Transsylvian selective amygdalohippocampectomy in children with hippocampal sclerosis: Seizure, intellectual and memory outcome

Beaton, Anne E., Durnford, Andrew, Heffer-Rahn, Phillip E., Kirkham, Fenella, Griffin, Angela and Gray, W. L.S. (2012) Transsylvian selective amygdalohippocampectomy in children with hippocampal sclerosis: Seizure, intellectual and memory outcome. Seizure, 21 (9), 699-705. (doi:10.1016/j.seizure.2012.07.012).

Abstract

Purpose: This study investigates the efficacy of transylvian selective amygdalohippocampectomy (TS SAH) in children with medically intractable epilepsy due to unilateral hippocampal sclerosis. Post-surgical seizure control, intellectual and memory outcomes are examined. Method: This study reports on pre- and post-surgical clinical data from 10 patients who underwent TS SAH between 2002 and 2010 after 24 months follow-up. Pre- and post-operative change in seizure frequency, AED use, intellect and memory are compared. Results: At 12 months and 24 months post-surgery, 9/10 (90%) and 7/8 (87.5%) patients respectively, were seizure free (Engel I). No patients were classed as Engel III or IV. No significant improvement or decline at a group level was found on measures of intellect or verbal or visual memory. One hundred per cent improved or remained within 1 SD of their pre-operatives score on verbal and perceptual reasoning learning and reasoning measures. Significant improvement was found post-operatively for both immediate and delayed facial memory. Conclusion: Our findings of good post-surgical seizure control and favourable cognitive outcome provides evidence against previous findings that SAH in children may not be effective.

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Contributors

Author: Fenella Kirkham

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