Comparison of therapeutic effects between selective amygdalohippocampectomy and anterior temporal lobectomy for the treatment of temporal lobe epilepsy: A meta-analysis

Abstract Background. Temporal lobe epilepsy (TLE) is a recurrent chronic nervous system disease. The conventional treatment is medicine. So far, anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SAH) are becoming the two main approaches. Methods.To compare the therapeutic effects between SAH and ATL in the treatment of temporal lobe epilepsy, we conducted a meta-analysis of published randomized controlled trials. The review applied the search strategy developed by the Cochrane Epilepsy Group and the Rev. Man 5.0 software to analyze. We also drew the forest plots with Risk Ratio (RR) as effect size. Six studies were eligible, with a total of 626 patients (337 patients with SAH and 289 patients with ATL). Results. There was no statistical significance of postoperative seizure control rate after 1 year, as well as the increase rate and decrease rate of verbal memory function between SAH and ATL. There is no statistical difference of therapeutic effects between SAH and ATL in the treatment of temporal lobe epilepsy. Conclusion. It is advised that clinically, physicians should choose the appropriate approach according to operation indications to improve the results of postoperative recovery.

[1]  Kenji Ohata,et al.  Comparison of neuropsychological outcomes after selective amygdalohippocampectomy versus anterior temporal lobectomy , 2006, Epilepsy & Behavior.

[2]  D. Gomez-Hassan,et al.  Seizure outcomes and mesial resection volumes following selective amygdalohippocampectomy and temporal lobectomy. , 2012, Neurosurgical focus.

[3]  M. Symms,et al.  Imaging memory in temporal lobe epilepsy: predicting the effects of temporal lobe resection , 2010, Brain : a journal of neurology.

[4]  J. Schramm,et al.  Surgery for temporal mediobasal tumors: experience based on a series of 235 patients. , 2007, Neurosurgery.

[5]  A Olivier,et al.  Mesial atrophy and outcome after amygdalohippocampectomy or temporal lobe removal , 1996, Annals of neurology.

[6]  B. Bourgeois,et al.  Subtemporal transparahippocampal amygdalohippocampectomy for surgical treatment of mesial temporal lobe epilepsy. Technical note. , 1996, Journal of neurosurgery.

[7]  O. Devinsky,et al.  Anterior temporal language areas in patients with early onset of temporal lobe epilepsy , 1993, Annals of neurology.

[8]  B. Bourgeois,et al.  Subtemporal transparahippocampal amygdalohippocampectomy for surgical treatment of mesial temporal lobe epilepsy: Technical note , 1996 .

[9]  D. Spencer,et al.  Characteristics of medial temporal lobe epilepsy: I. Results of history and physical examination , 1993, Annals of neurology.

[10]  C. Elger,et al.  Different effects of left anterior temporal lobectomy, selective amygdalohippocampectomy, and temporal cortical lesionectomy on verbal learning, memory, and recognition , 1996 .

[11]  K. Lehnertz,et al.  Differential Involvement of Left Temporolateral and Temporomesial Structures in Verbal Declarative Learning and Memory: Evidence from Temporal Lobe Epilepsy , 1997, Brain and Cognition.

[12]  W. Boling,et al.  Establishment of a Comprehensive Epilepsy Center in Pakistan: Initial Experiences, Results, and Reflections , 2012, Epilepsy research and treatment.

[13]  R P Lesser,et al.  Cognitive Effects of Resecting Basal Temporal Language Areas , 1996, Epilepsia.

[14]  G. Broggi,et al.  THE SURGERY OF EPILEPSY. Commentaries , 2008 .

[15]  I. Fried,et al.  Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. , 2012, JAMA.

[16]  A. Dey,et al.  Neurosurgical Management of Intractable Temporal Lobe Epilepsy by Amygdalohippocampectomy Plus Anterior Temporal Lobectomy: Report of Initial Three Pediatric Cases with Short Literature Review , 2012 .

[17]  A. Palmini,et al.  Seizure and memory outcome following temporal lobe surgery: selective compared with nonselective approaches for hippocampal sclerosis. , 2006, Journal of neurosurgery.

[18]  F. Chowdhury,et al.  Microneurosurgical management of temporal lobe epilepsy by amygdalohippocampectomy (AH) plus standard anterior temporal lobectomy (ATL): a report of our initial five cases in Bangladesh , 2010, Asian journal of neurosurgery.

[19]  T. Watanabe,et al.  Subtemporal amygdalohippocampectomy for treating medically intractable temporal lobe epilepsy. , 1993, Neurosurgery.

[20]  Christian E Elger,et al.  Prognostic factors and outcome after different types of resection for temporal lobe epilepsy. , 2002, Journal of neurosurgery.

[21]  W T Blume,et al.  A randomized, controlled trial of surgery for temporal-lobe epilepsy. , 2001, The New England journal of medicine.

[22]  H. Staunton,et al.  Learning and retention of words and designs following excision from medial or lateral temporal-lobe structures , 1997, Neuropsychologia.

[23]  Hans Clusmann,et al.  THE SURGERY OF EPILEPSY , 2008, Neurosurgery.

[24]  P. Kellaway,et al.  Anterior Temporal Lobectomy and Medically Refractory Temporal Lobe Epilepsy of Childhood , 1990, Epilepsia.

[25]  H. Stefan,et al.  Neuropsychologic findings depending on the type of the resection in temporal lobe epilepsy. , 1999, Advances in neurology.

[26]  P. Flor-Henry,et al.  Psychosis and Temporal Lobe Epilepsy; A Controlled Investigation , 1969, Epilepsia.

[27]  M. Yașargil,et al.  Selective amygdalo-hippocampectomy. Operative anatomy and surgical technique. , 1985, Advances and technical standards in neurosurgery.

[28]  R P Lesser,et al.  Basal temporal language area demonstrated by electrical stimulation , 1986, Neurology.

[29]  A. Olivier Temporal resections in the surgical treatment of epilepsy. , 1992, Epilepsy research. Supplement.