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

作者：Nascimento Fabio A^*; Maranha Gatto Luana Antunes; Silvado Carlos; Maeder Joaquim Maria Joana; Moro Marlus Sidney; Araujo Joao Candido

来源：Arquivos de Neuro-Psiquiatria, 2016, 74(1): 35-43.

DOI：10.1590/0004-282X20150188

• temporal lobe epilepsy
• amygdalo-hippocampal epilepsy
• anterior temporal lobectomy
• neuropsychological tests
• seizures
• postoperative complications

Objective: To contribute our experience with surgical treatment of patients with mesial temporal lobe epilepsy (mTLE) undergoing anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SeIAH). 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 SeIAH, 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 SeIAH) 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.

• 出版日期2016-1