Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy

Arquivos de Neuro-Psiquiatria

Fábio A. Nascimento¹  Luana Antunes Maranha Gatto¹  Carlos Silvado¹  Maria Joana Mäder-joaquim¹  Marlus Sidney Moro¹  Joao Candido Araujo¹ 

关键词: temporal lobe epilepsy;    amygdalo-hippocampal epilepsy;    anterior temporal lobectomy;    neuropsychological tests;    seizures;    postoperative complications;    epilepsia do lobo temporal;    epilepsia amígdalo-hipocampal;    lobectomia temporal anterior;    testes neuropsicológicos;    crises convulsivas;    complicações pós-operatórias;   

DOI  :  10.1590/0004-282X20150188

来源: SciELO

【 摘 要 】

ABSTRACTObjectiveTo contribute our experience with surgical treatment of patients with mesial temporal lobe epilepsy (mTLE) undergoing anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SelAH).MethodThis is a retrospective observational study. The sample included patients with medically refractory mTLE due to unilateral mesial temporal sclerosis who underwent either ATL or SelAH, at Hospital de Clinicas – UFPR, from 2005 to 2012. We report seizure outcomes, using Engel classification, cognitive outcomes, using measurements of verbal and visuospatial memories, as well as operative complications.ResultSixty-seven patients (33 ATL, 34 SelAH) were studied; median follow-up was 64 months. There was no statistically significant difference in seizure or neuropsychological outcomes, although verbal memory was more negatively affected in ATL operations on patients’ dominant hemispheres. Higher number of major complications was observed in the ATL group (p = 0.004).ConclusionSeizure and neuropsychological outcomes did not differ. ATL appeared to be associated with higher risk of complications.

【 授权许可】

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