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



Document title: Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy
Journal: Arquivos de neuro-psiquiatria
Database: PERIÓDICA
System number: 000390872
ISSN: 0004-282X
Authors: 1
2
2
2
2
2
Institutions: 1University of Toronto, Toronto Western Hospital, Toronto, Ontario. Canadá
2Universidade Federal do Parana, Hospital de Clinicas, Curitiba, Parana. Brasil
Year:
Season: Ene
Volumen: 74
Number: 1
Pages: 35-43
Country: Brasil
Language: Inglés
Document type: Artículo
Approach: Experimental, aplicado
English abstract To contribute our experience with surgical treatment of patients with mesial temporal lobe epilepsy (mTLE) undergoing anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SelAH). Method This 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. Result Sixty-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). Conclusion Seizure and neuropsychological outcomes did not differ. ATL appeared to be associated with higher risk of complications
Portuguese abstract Contribuir com nossa experiência para o tratamento cirúrgico de pacientes com epilepsia do lobo temporal mesial submetidos a lobectomia temporal anterior (LTA) ou amigdalohipocampectomia seletiva (AHS). Método Estudo retrospectivo observacional. Foram incluídos pacientes com epilepsia refratária devido a esclerose mesial temporal unilateral, submetidos a LTA ou AHS no Hospital de Clínicas – UFPR, entre 2005-2012. Foram comparados os resultados cognitivos (análises de memórias verbal e visuoespacial), controle de crises (Engel) e complicações cirúrgicas. Resultados Sessenta e sete pacientes (33 LTA, 34 AHS) foram estudados; o período de acompanhamento médio foi de 64 meses. Não houve diferença no controle das crises ou resultado neuropsicológico, mas a memória verbal foi mais negativamente afetada nos pacientes submetidos à LTA no hemisfério dominante. Maior número de complicações graves ocorreu no grupo de LTA (p = 0.004). Conclusão Controle de crises e resultados neuropsicológicos não diferiram. LTA pareceu estar associada a um maior risco cirúrgico
Disciplines: Medicina
Keyword: Cirugía,
Neurología,
Epilepsia de lóbulo temporal,
Amigdalohipocampectomia selectiva,
Lobectomía,
Convulsiones,
Pruebas neuropsicológicas
Keyword: Medicine,
Neurology,
Surgery,
Temporal lobe epilepsy,
Selective amygdalohippocampectomy,
Lobectomy,
Seizures,
Neuropsychological tests
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