MRI-guided stereotactic amygdalohippocampectomy: a single center experience

Zdenek Vojtěch,1 Hana Malíková,2 Lenka Krámská,3 Roman Li&scaron;čák,4 Vilibald Vladyka41Department of Neurology, 2Department of Radiodiagnostics, 3Department of Psychology, 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce...

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Autores principales:	Vojtěch Z, Malíková H, Krámská L, Li&scaron;čák R, Vladyka V
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/4bbf96a7a9a24b13a76028a6e819af70
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spelling	oai:doaj.org-article:4bbf96a7a9a24b13a76028a6e819af702021-12-02T07:40:30ZMRI-guided stereotactic amygdalohippocampectomy: a single center experience1178-2021https://doaj.org/article/4bbf96a7a9a24b13a76028a6e819af702015-02-01T00:00:00Zhttp://www.dovepress.com/mri-guided-stereotactic-amygdalohippocampectomy-a-single-center-experi-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021 Zdenek Vojtěch,1 Hana Malíková,2 Lenka Krámská,3 Roman Li&scaron;čák,4 Vilibald Vladyka41Department of Neurology, 2Department of Radiodiagnostics, 3Department of Psychology, 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech RepublicBackground: This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy 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.Keywords: temporal lobe epilepsy, epilepsy surgery, neuropsychology, hippocampal sclerosis, seizure outcomeVojtěch ZMalíková HKrámská LLi&scaron;čák RVladyka VDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2015, Iss default, Pp 359-374 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Vojtěch Z Malíková H Krámská L Li&scaron;čák R Vladyka V MRI-guided stereotactic amygdalohippocampectomy: a single center experience
description	Zdenek Vojtěch,1 Hana Malíková,2 Lenka Krámská,3 Roman Li&scaron;čák,4 Vilibald Vladyka41Department of Neurology, 2Department of Radiodiagnostics, 3Department of Psychology, 4Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech RepublicBackground: This paper presents our experience of stereotactic radiofrequency amygdalohippocampectomy 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.Keywords: temporal lobe epilepsy, epilepsy surgery, neuropsychology, hippocampal sclerosis, seizure outcome
format	article
author	Vojtěch Z Malíková H Krámská L Li&scaron;čák R Vladyka V
author_facet	Vojtěch Z Malíková H Krámská L Li&scaron;čák R Vladyka V
author_sort	Vojtěch Z
title	MRI-guided stereotactic amygdalohippocampectomy: a single center experience
title_short	MRI-guided stereotactic amygdalohippocampectomy: a single center experience
title_full	MRI-guided stereotactic amygdalohippocampectomy: a single center experience
title_fullStr	MRI-guided stereotactic amygdalohippocampectomy: a single center experience
title_full_unstemmed	MRI-guided stereotactic amygdalohippocampectomy: a single center experience
title_sort	mri-guided stereotactic amygdalohippocampectomy: a single center experience
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/4bbf96a7a9a24b13a76028a6e819af70
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MRI-guided stereotactic amygdalohippocampectomy: a single center experience

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