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Transcortical selective amygdalohippocampectomy for intractable mesial temporal lobe epilepsy: a review of outcomes in a single center

  • Aris Catur Bintoro ,
  • Muhamad Thohar Arifin ,
  • Harsono ,
  • Amin Husni ,
  • Surya Pratama Brilliantika ,
  • Yuriz Bakhtiar ,
  • Novita Ikbar Khairunnisa ,
  • Rofat Askoro ,
  • Jacob Bunyamin ,
  • Soeharyo Hadisapurto ,
  • Zainal Muttaqin ,


Abstract

Introduction: Various surgical procedures have been found to effectively treat intractable temporal lobe epilepsy (TLE), including transcortical selective amygdalohippocampectomy (SAH), which is intended to protect the temporal lobe and to prevent interference with vascular structure. This research analyzed the outcome of post-operative seizure-free with transcortical selective amygdalohippocampectomy for intractable mesial temporal lobe epilepsy patients in a minimum two-year follow-up after surgery.

Methods: Data of one hundred ninety-two patients who had undergone transcortical selective amygdalohippocampectomy for non-lesional, medically intractable, temporal lobe epilepsy were analyzed.

Result: The statistical analysis indicated that Focal to Bilateral Tonic-Clonic Seizure had a more significant outcome (p=0.019) than other seizures. In all research subjects, after three, six, and twelve years of follow-up, the chance for a seizure-free after surgery was respectively 93.2 percent, 67.9 percent, and 36.7 percent with a median average survival period for all subjects of 11.00 years (95 % CI: 8.55 – 13.44)

Conclusions: Transcortical selective amygdalohippocampectomy is an effective therapy for intractable mesial temporal lobe epilepsy and provides a satisfactory outcome. The transcortical approach allows an appropriate operative field by careful dissection with limited retraction to eliminate the epileptogenic target while preventing damage to the underlying vascular and cortical structures.

Keywords: Temporal lobe epilepsy selective amygdalohippocampectomy seizure outcome

