Selective Amygdalohippocampectomy in Temporal Lobe Epilepsy: Results in 200 Patients
Abstract number :
2.302
Submission category :
Year :
2001
Submission ID :
2943
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
A. Olivier, M.D., Ph.D., Neurosurgery, Montreal Neurological Hospital-Institute, Montreal, QC, Canada; F. Andermann, M.D., Neurology, Montreal Neurological Hospital-Institute, Montreal, QC, Canada; F. Dubeau, M.D., Neurology, Montreal Neurological Hospita
RATIONALE: Numerous studies of the electrophysiology and neuropathology of temporal lobe epilepsy have demonstrated the mesial temporal structures to be the site of seizure origin in the majority of cases. This is the rationale for a selective amygdalo-hippocampectomy approach first introduced by Niemeyer.
METHODS: A series of 200 consecutive patients operated for mesial temporal epilepsy diagnosed by clinical features, the presence of mesial inter ictal and ictal discharges on EEG and the demonstration of hippocampal slcerosis and atrophy on MRI. The image guided technique developed at the Montreal Neurological Institute uses a transcortical approach and consists in a strictly endopial resection of the hippocampal formation and amygdala.
RESULTS: Ninety percent of patients who underwent selective amygdalo-
hippocampectomy at the Montreal Neurological Institute realized a cessation of seizures or greater than 90% reduction. Poor results are seen in instances of neocortical, multifocal and bitemporal epilepsy. Neurological complications consist in 1 case of transient 3rd nerve paresis and 3 cases of transient dysphasia. Results are excellent on seizure tendency with minimal risks.
CONCLUSIONS: Selective amygdalo-hippocampectomy is in our experience the procedure of choice for mesial temporal epilepsy in well selected patients.