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Vascular events after transsylvian selective amygdalohippocampectomy and impact on epilepsy outcome

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Vascular events after transsylvian selective amygdalohippocampectomy and impact on epilepsy outcome. / Martens, Tobias; Merkel, Martin; Holst, Brigitte; Brückner, Katja; Lindenau, Matthias; Stodieck, Stefan; Fiehler, Jens; Westphal, Manfred; Heese, Oliver.

In: EPILEPSIA, Vol. 55, No. 5, 2015, p. 763-769.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Martens, T, Merkel, M, Holst, B, Brückner, K, Lindenau, M, Stodieck, S, Fiehler, J, Westphal, M & Heese, O 2015, 'Vascular events after transsylvian selective amygdalohippocampectomy and impact on epilepsy outcome', EPILEPSIA, vol. 55, no. 5, pp. 763-769.

APA

Martens, T., Merkel, M., Holst, B., Brückner, K., Lindenau, M., Stodieck, S., Fiehler, J., Westphal, M., & Heese, O. (2015). Vascular events after transsylvian selective amygdalohippocampectomy and impact on epilepsy outcome. EPILEPSIA, 55(5), 763-769.

Vancouver

Martens T, Merkel M, Holst B, Brückner K, Lindenau M, Stodieck S et al. Vascular events after transsylvian selective amygdalohippocampectomy and impact on epilepsy outcome. EPILEPSIA. 2015;55(5):763-769.

Bibtex

@article{8e5c5dab3c7e4a9eb209222700169093,
title = "Vascular events after transsylvian selective amygdalohippocampectomy and impact on epilepsy outcome",
abstract = "OBJECTIVE: Epilepsy surgery is a standard treatment option for medically intractable temporal lobe epilepsy. Selective amygdalohippocampectomy (SAH) and anterior temporal lobectomy (ATL) are two of the standard surgical procedures in these cases. We conducted a retrospective analysis of patients treated with SAH via a modified transsylvian approach in our epilepsy center between 2008 and 2011, and we analyzed the impact of adjacent procedure-related infarctions on seizure outcome in these patients.METHODS: Infarctions were detected by magnetic resonance imaging (MRI) within the first week postoperatively and by a second MRI 9 months after surgical intervention. Neuropsychological testing was performed preoperatively. Evaluation of seizure outcome and postoperative neuropsychological testing were conducted approximately 1 year after epilepsy surgery. Correlative clinical data were analyzed by retrospective chart review.RESULTS: The postoperative MRI revealed temporal infarctions in 47.9% (n = 23/48) and frontal infarctions in 10.4% (n = 5/48) of the patients. These vascular events were asymptomatic in terms of focal neurologic deficits. Of the patients, 68.5% (n = 37/54) were free of disabling seizures (Engel class I) 1 year after the procedure. Patients with temporal infarctions were significantly more often free of disabling seizures (Engel class I, p = 0.046) than patients without temporal infarctions. Neuropsychological testing indicated a deterioration in verbal memory after SAH in patients with infarctions on the language-lateralized hemisphere compared to patients without infarction (p = 0.011). All other tested neuropsychological categories showed no significant differences between patients with or without infarctions.SIGNIFICANCE: Our results indicate a surprisingly high number of procedure-related temporal infarctions after transsylvian SAH. Hence, the volume of nonfunctional {"}eliminated{"} tissue is enlarged unintentionally, which is a possible explanation for better seizure outcome in these patients. This result supports the notion that ATL is the favorable procedure for temporal lobe epilepsy compared to SAH in the nondominant hemisphere, as neuropsychological deficits are rarely to be expected.",
author = "Tobias Martens and Martin Merkel and Brigitte Holst and Katja Br{\"u}ckner and Matthias Lindenau and Stefan Stodieck and Jens Fiehler and Manfred Westphal and Oliver Heese",
year = "2015",
language = "Deutsch",
volume = "55",
pages = "763--769",
journal = "EPILEPSIA",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "5",

}

RIS

TY - JOUR

T1 - Vascular events after transsylvian selective amygdalohippocampectomy and impact on epilepsy outcome