References

  1. Engel J. Epileptic Seizures. Seizures and Epilepsy. Oxford University Press; 2013. p. 193–242. Available from: http://dx.doi.org/10.1093/med/9780195328547.003.0006
  2. Muzumdar D, Patil M, Goel A, Ravat S, Sawant N, Shah U. Mesial temporal lobe epilepsy – An overview of surgical techniques. Int J Surg. 2016;36:411–9. Available from: http://dx.doi.org/10.1016/j.ijsu.2016.10.027
  3. Asadi-Pooya AA, Rostami C. History of surgery for temporal lobe epilepsy. Epilepsy & Behav. 2017;70:57–60. Available from: http://dx.doi.org/10.1016/j.yebeh.2017.02.020
  4. Alonso Vanegas MA, Lew SM, Morino M, Sarmento SA. Microsurgical techniques in temporal lobe epilepsy. Epilepsia. 2017;58:10–8. Available from: http://dx.doi.org/10.1111/epi.13684
  5. Wieser G. Role of Surgery in the Therapy of Epilepsy. Eur Neurol. 1994;34(1):66–70. Available from: http://dx.doi.org/10.1159/000119513
  6. Weiser HG. Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis. Epilepsia. 2004;45(6):695–714. Available from: http://dx.doi.org/10.1111/j.0013-9580.2004.09004.x
  7. Wieser HG, Ortega M, Friedman A, Yonekawa Y. Long-term seizure outcomes following amygdalohippocampectomy. J Neurosurg. 2003;98(4):751–63. Available from: http://dx.doi.org/10.3171/jns.2003.98.4.0751
  8. Dorfer C, Czech T, Aull-Watschinger S, Baumgartner C, Jung R, Kasprian G, et al. Mesial temporal lobe epilepsy: long-term seizure outcome of patients primarily treated with transsylvian selective amygdalohippocampectomy. J Neurosurg. 2018;129(1):174–81. Available from: http://dx.doi.org/10.3171/2017.4.jns162699
  9. von Rhein B, Nelles M, Urbach H, Von Lehe M, Schramm J, Helmstaedter C. Neuropsychological outcome after selective amygdalohippocampectomy: subtemporal versus transsylvian approach. J Neurol Neurosurg & Psychiatry. 2012;83(9):887–93. Available from: http://dx.doi.org/10.1136/jnnp-2011-302025
  10. Bujarski KA, Hirashima F, Roberts DW, Jobst BC, Gilbert KL, Roth RM, et al. Long-term seizure, cognitive, and psychiatric outcome following trans-middle temporal gyrus amygdalohippocampectomy and standard temporal lobectomy. J Neurosurg. 2013/04/26. 2013;119(1):16–23. Available from: https://pubmed.ncbi.nlm.nih.gov/23621601
  11. Krámská L, Vojtěch Z, Lukavský J, Stará M, Malíková H. Five-Year Neuropsychological Outcome after Stereotactic Radiofrequency Amygdalohippocampectomy for Mesial Temporal Lobe Epilepsy: Longitudinal Study. Stereotact Funct Neurosurg. 2017;95(3):149–57. Available from: http://dx.doi.org/10.1159/000468527
  12. Chang RS, Leung CYW, Ho CCA, Yung A. Classifications of seizures and epilepsies, where are we? – A brief historical review and update. J Formos Med Assoc. 2017;116(10):736–41. Available from: http://dx.doi.org/10.1016/j.jfma.2017.06.001
  13. Wiebe S. Effectiveness and Safety of Epilepsy Surgery: What is the Evidence? CNS Spectr. 2004;9(2):120–32. Available from: http://dx.doi.org/10.1017/s1092852900008488
  14. Wiebe S, Blume WT, Girvin JP, Eliasziw M. A Randomized, Controlled Trial of Surgery for Temporal-Lobe Epilepsy. N Engl J Med. 2001;345(5):311–8. Available from: http://dx.doi.org/10.1056/nejm200108023450501
  15. Engel J Jr, McDermott MP, Wiebe S, Langfitt JT, Stern JM, Dewar S, Sperling MR, Gardiner I, Erba G, Fried I, Jacobs M, Vinters HV, Mintzer S, Kieburtz K; Early Randomized Surgical Epilepsy Trial (ERSET) Study Group. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. JAMA. 2012;307(9):922-30. Available from: doi: 10.1001/jama.2012.220.
  16. Englot DJ. A modern epilepsy surgery treatment algorithm: Incorporating traditional and emerging technologies. Epilepsy Behav. 2018/02/02. 2018;80:68–74. Available from: https://pubmed.ncbi.nlm.nih.gov/29414561
  17. Hu W-H, Zhang C, Zhang K, Meng F-G, Chen N, Zhang J-G. Selective amygdalohippocampectomy versus anterior temporal lobectomy in the management of mesial temporal lobe epilepsy: a meta-analysis of comparative studies. J Neurosurg. 2013;119(5):1089–97. Available from: http://dx.doi.org/10.3171/2013.8.jns121854
  18. Josephson CB, Dykeman J, Fiest KM, Liu X, Sadler RM, Jette N, et al. Systematic review and meta-analysis of standard vs selective temporal lobe epilepsy surgery. Neurology. 2013;80(18):1669–76. Available from: http://dx.doi.org/10.1212/wnl.0b013e3182904f82
  19. Tanriverdi T, Poulin N, Olivier A. Life 12 years after temporal lobe epilepsy surgery: A long-term, prospective clinical study. Seizure. 2008;17(4):339–49. Available from: http://dx.doi.org/10.1016/j.seizure.2007.11.003
  20. Mohan M, Keller S, Nicolson A, Biswas S, Smith D, Osman Farah J, et al. The long-term outcomes of epilepsy surgery. PLoS One. 2018;13(5):e0196274–e0196274. Available from: https://pubmed.ncbi.nlm.nih.gov/29768433
  21. Camfield CS, Camfield PR. The adult seizure and social outcomes of children with partial complex seizures. Brain. 2013;136(2):593–600. Available from: http://dx.doi.org/10.1093/brain/aws352
  22. Adada B. Selective amygdalohippocampectomy via the transsylvian approach. Neurosurg Focus. 2008;25(3):E5. Available from: http://dx.doi.org/10.3171/foc/2008/25/9/e5
  23. Wheatley BM. Selective amygdalohippocampectomy: the trans-middle temporal gyrus approach. Neurosurg Focus. 2008;25(3):E4. Available from: http://dx.doi.org/10.3171/foc/2008/25/9/e4
  24. Lutz MT, Clusmann H, Elger CE, Schramm J, Helmstaedter C. Neuropsychological Outcome after Selective Amygdalohippocampectomy with Transsylvian versus Transcortical Approach: A Randomized Prospective Clinical Trial of Surgery for Temporal Lobe Epilepsy. Epilepsia. 2004;45(7):809–16. Available from: http://dx.doi.org/10.1111/j.0013-9580.2004.54003.x
  25. Rao MB, Radhakrishnan K. Is Epilepsy Surgery Possible in Countries with Limited Resources’. Epilepsia. 2000;41(s4):S31–4. Available from: http://dx.doi.org/10.1111/j.1528-1157.2000.tb01543.x
  26. Mbuba CK, Ngugi AK, Newton CR, Carter JA. The epilepsy treatment gap in developing countries: a systematic review of the magnitude, causes, and intervention strategies. Epilepsia. 2008/06/13. 2008;49(9):1491–503. Available from: https://pubmed.ncbi.nlm.nih.gov/18557778

How to Cite

Bintoro, A. C. ., Arifin, M. T., Harsono, Husni, A. ., Brilliantika, S. P. ., Bakhtiar, Y. ., Khairunnisa, N. I. ., Askoro, R. ., Bunyamin, J. ., Hadisapurto, S. ., & Muttaqin, Z. . (2022). Transcortical selective amygdalohippocampectomy for intractable mesial temporal lobe epilepsy: a review of outcomes in a single center. Bali Medical Journal, 11(3), 1468–1475. https://doi.org/10.15562/bmj.v11i3.3475
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Aris Catur Bintoro
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Muhamad Thohar Arifin
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Harsono
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Amin Husni
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Surya Pratama Brilliantika
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Yuriz Bakhtiar
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Novita Ikbar Khairunnisa
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Rofat Askoro
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Jacob Bunyamin
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Soeharyo Hadisapurto
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Zainal Muttaqin
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