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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Surgical treatment of mesiotemporal epilepsy: Which surgical approach is favorable?

Meeting Abstract

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  • Barbara Schmeiser - Klinik für Neurochirurgie, Universitätsklinikum Freiburg
  • Andreas Schulze-Bonhage - Sektion Prächirurgische Epilepsiediagnostik, Universitätsklinikum Freiburg
  • Martin Schumacher - Klinik für Neuroradiologie, Universitätsklinikum Freiburg
  • Marco Prinz - Institut für Neuropathologie, Universitätsklinikum Freiburg
  • Bernhard Steinhoff - Epilepsiezentrum Kehl-Kork, Universitätsklinikum Freiburg
  • Josef Zentner - Klinik für Neurochirurgie, Universitätsklinikum Freiburg

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.16.03

doi: 10.3205/14dgnc362, urn:nbn:de:0183-14dgnc3629

Published: May 13, 2014

© 2014 Schmeiser et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: The goal of this study was to analyse the efficacy and safety of different surgical approaches in patients with pharmacoresistant mesiotemporal lobe epilepsy (MTLE).

Method: This study is based on a consecutive series of 508 surgical procedures in a total of 500 patients with medically refractory mesiotemporal lobe epilepsy operated at the Epilepsy Center Freiburg during 1998–2012. Clinical, neuroradiological and histopathological findings were evaluated. Mean duration of postoperative follow-up was 28 months.

Results: The following procedures were performed: Standard anterior temporal lobectomy with amygdalohippocampectomy (N=184, 36.2%), keyhole resections with amygdalohippocampectomy (N=48, 9.4%), lesionectomy with amygdalohippocampectomy (N=62, 12.2%), transsylvian selective amygdalohippocampectomy (N=189, 37.2%) and subtemporal selective amygladohippocampectomy (N=25, 4.9%). Overall, 270 of 387 patients (69.7%) remained seizure free (Engel I) at one year after operation and 340 (87.7%) had a worthwhile improvement (Engel I-III). We did not observe significant differences in epileptological outcome in relation to the surgical approach used. There was no death in our series. Transient morbidity including surgical and neurological complications was encountered in 93 patients (18.6%) and permanent morbidity in 20 patients (4.0%). There were no significantly differences in complications in relation to the surgical approach performed.

Conclusions: Different surgical approaches for mesiotemporal epilepsy used in this series resulted in equally favorable seizure control and surgical outcome.