We are witnessing a renaissance of the surgical treatment of epilepsy, with renewed interest in the classic procedures and development of new ones such as selective amygdalohippocampectomy. Surgery is being increasingly used in the treatment of medically intractable seizures. Exact presurgical evaluation, with definition of the focus, is of the utmost importance and good results are largely dependent on case selection for surgical therapy. The various therapeutic options such as temporal lobectomy, selective amygdalohippocampectomy, extratemporal cortical resections, hemispherectomy and corpus callosotomy are described and the risks and benefits of surgery discussed. Selective amygdalohippocampectomy, anterior temporal lobectomy and hemispherectomy yield very rewarding results as regards seizure control, while corpus callosotomies frequently reduce the number and severity of generalized seizures.
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Front Neurol
December 2024
Department of Diagnostic Radiology, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.
Acta Neurochir (Wien)
November 2024
Department of Neurosurgery, University of Chicago, Chicago, IL, USA.
Background: This study compares Selective Amygdalohippocampectomy (SAHE) and Anterior Temporal Lobectomy (ATL) for temporal lobe epilepsy (TLE), focusing on seizure control and visual field deficits (VFD). While previous research suggests potential benefits of SAHE, this meta-analysis aims to clarify the comparative effectiveness of bothprocedures.
Methods: This study adhered to PRISMA guidelines, comparing seizure outcomes and VFDs between SAHE and ATL for temporal lobe epilepsy.
Surg Radiol Anat
November 2024
Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
Purpose: Mesial temporal lobe epilepsy is a common form of focal drug resistant epilepsy in adults. Various mesial temporal lobe structures are integral in the genesis of temporal seizures and the hippocampal sclerosis is the primary neuropathological finding in these cases. Surgical treatment is considered the preferred management.
View Article and Find Full Text PDFPediatr Neurol
January 2025
Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
Background: Epilepsy surgery can potentially cure pharmacoresistant temporal lobe epilepsy (TLE) in children. However, surgical failures, where patients continue to experience seizures, still exist. We evaluated outcomes in pediatric patients after resective temporal lobe surgery to identify risk factors for failure.
View Article and Find Full Text PDFNeurochirurgie
November 2024
Department of Neurosurgery, Fleni. Montañeses 2325, Buenos Aires, Argentina; Department of Neurosurgery, Garrahan Children's Hospital, Buenos Aires, Argentina.
Purpose: Since it was first described in the 1970s, functional hemispherotomy has been an essential tool in treating disabling, medically refractory epilepsy resulting from diffuse unilateral hemispheric disease. We report our experience with 23 patients who underwent hemispherotomy, both using the functional hemispherotomy (FH) as well as a modified peri-insular hemispherotomy (PIH) technique. We present the surgical technique for the latter, review outcomes following disconnection surgery and discuss the differences between the techniques when it comes to complications and postoperative results.
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