Abstract
Studies on surgery for temporal lobe epilepsy are hampered by lack of information about the actual surgery that has taken place. A method is described for accurately measuring the volumes of resection by MRI after surgery. Ten cases of surgically treated temporal lobe epilepsy (nine non-tailored resections, one selective amygdalohippocampectomy) are presented to show the technique. Indices of extent of resection in both the mesiobasal and lateral temporal lobe compartments have been measured, compared, and evaluated. By comparison with identical preoperative volumetric MRI the hippocampal resections have been correlated with the demonstrated hippocampal volume loss, thought to be of relevance in the aetiology of temporal lobe epilepsy. Detailed postoperative audit in this manner is vital in providing a rational basis for follow up studies of outcome.
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- Awad I. A., Katz A., Hahn J. F., Kong A. K., Ahl J., Lüders H. Extent of resection in temporal lobectomy for epilepsy. I. Interobserver analysis and correlation with seizure outcome. Epilepsia. 1989 Nov-Dec;30(6):756–762. doi: 10.1111/j.1528-1157.1989.tb05335.x. [DOI] [PubMed] [Google Scholar]
- Bengzon A. R., Rasmussen T., Gloor P., Dussault J., Stephens M. Prognostic factors in the surgical treatment of temporal lobe epileptics. Neurology. 1968 Aug;18(8):717–731. doi: 10.1212/wnl.18.8.717. [DOI] [PubMed] [Google Scholar]
- Cahan L. D., Sutherling W., McCullough M. A., Rausch R., Engel J., Jr, Crandall P. H. Review of the 20-year UCLA experience with surgery for epilepsy. Cleve Clin Q. 1984 Summer;51(2):313–318. doi: 10.3949/ccjm.51.2.313. [DOI] [PubMed] [Google Scholar]
- Cascino G. D., Jack C. R., Jr, Parisi J. E., Marsh W. R., Kelly P. J., Sharbrough F. W., Hirschorn K. A., Trenerry M. R. MRI in the presurgical evaluation of patients with frontal lobe epilepsy and children with temporal lobe epilepsy: pathologic correlation and prognostic importance. Epilepsy Res. 1992 Mar;11(1):51–59. doi: 10.1016/0920-1211(92)90021-k. [DOI] [PubMed] [Google Scholar]
- Cook M. J., Fish D. R., Shorvon S. D., Straughan K., Stevens J. M. Hippocampal volumetric and morphometric studies in frontal and temporal lobe epilepsy. Brain. 1992 Aug;115(Pt 4):1001–1015. doi: 10.1093/brain/115.4.1001. [DOI] [PubMed] [Google Scholar]
- Elwes R. D., Dunn G., Binnie C. D., Polkey C. E. Outcome following resective surgery for temporal lobe epilepsy: a prospective follow up study of 102 consecutive cases. J Neurol Neurosurg Psychiatry. 1991 Nov;54(11):949–952. doi: 10.1136/jnnp.54.11.949. [DOI] [PMC free article] [PubMed] [Google Scholar]
- FALCONER M. A., MEYER A., HILL D., MITCHELL W., POND D. A. Treatment of temporal-lobe epilepsy by temporal lobectomy; a survey of findings and results. Lancet. 1955 Apr 23;268(6869):827–835. doi: 10.1016/s0140-6736(55)90421-9. [DOI] [PubMed] [Google Scholar]
- Glaser G. H. Treatment of intractable temporal lobe-limbic epilepsy (complex partial seizures) by temporal lobectomy. Ann Neurol. 1980 Nov;8(5):455–459. doi: 10.1002/ana.410080502. [DOI] [PubMed] [Google Scholar]
- Jack C. R., Jr, Sharbrough F. W., Cascino G. D., Hirschorn K. A., O'Brien P. C., Marsh W. R. Magnetic resonance image-based hippocampal volumetry: correlation with outcome after temporal lobectomy. Ann Neurol. 1992 Feb;31(2):138–146. doi: 10.1002/ana.410310204. [DOI] [PubMed] [Google Scholar]
- Jack C. R., Jr, Sharbrough F. W., Marsh W. R. Use of MR imaging for quantitative evaluation of resection for temporal lobe epilepsy. Radiology. 1988 Nov;169(2):463–468. doi: 10.1148/radiology.169.2.3174994. [DOI] [PubMed] [Google Scholar]
- Jackson G. D., Berkovic S. F., Tress B. M., Kalnins R. M., Fabinyi G. C., Bladin P. F. Hippocampal sclerosis can be reliably detected by magnetic resonance imaging. Neurology. 1990 Dec;40(12):1869–1875. doi: 10.1212/wnl.40.12.1869. [DOI] [PubMed] [Google Scholar]
- Jensen I., Vaernet K. Temporal lobe epilepsy. Follow-up investigation of 74 temporal lobe resected patients. Acta Neurochir (Wien) 1977;37(3-4):173–200. doi: 10.1007/BF01402126. [DOI] [PubMed] [Google Scholar]
- Katz A., Awad I. A., Kong A. K., Chelune G. J., Naugle R. I., Wyllie E., Beauchamp G., Lüders H. Extent of resection in temporal lobectomy for epilepsy. II. Memory changes and neurologic complications. Epilepsia. 1989 Nov-Dec;30(6):763–771. doi: 10.1111/j.1528-1157.1989.tb05336.x. [DOI] [PubMed] [Google Scholar]
