gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Transsylvian selective amygdalohippocampectomy for mesiotemporal epilepsy: experience with 151 procedures

Transsylvische selektive Amygdalohippokampektomie bei Temporallappenepilepsie: Erfahrung mit 151 Fällen

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  • corresponding author C. Scheiwe - Neurochirurgische Universitätsklinik Freiburg
  • C. E. Elger - Universitätsklinik für Epileptologie Bonn
  • J. Schramm - Neurochirurgische Universitätsklinik Bonn
  • A. Schulze-Bonhage - Neurochirurgische Universitätsklinik Freiburg
  • J. Zentner - Neurochirurgische Universitätsklinik Freiburg

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.10.06

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc104.shtml

Published: May 30, 2008

© 2008 Scheiwe et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Mesial temporal lobe epilepsy (MTLE) is the most common form of epilepsy refractory to medical therapy. Among different surgical approaches available, selective amygdalohippocampectomy (SAH) has gained increasing interest. The aim of this study was to summarize our experience with surgical treatment of MTLE in 151 patients using the transsylvian approach.

Methods: Clinical, radiological and histopathological findings of 151 patients with MTLE who were operated between 1993 and 2001 were operated. Postoperative follow-up ranged from 6 to 14 years (mean: 10 years). Epileptological results were available from 140 cases. In 55 patients, postoperative neuroimaging was correlated to seizure outcome and neuropsychological performance.

Results: Overall, 110 (79%) of 141 patients remained completely seizure-free, and 127 (91%) had a worthwile improvement after surgery (≥90% reduction of seizure frequency). Operative complications occurred in 15 patients (9.9%) which were temporary in 14 cases and permanent in one case. There was no peri-operative mortality. Postoperative gliosis was observed in 18 (33%) of 55 cases but without significant relation neither to seizure outcome (p<0.05) nor to neuropsychological performance (all p<0.05).

Conclusions: Transsylvian SAH can be recommended as an adequate procedure for the surgical treatment of mesiotemporal epilepsy in the presence of hippocampal sclerosis, tumorous and non-tumorous focal lesions with favorable long-term results.