Citation

Vojtěch Z, Malíková H, Krámská L, Liščák R, Vladyka V. Neuropsychiatr. Dis. Treat. 2015; 11: 359-374.

Copyright

(Copyright © 2015, Dove Press)

DOI

10.2147/NDT.S69350

PMID

unavailable

Abstract

BACKGROUND: This paper presents our experience of stereotactic radiofrequency amygdalohip-pocampectomy performed for intractable mesial temporal lobe epilepsy.; Methods: The article describes the cases of 61 patients who were treated during the period from 2004 to 2010. Mean postoperative follow-up was 5.3 years. Neuropsychological results were obtained for a subset of 31 patients.; Results: At their last postsurgical visit, 43 (70.5%) patients were Engel class I, six (9.8%) class II, nine (14.8%) class III, and three (4.9%) class IV. The surgery was complicated by four intracranial hematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae, while another caused transitory aphasia. The remaining hematomas were asymptomatic. There were two cases of meningitis which required antibiotic treatment. One patient committed suicide due to postoperative depression. After the procedure, we performed open epilepsy surgery and rethermolesions in three and two patients, respectively (8.2%). Patients showed increases in their mean full scale, verbal, and performance intelligence quotient (IQ) scores of 4, 3, and 4 IQ points, respectively (P<0.05). Five (17.2%), four (13.8%), and four (13.3%) patients improved their full scale, verbal, and performance IQ scores, respectively. No significant changes were found in memory performance, with a mean increase of 1, 3, and 0 memory quotient points in global, verbal, and visual memory, respectively (P<0.05). Global memory improved in three (10.3%) patients, verbal memory in one (3.4%), and one patient (3.3%) showed deterioration in visual memory.; Conclusion: Stereotactic radiofrequency amygdalohippocampectomy offers a safe, effective, and less aggressive treatment modality in cases of well-defined mesial temporal lobe epilepsy. Seizure outcome is comparable with the results of conventional epilepsy surgery and cognitive results could be even better. © 2015 Vojtěch et al.

Language: en

Keywords

adolescent; memory; adult; human; suicide; female; male; Review; aged; psychosis; patient safety; treatment outcome; neuroimaging; major clinical study; analgesic agent; personality disorder; headache; nuclear magnetic resonance imaging; follow up; onset age; temporal lobe epilepsy; brain hematoma; intermethod comparison; Neuropsychology; intelligence quotient; disease duration; antibiotic therapy; stereotaxic surgery; aphasia; clinical effectiveness; hydrocephalus; meningitis; gadolinium; Temporal lobe epilepsy; temporal lobectomy; visual memory; verbal memory; postoperative depression; anomia; stereotactic device; radiofrequency ablation; anteromesial temporal lobectomy; Epilepsy surgery; global memory; guide wire; Hippocampal sclerosis; memory assessment; meningism; neurological equipment; Seizure outcome; shunting; stereotactic radiofrequency amygdalohippocampectomy; thermocoagulation