AU - Martens, Tobias

AU - Merkel, Martin

AU - Holst, Brigitte

AU - Brückner, Katja

AU - Lindenau, Matthias

AU - Stodieck, Stefan

AU - Fiehler, Jens

AU - Westphal, Manfred

AU - Heese, Oliver

PY - 2015

Y1 - 2015

N2 - OBJECTIVE: Epilepsy surgery is a standard treatment option for medically intractable temporal lobe epilepsy. Selective amygdalohippocampectomy (SAH) and anterior temporal lobectomy (ATL) are two of the standard surgical procedures in these cases. We conducted a retrospective analysis of patients treated with SAH via a modified transsylvian approach in our epilepsy center between 2008 and 2011, and we analyzed the impact of adjacent procedure-related infarctions on seizure outcome in these patients.METHODS: Infarctions were detected by magnetic resonance imaging (MRI) within the first week postoperatively and by a second MRI 9 months after surgical intervention. Neuropsychological testing was performed preoperatively. Evaluation of seizure outcome and postoperative neuropsychological testing were conducted approximately 1 year after epilepsy surgery. Correlative clinical data were analyzed by retrospective chart review.RESULTS: The postoperative MRI revealed temporal infarctions in 47.9% (n = 23/48) and frontal infarctions in 10.4% (n = 5/48) of the patients. These vascular events were asymptomatic in terms of focal neurologic deficits. Of the patients, 68.5% (n = 37/54) were free of disabling seizures (Engel class I) 1 year after the procedure. Patients with temporal infarctions were significantly more often free of disabling seizures (Engel class I, p = 0.046) than patients without temporal infarctions. Neuropsychological testing indicated a deterioration in verbal memory after SAH in patients with infarctions on the language-lateralized hemisphere compared to patients without infarction (p = 0.011). All other tested neuropsychological categories showed no significant differences between patients with or without infarctions.SIGNIFICANCE: Our results indicate a surprisingly high number of procedure-related temporal infarctions after transsylvian SAH. Hence, the volume of nonfunctional "eliminated" tissue is enlarged unintentionally, which is a possible explanation for better seizure outcome in these patients. This result supports the notion that ATL is the favorable procedure for temporal lobe epilepsy compared to SAH in the nondominant hemisphere, as neuropsychological deficits are rarely to be expected.

AB - OBJECTIVE: Epilepsy surgery is a standard treatment option for medically intractable temporal lobe epilepsy. Selective amygdalohippocampectomy (SAH) and anterior temporal lobectomy (ATL) are two of the standard surgical procedures in these cases. We conducted a retrospective analysis of patients treated with SAH via a modified transsylvian approach in our epilepsy center between 2008 and 2011, and we analyzed the impact of adjacent procedure-related infarctions on seizure outcome in these patients.METHODS: Infarctions were detected by magnetic resonance imaging (MRI) within the first week postoperatively and by a second MRI 9 months after surgical intervention. Neuropsychological testing was performed preoperatively. Evaluation of seizure outcome and postoperative neuropsychological testing were conducted approximately 1 year after epilepsy surgery. Correlative clinical data were analyzed by retrospective chart review.RESULTS: The postoperative MRI revealed temporal infarctions in 47.9% (n = 23/48) and frontal infarctions in 10.4% (n = 5/48) of the patients. These vascular events were asymptomatic in terms of focal neurologic deficits. Of the patients, 68.5% (n = 37/54) were free of disabling seizures (Engel class I) 1 year after the procedure. Patients with temporal infarctions were significantly more often free of disabling seizures (Engel class I, p = 0.046) than patients without temporal infarctions. Neuropsychological testing indicated a deterioration in verbal memory after SAH in patients with infarctions on the language-lateralized hemisphere compared to patients without infarction (p = 0.011). All other tested neuropsychological categories showed no significant differences between patients with or without infarctions.SIGNIFICANCE: Our results indicate a surprisingly high number of procedure-related temporal infarctions after transsylvian SAH. Hence, the volume of nonfunctional "eliminated" tissue is enlarged unintentionally, which is a possible explanation for better seizure outcome in these patients. This result supports the notion that ATL is the favorable procedure for temporal lobe epilepsy compared to SAH in the nondominant hemisphere, as neuropsychological deficits are rarely to be expected.

M3 - SCORING: Zeitschriftenaufsatz

VL - 55

SP - 763

EP - 769

JO - EPILEPSIA

JF - EPILEPSIA

SN - 0013-9580

IS - 5

ER -