Document Detail

Outcome after cortico-amygdalo-hippocampectomy in patients with temporal lobe epilepsy and normal MRI.
MedLine Citation:
PMID:  20494592     Owner:  NLM     Status:  MEDLINE    
RATIONALE: We describe seizure and neuropsychological outcome obtained after CAH in patients with TLE and normal MRI evaluated in the modern imaging era.
METHODS: Forty-five adult consecutive patients with TLE and normal MRI were studied. All patients had neuropsychological testing, interictal and ictal EEG recordings and MRI. They were divided into two groups: Group 1 (n=18), included patients in whom non-invasive neurophysiological evaluation was lateralizing and Group 2 (n=27) included patients with non-lateralizing neurophysiological data who were submitted to invasive recordings.
RESULTS: Seventy-seven percent of the Group 1 patients were rated as Engel I; 11% were rated as Engel II and 11% as Engel III. In Group 2, there were 57% of patients seizure-free, 26% in Engel II and 14% in Engel III. Pre-operatively, mean general IQ was 82 and 78 in Groups 1 and 2, respectively; post-operatively, mean general IQ was respectively 86 and 71. Some degree of verbal memory decline was noted in all patients submitted to dominant temporal lobe resection in both Groups 1 and 2. At last follow-up visit, 22% of Group 1 and 11% of Group 2 patients were receiving no antiepileptic drugs (AED).
CONCLUSIONS: Our data showed that patients with TLE and normal MRI could get good surgical results after CAH although 60% of them would need invasive recordings and their results regarding seizure control and cognition were worse than those obtained in patients with MRI defined temporal lobe lesions. Caution should be taken in offering dominant temporal lobe resection to this subset of patients.
Arthur Cukiert; José Augusto Burattini; Pedro Paulo Mariani; Cristine Mella Cukiert; Meire Argentoni; Carla Baise-Zung; Cássio Roberto Forster; Valeria Antakli Mello
Publication Detail:
Type:  Journal Article     Date:  2010-05-21
Journal Detail:
Title:  Seizure     Volume:  19     ISSN:  1532-2688     ISO Abbreviation:  Seizure     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-13     Completed Date:  2010-10-19     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  319-23     Citation Subset:  IM    
Copyright Information:
2010 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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MeSH Terms
Age of Onset
Amygdala / pathology,  surgery*
Cerebral Cortex / pathology,  surgery*
Epilepsy, Temporal Lobe / pathology,  surgery*
Follow-Up Studies
Functional Laterality / physiology
Hippocampus / pathology,  surgery*
Magnetic Resonance Imaging
Memory / physiology
Memory Disorders / etiology,  psychology,  therapy
Neuropsychological Tests
Seizures / etiology,  surgery
Treatment Outcome
Young Adult

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