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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
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Multiple hippocampal transection for mesial temporal lobe epilepsy: A systematic review.
Irakliy Abramov1, Jubran H Jubran1, Lena Mary Houlihan1
1The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ.
Seizure
|August 30, 2022
Summary
Multiple hippocampal transection (MHT) shows promise for controlling intractable epilepsy seizures. While neurocognitive benefits require further study, MHT offers a potentially effective surgical option for patients with difficult-to-treat epilepsy.
Area of Science:
- Neurosurgery
- Epilepsy Research
- Systematic Review
Background:
- Multiple hippocampal transection (MHT) is a surgical approach for intractable epilepsy.
- Evidence guiding MHT selection for specific patients is limited.
- This review focuses on seizure control and memory outcomes post-MHT.
Purpose of the Study:
- To systematically review patient-level data on Multiple hippocampal transection (MHT).
- To analyze seizure control and memory outcomes following MHT for intractable epilepsy.
- To provide evidence for neurosurgeons regarding MHT patient selection.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searched PubMed, Medline, and Embase databases up to August 2021.
- Included studies with intractable epilepsy, MHT as primary procedure, and patient-level data.
Main Results:
- Eleven studies identified 59 patients who underwent MHT.
- 75% of patients with ≥12 months follow-up achieved seizure freedom.
- Postoperative memory outcomes varied, with some patients showing improvement and others decline in both verbal and nonverbal memory.
Conclusions:
- Few patients have been analyzed following MHT.
- MHT shows promise for seizure management in intractable epilepsy.
- Further structured trials assessing MHT in isolation are needed to confirm neurocognitive benefits.
