysis of comparative studies

Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy

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