Surgical outcome in hippocampal sclerosis following selective amygdalo-hippocampectomy

Turk Neurosurg. 2008 Oct;18(4):374-9.


Objectives: Temporal lobe epilepsy is the most common form of intractable partial epilepsy in adults with hippocampal sclerosis accounting for the majority of cases. Selective amygdalo-hippocampectomy (SEAH) is suggested as a safe and effective surgical procedure with the advantage of a better cognitive outcome.

Methods: We prospectively documented 56 consecutive patients with medically refractory medial temporal lob epilepsy. Candidates for surgery were determined as those with characteristic clinical and imaging findings, ictal recordings, and neuropsychological evaluation. A standard SEAH was performed and hippocampal sclerosis was histologically confirmed.

Results: In our study 76.7% of patients were classified as Engel I and 62.2% as ILAE I at their last follow up. Overall, at the last follow-up, 51.8% of patients were seizure-free since surgery (Engel 1a and ILAE 1a), 25% had stopped antiepileptic treatment, and another 52% had decreased either the dosage or number of antiepileptic drugs. 86.3% of the patients with abnormality on neurocognitive tasks showed improvement at the end of the 6 months post surgery.

Conclusion: SEAH is a safe and effective surgical procedure without the necessity of a larger resection and further invasive methods.

MeSH terms

  • Adolescent
  • Adult
  • Amygdala / surgery*
  • Child
  • Cognition / physiology
  • Drug Resistance
  • Electrophysiology
  • Epilepsy, Temporal Lobe / etiology
  • Epilepsy, Temporal Lobe / surgery
  • Female
  • Hippocampus / pathology*
  • Hippocampus / surgery*
  • Humans
  • Intelligence Tests
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Neurosurgical Procedures*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / psychology
  • Prospective Studies
  • Recurrence
  • Sclerosis
  • Seizures / etiology
  • Treatment Outcome
  • Young Adult