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Stereotactic radiofrequency amygdalohippocampectomy in the treatment of mesial temporal lobe epilepsy

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Abstract

Purpose

Minimally invasive percutaneous single trajectory stereotactic radiofrequency amygdalohippocampectomy was used to treat mesial temporal lobe epilepsy (MTLE). The aim of the study was to evaluate complications and effectiveness of this procedure.

Materials and methods

A group of 51 patients with MTLE was treated using stereotactic thermo-lesion of amygdalohippocampal complex under local anaesthesia. The target was reached through the occipital approach with a single trajectory using MRI stereotactic localisation. Thermocoagulation of the amygdalohippocampal complex was planned according to the individual anatomy of each patient. Amygdalohippocampectomy was performed using a string electrode with a 10-mm active tip, and 16–38 lesions (median = 25) were performed in all patients along the 30- to 45-mm trajectory (median = 35) in the amygdalohippocampal complex.

Results

The procedure was well tolerated by all patients with no severe permanent morbidity; meningitis was recorded in two patients (4%), hematoma was detected in four patients, clinically insignificant in three of them, and one patient required temporary ventricular drainage (2%). Thirty-two patients were followed up over at least 2 years, and the clinical outcomes were evaluated by Engel’s classification; 25 of them (78%) were Engel I, five (16%) were Engel II, and two (6%) were Engel IV.

Conclusions

Stereotactic amygdalohippocampectomy is a minimally invasive procedure with low morbidity and good results that can be the method of choice in selected patients with MTLE.

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Authors and Affiliations

  1. Department of Stereotactic and Radiation Neurosurgery, Hospital Na Homolce, Roentgenova 2, Prague, 150 30, Czech Republic

    Roman Liscak & Vilibald Vladyka

  2. Department of Radiology, Hospital Na Homolce, Roentgenova 2, Prague, 150 30, Czech Republic

    Hana Malikova

  3. Department of Neurology, Hospital Na Homolce, Roentgenova 2, Prague, 150 30, Czech Republic

    Miroslav Kalina, Zdenek Vojtech & Tomas Prochazka

  4. Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol Hospital, Prague, Czech Republic

    Petr Marusic

Authors
  1. Roman Liscak
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  2. Hana Malikova
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  3. Miroslav Kalina
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  4. Zdenek Vojtech
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  5. Tomas Prochazka
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  6. Petr Marusic
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  7. Vilibald Vladyka
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Correspondence to Roman Liscak.

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Liscak, R., Malikova, H., Kalina, M. et al. Stereotactic radiofrequency amygdalohippocampectomy in the treatment of mesial temporal lobe epilepsy. Acta Neurochir 152, 1291–1298 (2010). https://doi.org/10.1007/s00701-010-0637-2

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  • DOI: https://doi.org/10.1007/s00701-010-0637-2

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