Stereotactic Surgery for Epilepsy

Ravagnati, L.

doi:10.1007/978-3-642-71103-9_51

Cited by 5 publications

(9 citation statements)

References 19 publications

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“…With the goal to use minimally invasive surgical modalities, several authors have performed stereotactic lesioning of limbic targets and in particular, the amygdala, as treatment for TLE. Reviewing the literature, Ojemann and Ward (1975) and Ravagnati (1987) concluded that overall results of stereotactic approaches were inferior compared to resective surgery. Regarding the treatment of TLE due to amygdalar epilepsy, only limited data on long‐term efficacy of amygdalotomy are available (Hood et al , 1983; Narabayashi and Mizutani, 1970; Narabayashi, 1976; Ravagnati, 1987; Siegfried and Wieser, 1988).…”

Section: Discussionmentioning

confidence: 99%

“…Reviewing the literature, Ojemann and Ward (1975) and Ravagnati (1987) concluded that overall results of stereotactic approaches were inferior compared to resective surgery. Regarding the treatment of TLE due to amygdalar epilepsy, only limited data on long‐term efficacy of amygdalotomy are available (Hood et al , 1983; Narabayashi and Mizutani, 1970; Narabayashi, 1976; Ravagnati, 1987; Siegfried and Wieser, 1988). Research is ongoing to define the number of patients who are completely “cured” ( i.e.…”

Section: Discussionmentioning

confidence: 99%

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Superselective anterior temporal resection in mesial temporal lobe epilepsy

Cordeiro

Wagner

Trippel

et al. 2011

Epileptic Disorders

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We report the case of a patient with pharmacoresistant mesial temporal lobe epilepsy presenting psychomotor seizures with onset at early childhood. MRI showed a blurred internal structure of the right hippocampus and right mammillary body atrophy. Neuropsychological testing revealed deficits in selective attention and visual planning. Non‐invasive recording was not sufficient to precisely detect the seizure onset zone. Invasive recording showed seizure onset in the temporo‐polar neocortex, with spread to the amygdalum and hippocampus. A superselective resection of the temporal pole and amygdalum was performed with preservation of the hippocampus. Histology revealed the presence of focal cortical dysplasia (Palmini type Ib). Seizure frequency was reduced after surgery, and seizure freedom for two years was achieved with optimisation of the antiepileptic drug regime. Memory functions were preserved, and selective attention and visual planning improved following limited resection. This case suggests that, in selected cases, highly targeted resections with preservation of memory‐relevant structures may be the best choice considering both seizure control and unimpaired cognitive functioning.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Superselective anterior temporal resection in mesial temporal lobe epilepsy

Cordeiro

Wagner

Trippel

et al. 2011

Epileptic Disorders

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“…Several authors have performed stereotactic lesioning of various limbic targets, and in particular, the amygdala, as a 148 surgical treatment forTLE. Ojemann and Ward [34] and Ravagnati [35] reviewed the literature (tables I and 11). Their overall conclusion was that the efficacy in the reported series was difficult to evaluate and that, overall, results of stereotactic approaches were lessgood compared to resective surgery.…”

Section: Discussionmentioning

confidence: 99%

Mesial temporal lobe epilepsy versus amygdalar epilepsy: Late seizure recurrence after initially successful amygdalotomy and regained seizure control following hippocampectomy

Wieser

2000

Epileptic Disorders

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We summarise the concept of mesial temporal lobe epilepsy and the pros and cons in order to define amygdala epilepsy. We present a patient with stereotactically proven right amygdalar seizure onset, associated with fear and vegetative autonomic signs and symptoms as the most prominent clinical ictal features. Following a right stereotactic amygdalotomy, the patient experienced an 11‐year seizure‐free period. Similar, but not identical, semeiology of complex partial seizures then recurred. A right‐sided selective hippocampectomy and excision of the previously lesioned amygdala was performed. Except for 2 complex partial seizures associated with withdrawal of antiepileptic drugs, the patient remained seizure‐free 9.5 years. This case underscores the important role of the amygdala in generating the semiology, and raises several questions concerning the existence of “amygdalar epilepsy”. The 11‐year seizure‐free period following the stereotactic destruction of the amygdala is a strong argument for this notion. The late seizure recurrence requiring a second operation might, however, be seen as an argument for the important role of the hippocampal formation in the syndrome of mesial temporal lobe epilepsy even when the amygdala has been identified as the seizure onset zone. The role of stereotactic amygdalotomy is briefly reviewed.

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“…!e werden zur Zeit nur noch se!ten durchgeführt (vg!. Ravagnati, 1987). Die wesentliche Indikation ist eine Anfallsform, deren kritische Aktivitãt auf den Nc.…”

Section: Stereotaktische Eingriffeunclassified

Chirurgische Epilepsietherapie - Indikationen und prächirurgische Diagnostik

Elger¹

1988

Akt Neurol

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Stereotactic Surgery for Epilepsy

Cited by 5 publications

References 19 publications

Superselective anterior temporal resection in mesial temporal lobe epilepsy

Superselective anterior temporal resection in mesial temporal lobe epilepsy

Mesial temporal lobe epilepsy versus amygdalar epilepsy: Late seizure recurrence after initially successful amygdalotomy and regained seizure control following hippocampectomy

Chirurgische Epilepsietherapie - Indikationen und prächirurgische Diagnostik

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