A PROSPECTIVE ANALYSIS OF DIPLOPIA AFTER ANTERIOR TEMPORAL LOBECTOMY FOR MESIAL TEMPORAL LOBE SCLEROSIS
Abstract number :
1.434
Submission category :
Year :
2003
Submission ID :
3743
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Aaron A. Cohen-Gadol, Jacqulene Leavitt, Richard W. Marsh, Gregory D. Cascino Neurosurgery/Ophthalmology/Neurology, The Mayo Clinic, Rochester, MN
This prospective study investigates the incidence and natural history of postoperative diplopia in patients undergoing anterior temporal lobectomy and amygdalohippocampectomy (ATL) for medically intractable mesial temporal lobe epilepsy.
Forty-seven patients scheduled for ATL for medically refractory seizures were examined preoperatively, 2-7 days postoperatively, and three to six months later. Ophthalmologic examination including pupil measurements, stereoacuity, palpebral fissure measurements, vertical fusional amplitudes, Lancaster Red-Green, visual fields, and alternate cover testing was performed. Antiepileptic drug levels were monitored.
Nine of 47 patients (19%) developed diplopia postoperatively. The diplopia was secondary to trochlear nerve palsy in every case. No oculomotor nerve dysfunction was documented. Trochlear nerve function recovered completely in all patients within three to six months postoperatively.
Postoperative diplopia following ATL is more common than previously thought and is primarily due to trochlear nerve dysfunction. Awareness of this transient complication is important in preoperative patient counseling.