- Kelly P. J., Sharbrough F. W., Kall B. A., Goerss S. J. Magnetic resonance imaging-based computer-assisted stereotactic resection of the hippocampus and amygdala in patients with temporal lobe epilepsy. Mayo Clin Proc. 1987 Feb;62(2):103–108. doi: 10.1016/s0025-6196(12)61877-1. [DOI] [PubMed] [Google Scholar]
- Kim H. I., Olivier A., Jones-Gotman M., Primrose D., Andermann F. Corticoamygdalectomy in memory-impaired patients. Stereotact Funct Neurosurg. 1992;58(1-4):162–167. doi: 10.1159/000098990. [DOI] [PubMed] [Google Scholar]
- Kitchen N. D., Thomas D. G., Shorvon S. D., Fish D. R., Stevens J. M. Volumetric analysis of epilepsy surgery resections using high resolution magnetic imaging: technical report. Br J Neurosurg. 1993;7(6):651–656. doi: 10.3109/02688699308995094. [DOI] [PubMed] [Google Scholar]
- Kitchen N. D., Thomas D. G., Thompson P. J., Shorvon S. D., Fish D. R. Open stereotactic amygdalohippocampectomy--clinical, psychometric, and MRI follow-up. Acta Neurochir (Wien) 1993;123(1-2):33–38. doi: 10.1007/BF01476282. [DOI] [PubMed] [Google Scholar]
- Kratimenos G. P., Pell M. F., Thomas D. G., Shorvon S. D., Fish D. R., Smith S. J. Open stereotactic selective amygdalo-hippocampectomy for drug resistant epilepsy. Acta Neurochir (Wien) 1992;116(2-4):150–154. doi: 10.1007/BF01540868. [DOI] [PubMed] [Google Scholar]
- Kuzniecky R., Burgard S., Faught E., Morawetz R., Bartolucci A. Predictive value of magnetic resonance imaging in temporal lobe epilepsy surgery. Arch Neurol. 1993 Jan;50(1):65–69. doi: 10.1001/archneur.1993.00540010059018. [DOI] [PubMed] [Google Scholar]
- MORRIS A. A. Temporal lobectomy with removal of uncus, hippocampus, and amygdala; results for psychomotor epilepsy three to nine years after operation. AMA Arch Neurol Psychiatry. 1956 Nov;76(5):479–496. doi: 10.1001/archneurpsyc.1956.02330290023003. [DOI] [PubMed] [Google Scholar]
- Marino R., Jr, Rasmussen T. Visual field changes after temporal lobectomy in man. Neurology. 1968 Sep;18(9):825–835. doi: 10.1212/wnl.18.9.825. [DOI] [PubMed] [Google Scholar]
- Meyer F. B., Marsh W. R., Laws E. R., Jr, Sharbrough F. W. Temporal lobectomy in children with epilepsy. J Neurosurg. 1986 Mar;64(3):371–376. doi: 10.3171/jns.1986.64.3.0371. [DOI] [PubMed] [Google Scholar]
- Nayel M. H., Awad I. A., Luders H. Extent of mesiobasal resection determines outcome after temporal lobectomy for intractable complex partial seizures. Neurosurgery. 1991 Jul;29(1):55–61. doi: 10.1097/00006123-199107000-00009. [DOI] [PubMed] [Google Scholar]
- Ojemann G. A. Different approaches to resective epilepsy surgery: standard and tailored. Epilepsy Res Suppl. 1992;5:169–174. [PubMed] [Google Scholar]
- Ojemann G. A. Surgical therapy for medically intractable epilepsy. J Neurosurg. 1987 Apr;66(4):489–499. doi: 10.3171/jns.1987.66.4.0489. [DOI] [PubMed] [Google Scholar]
- PENFIELD W., BALDWIN M. Temporal lobe seizures and the technic of subtotal temporal lobectomy. Ann Surg. 1952 Oct;136(4):625–634. [PMC free article] [PubMed] [Google Scholar]
- Rougier A., Dartigues J. F., Commenges D., Claverie B., Loiseau P., Cohadon F. A longitudinal assessment of seizure outcome and overall benefit from 100 cortectomies for epilepsy. J Neurol Neurosurg Psychiatry. 1992 Sep;55(9):762–767. doi: 10.1136/jnnp.55.9.762. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Siegel A. M., Wieser H. G., Wichmann W., Yasargil G. M. Relationships between MR-imaged total amount of tissue removed, resection scores of specific mediobasal limbic subcompartments and clinical outcome following selective amygdalohippocampectomy. Epilepsy Res. 1990 May-Jun;6(1):56–65. doi: 10.1016/0920-1211(90)90009-k. [DOI] [PubMed] [Google Scholar]
- Spencer D. D., Spencer S. S., Mattson R. H., Williamson P. D., Novelly R. A. Access to the posterior medial temporal lobe structures in the surgical treatment of temporal lobe epilepsy. Neurosurgery. 1984 Nov;15(5):667–671. doi: 10.1227/00006123-198411000-00005. [DOI] [PubMed] [Google Scholar]
- Spencer D. D., Spencer S. S. Surgery for epilepsy. Neurol Clin. 1985 May;3(2):313–330. [PubMed] [Google Scholar]
- Walker A. E. Temporal lobectomy. J Neurosurg. 1967 Jun;26(6):642–649. doi: 10.3171/jns.1967.26.6.0642. [DOI] [PubMed] [Google Scholar]
- Wolf R. L., Ivnik R. J., Hirschorn K. A., Sharbrough F. W., Cascino G. D., Marsh W. R. Neurocognitive efficiency following left temporal lobectomy: standard versus limited resection. J Neurosurg. 1993 Jul;79(1):76–83. doi: 10.3171/jns.1993.79.1.0076. [DOI] [PubMed] [Google Scholar]
- Yaşargil M. G., Teddy P. J., Roth P. Selective amygdalo-hippocampectomy. Operative anatomy and surgical technique. Adv Tech Stand Neurosurg. 1985;12:93–123. doi: 10.1007/978-3-7091-7008-3_2. [DOI] [PubMed] [Google Scholar]



