Surgical treatment for the temporal lobe epilepsy with hippocampal sclerosis: report of 42 cases_Journal of Epilepsy

Authors：

 WANG Huanming , HU Fei , CHEN Jun , XIONG YuBo , YANG Congyang , CHEN Yang , YANG Yanping

Department of Neurosurgery, Wuhan Brain Hospital & Changhang General Hospital, Wuhan 430010, China;

Corresponding?author：

WANG Huanming, Email: 1808381741@qq.com

Keywords：

Hippocampal sclerosis; Temporal lobe epilepsy; Operation

DOI：

10.7507/2096-0247.20190032

Video：

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Objective To explore the clinical features and surgical treatment effects of the temporal lobe epilepsy with hippocampal sclerosis.Methods Forty two patients diagnosed as temporal lobe epilepsy with hippocampal sclerosis and underwent protemporal lobectomy in Wuhan Brain Hospital from Jan. 2012 to Dec. 2018 were collected, which included 30 males and 12 females, with the age between 9 to 60 years. Their disease duration ranged from 3 to 10 years. The clinical manifestations showed complex partial seizure in 18 cases, partial-secondary –generalized seizure in 4 cases, and generalized tonic-clonic seizure in 20 cases. Based on their results of clinical manifestations, combined with MRI and VEEG results, all the patients underwent anterior temporal lobectomy (including the most parts of the hippocampus and amydala).Results The postoperative pathology confirmed the diagnosis of hippocampal sclerosis. The follow-up of more than 1 year showed seizure-free in 38 cases, and significant improvement in 4 cases.Conclusions To the patients of temporal lobe epilepsy with hippocampal sclerosis, anterior temporal lobectomy should be performed (including the most parts of the hippocampus and amydala) if the VEEG monitoring results show that there are epileptic discharges in the ipsilateral temporal lobe. And the postoperative curative result is satisfactory.

Citation： WANG Huanming, HU Fei, CHEN Jun, XIONG YuBo, YANG Congyang, CHEN Yang, YANG Yanping. Surgical treatment for the temporal lobe epilepsy with hippocampal sclerosis: report of 42 cases. Journal of Epilepsy, 2019, 5(3): 182-186. doi: 10.7507/2096-0247.20190032 Copy

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8.	Briellmann RS, Kalnins RM, Berkovie SF, et al. Hippocampal pathology in refractory temporal lobe epilepsy T2-weighted signal change reflects dentate gliosis. Neurology, 2002, 58(2): 265-271.
9.	Ana MG, Juan FO. Diagnosis of mesial temporal sclerosis: sensitivity, specificity and predictive values of the quantitative analysis of magnetic resonance imaging. J Neuroradiol, 2018, 31(1): 50-59.
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11.	Susanne GM, Kenneth DL, Joyce S, et al. Spectroscopic metabolic abnormalities in mTLE with and without MRI evidence for mesial temporal sclerosis using hippocampal short-TE MRSI. Epilepsia, 2003, 44(7): 977-980.
12.	高翔, 江澄川, 洪震, 等. 海馬硬化與顳葉癲癇的關系. 上海醫科大學學報, 2000, 27(2): 115-116.
13.	段寶奇, 傅傳經, 高覺民, 等. 探討手術對海馬硬化型顳葉癲癇的療效. 中國繼續醫學教育, 2017, 8(23): 95-97.
14.	錢海燕, 馬羽, 許尚臣, 等. 前顳葉切除術與選擇性海馬杏仁核切除術治療海馬硬化性顳葉內側癲癇療效比較. 山東醫藥, 2011, 51(46): 84-85.
15.	董艷芳, 張春陽, 梅小龍, 等. 海馬硬化型癲癇的手術治療. 中華神經外科雜志, 2012, 28(1): 82-83.

1. Fernando C, William HT, Benjamin HB, et al. Neuroimaging of epilepsy. Handb Clin Neurol, 2016, 136: 985-1014.
2. Boling WW. Surgical considerations of intractable mesial temporal lobe epilepsy. Brain Sci, 2018, 8(2): 22-35.
3. Thom M. Review: hippocampal sclerosis in epilepsy: a neuropathology review. Neuropathol Appl Neurobiol, 2014, 40(5): 520-543.
4. Englot DJ, Chang EF. Rates and predictors of seizure freedom in resective epilepsy surgery: an update. Neurosurg Rev, 2014, 37(3): 389-405.
5. 譚啟富, 李齡, 吳承遠. 癲癇外科學(第二版). 北京: 人民衛生出版社, 2012, 102-105.
6. 姜保東. 海馬硬化的MRI研究進展. 醫學影像學雜志, 2008, 18(9): 1076-1080.
7. Briellmann RS, Pell GS, Wellard RM, et al. MR imaging of epilepsy: state of the art at 1.5T and potential of 3T. Epileptic Disord, 2003, 5(1): 3-20.
8. Briellmann RS, Kalnins RM, Berkovie SF, et al. Hippocampal pathology in refractory temporal lobe epilepsy T2-weighted signal change reflects dentate gliosis. Neurology, 2002, 58(2): 265-271.
9. Ana MG, Juan FO. Diagnosis of mesial temporal sclerosis: sensitivity, specificity and predictive values of the quantitative analysis of magnetic resonance imaging. J Neuroradiol, 2018, 31(1): 50-59.
10. Mueller SG, Laxer KD, Cashdollar N, et a1. Spectroscopic evidence of hippocam- -pal abnormalities in neocortical epilepsy. Eur J Neurol, 2006, 13(2): 256-260.
11. Susanne GM, Kenneth DL, Joyce S, et al. Spectroscopic metabolic abnormalities in mTLE with and without MRI evidence for mesial temporal sclerosis using hippocampal short-TE MRSI. Epilepsia, 2003, 44(7): 977-980.
12. 高翔, 江澄川, 洪震, 等. 海馬硬化與顳葉癲癇的關系. 上海醫科大學學報, 2000, 27(2): 115-116.
13. 段寶奇, 傅傳經, 高覺民, 等. 探討手術對海馬硬化型顳葉癲癇的療效. 中國繼續醫學教育, 2017, 8(23): 95-97.
14. 錢海燕, 馬羽, 許尚臣, 等. 前顳葉切除術與選擇性海馬杏仁核切除術治療海馬硬化性顳葉內側癲癇療效比較. 山東醫藥, 2011, 51(46): 84-85.
15. 董艷芳, 張春陽, 梅小龍, 等. 海馬硬化型癲癇的手術治療. 中華神經外科雜志, 2012, 28(1): 82-83.

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Surgical treatment for the temporal lobe epilepsy with hippocampal sclerosis: report of 42 cases

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