Transsylvian selective amygdalohippocampectomy in children with hippocampal sclerosis: seizure, intellectual and memory outcome

Seizure. 2012 Nov;21(9):699-705. doi: 10.1016/j.seizure.2012.07.012. Epub 2012 Aug 13.

Abstract

Purpose: This study investigates the efficacy of transylvian selective amygdalohippocampectomy (TS SAH) in children with medically intractable epilepsy due to unilateral hippocampal sclerosis. Post-surgical seizure control, intellectual and memory outcomes are examined.

Method: This study reports on pre- and post-surgical clinical data from 10 patients who underwent TS SAH between 2002 and 2010 after 24 months follow-up. Pre- and post-operative change in seizure frequency, AED use, intellect and memory are compared.

Results: At 12 months and 24 months post-surgery, 9/10 (90%) and 7/8 (87.5%) patients respectively, were seizure free (Engel I). No patients were classed as Engel III or IV. No significant improvement or decline at a group level was found on measures of intellect or verbal or visual memory. One hundred per cent improved or remained within 1 SD of their pre-operatives score on verbal and perceptual reasoning learning and reasoning measures. Significant improvement was found post-operatively for both immediate and delayed facial memory.

Conclusion: Our findings of good post-surgical seizure control and favourable cognitive outcome provides evidence against previous findings that SAH in children may not be effective.

MeSH terms

  • Adolescent
  • Amygdala / pathology*
  • Amygdala / surgery
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hippocampus / pathology*
  • Hippocampus / physiology*
  • Hippocampus / surgery
  • Humans
  • Intelligence / physiology*
  • Male
  • Memory / physiology*
  • Neuropsychological Tests
  • Sclerosis
  • Seizures / pathology*
  • Seizures / surgery
  • Treatment Outcome