Stereotactic radiofrequency amygdalohippocampectomy: two years of good neuropsychological outcomes.

PURPOSE

To provide two-year seizure and neuropsychological outcomes in patients treated by stereotactic radiofrequency amygdalohippocampectomy (SAHE), an alternative, minimally invasive method for the treatment of mesial temporal lobe epilepsy (MTLE).

MATERIAL AND METHODS

Thirty-seven MTLE patients treated by SAHE (26 left-sided, 11 right-sided) were included. Patients underwent neuropsychological evaluation by the Wechsler Adult Intelligence Scale-Revised and the Wechsler Memory Scale-Revised preoperatively, 1 year and 2 years after SAHE.

RESULTS

Two years after SAHE twenty-eight (75.5%) patients were assessed as Engel Class I and seven (18.9%) patients as Engel Class II. In two patients (5.4%) treatment failed, one of them was classified as Class III and one as Class IV. Irrespective of the laterality of the procedure, the group improved significantly in Global and Verbal Memory Quotients, Attention, Delayed Recall, Semantic Long-term memory subtest and Working Memory. Additionally, increases in Full-scale, Verbal and Visual Intelligence Quotients were detected on the group level.

CONCLUSION

In the present study we report good seizure control and neuropsychological outcomes after SAHE in our patients. We hypothesize that good neuropsychological results were achieved by the incomplete destruction of target structures, sparing the lateral temporal neocortex, and also partially by practice effect. Treatment failures in seizure control may be attributed to larger epileptogenic zones.