Acta Neurochirurgica

, Volume 156, Issue 8, pp 1529–1537

Long-term seizure outcome after stereotactic amygdalohippocampectomy

  • Zdeněk Vojtěch
  • Hana Malíková
  • Lenka Krámská
  • Jiří Anýž
  • Martin Syrůček
  • Josef Zámečník
  • Roman Liščák
  • Vilibald Vladyka
Clinical Article - Functional

DOI: 10.1007/s00701-014-2126-5

Cite this article as:
Vojtěch, Z., Malíková, H., Krámská, L. et al. Acta Neurochir (2014) 156: 1529. doi:10.1007/s00701-014-2126-5

Abstract

Background

The aim of the study was to evaluate the long-term seizure outcome and complications after stereotactic radiofrequency amygdalohippocampectomy (SAHE) performed for mesial temporal lobe epilepsy (MTLE).

Methods

The article describes the cases of 61 patients who were treated at our institution during the period 2004–2010. Mean post-operative follow-up was 5.3 years.

Results

At the 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 haematomas. One of them caused acute hydrocephalus and was treated by shunting and resolved without sequelae. After SAHE, we performed open epilepsy surgery and re-thermo lesions in three and two patients, respectively (8.2 %). There were two cases of meningitis which required antibiotic treatment. In six patients psychiatric disorders developed and one of these committed suicide due to postoperative depression.

Conclusions

Our results provide preliminary evidence for good long-term seizure outcomes after SAHE. SAHE could be an alternative therapy for MTLE.

Keywords

Stereotactic neurosurgeryTemporal lobe epilepsyEpilepsy surgeryHippocampal sclerosis

Supplementary material

701_2014_2126_MOESM1_ESM.xlsx (17 kb)
Table AHistorical data and evaluation results. Patients with less than perfect agreement of preoperative results are set off in red. Patients with another potentially epileptogenic lesion are blue. The patient with both conditions is green. Abbreviations: MRI= magnetic resonance imaging, PET= FDG positron emission tomography, scalp/invasive=scalp ictal pattern lateralization/invasive study performed or not, PT= perinatal trauma, FS= febrile seizure, TBI= traumatic brain injury, ME= meningoencephalitis, n.II/str.= optic nerve atrophy, strabism, LE= limbic encephalitis, HS= hippocampal sclerosis, dx/sin/biL/neg= right/left/bilateral/negative, dysplP= dysplastic parahippocampal gyrus, dyspl biO= bilaterally dysplastic occipital cortex, PVH= periventricular heterotopia, NP= not performed, N/A= not applicable. (XLSX 17 kb)
701_2014_2126_MOESM2_ESM.xlsx (18 kb)
Table BEarly and late complications, outcome with respect to seizures. Abbreviations: M= meningitis, DP= transient dysphasia, CC= cortical contussion, PE= pulmonary embolism, SDH= subdural hematoma, MS/P= stiffness of the neck, lumbar tap performed, MS/N= stiffness of the neck, lumbar tap not performed, QA= quadrantanopia, H= headache, BP= broken tip of the probe, ICH= intracerebral hematoma, OH= obstructive hydrocephalus, ATL= anterotemporal lobectomy, PA= pituitary adenoma, VNS imp/expl= vagus nerve stimulator implanted/explanted, re-SAHE= repeated SAHE, D= depression, PD= decompensated personality disorder, PNES= psychogenic non-epileptic seizure. R= reduced, U= unchanged, I= increased, CH= changed, RR= relapse. (XLSX 18 kb)

Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Zdeněk Vojtěch
    • 1
  • Hana Malíková
    • 3
  • Lenka Krámská
    • 2
  • Jiří Anýž
    • 6
  • Martin Syrůček
    • 4
  • Josef Zámečník
    • 7
  • Roman Liščák
    • 5
  • Vilibald Vladyka
    • 5
  1. 1.Department of NeurologyNa Homolce HospitalPragueCzech Republic
  2. 2.Department of PsychologyNa Homolce HospitalPragueCzech Republic
  3. 3.Department of RadiologyNa Homolce HospitalPragueCzech Republic
  4. 4.Department of PathologyNa Homolce HospitalPragueCzech Republic
  5. 5.Department of Stereotactic and Radiation NeurosurgeryNa Homolce HospitalPragueCzech Republic
  6. 6.Department of Cybernetics, Faculty of Electrical EngineeringCzech Technical UniversityPragueCzech Republic
  7. 7.Department of Pathology and Molecular Medicine, 2nd Faculty of MedicineCharles UniversityPragueCzech Republic