Consequences of mesial temporal sparing temporal lobe surgery in medically refractory epilepsy
| Autor: | Joseph I. Tracy, Michael R. Sperling, Christopher Skidmore, Richard Gorniak, Caio M. Matias, Chengyuan Wu, Mitra Dehghan Harati, Kathryn N. Devlin, Scott Mintzer, Maromi Nei, Lilach Goldstein, Ashwini Sharan |
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| Rok vydání: | 2021 |
| Předmět: |
Drug Resistant Epilepsy
Wechsler Memory Scale medicine.medical_specialty medicine.medical_treatment Neuropsychological Tests Hippocampus Article Temporal lobe surgery 03 medical and health sciences Behavioral Neuroscience Epilepsy 0302 clinical medicine Physical medicine and rehabilitation Humans Medicine 030212 general & internal medicine Neuropsychological assessment Anterior temporal lobectomy medicine.diagnostic_test business.industry Neuropsychology Anterior Temporal Lobectomy medicine.disease Temporal Lobe Treatment Outcome Free recall Epilepsy Temporal Lobe Neurology Neurology (clinical) Verbal memory business 030217 neurology & neurosurgery |
| Zdroj: | Epilepsy Behav |
| ISSN: | 1525-5050 |
| DOI: | 10.1016/j.yebeh.2020.107642 |
| Popis: | Objective We compared long-term seizure outcome, neuropsychological outcome, and occupational outcome of anterior temporal lobectomy (ATL) with and without sparing of mesial structures to determine whether mesial sparing temporal lobectomy prevents memory decline and thus disability, with acceptable seizure outcome. Methods We studied patients (n = 21) and controls (n = 21) with no evidence of mesial temporal sclerosis (MTS) on MRI who had surgery to treat drug-resistant epilepsy. Demographic and pre- and postsurgical clinical characteristics were compared. Patients had neuropsychological assessment before and after surgery. Neuropsychological analyses were limited to patients with left-sided surgery and available data (n = 14 in each group) as they were at risk of verbal memory impairment. The California Verbal Learning Test II (CVLT-II) (sum of trials 1–5, delayed free recall) and the Logical Memory subtest of the Wechsler Memory Scale III or IV (WMS-III or WMS-IV) (learning and delayed recall of prose passages) were used to assess verbal episodic learning and memory. Seizure and occupational outcomes were assessed. Results The chance of attaining seizure freedom was similar in the two groups, so sparing mesial temporal structures did not lessen the chance of stopping seizures. Sparing mesial temporal structures mitigated the extent of postoperative verbal memory impairment, though some of these individuals suffered decline as a consequence of surgery. Occupational outcome was similar in both groups. Significance Mesial temporal sparing resections provide a similar seizure outcome as ATL, while producing a better memory outcome. Anterior temporal lobectomy including mesial structure resection did not increase the risk of postoperative disability. |
| Databáze: | OpenAIRE |
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