4.4 Article

Long-term seizure outcome after stereotactic amygdalohippocampectomy

Journal

ACTA NEUROCHIRURGICA
Volume 156, Issue 8, Pages 1529-1537

Publisher

SPRINGER WIEN
DOI: 10.1007/s00701-014-2126-5

Keywords

Stereotactic neurosurgery; Temporal lobe epilepsy; Epilepsy surgery; Hippocampal sclerosis

Funding

  1. MH CZ - DRO (Nemocnice Na Homolce - NNH) [00023884]

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The aim of the study was to evaluate the long-term seizure outcome and complications after stereotactic radiofrequency amygdalohippocampectomy (SAHE) performed for mesial temporal lobe epilepsy (MTLE). The article describes the cases of 61 patients who were treated at our institution during the period 2004-2010. Mean post-operative follow-up was 5.3 years. At the last postsurgical visit, 43 (70.5 %) patients were Engel Class I, six (9.8 %) Class II, nine (14.8 %) Class III and three (4.9 %) Class IV. The surgery was complicated by four intracranial haematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae. After SAHE, we performed open epilepsy surgery and re-thermo lesions in three and two patients, respectively (8.2 %). There were two cases of meningitis which required antibiotic treatment. In six patients psychiatric disorders developed and one of these committed suicide due to postoperative depression. Our results provide preliminary evidence for good long-term seizure outcomes after SAHE. SAHE could be an alternative therapy for MTLE.

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