Subtemporal transparahippocampal amygdalohippocampectomy for surgical treatment of mesial temporal lobe epilepsy: Technical note

T. S. Park, Blaise F.D. Bourgeois, Daniel L. Silbergeld, W. Edwin Dodson

Research output: Contribution to journalArticlepeer-review

100 Scopus citations

Abstract

Amygdalohippocampectomy (AH) is an accepted surgical option for treatment of medically refractory mesial temporal lobe epilepsy. Operative approaches to the amygdala and hippocampus that previously have been reported include: the sylvian fissure, the superior temporal sulcus, the middle temporal gyrus, and the fusiform gyrus. Regardless of the approach, AH permits not only extirpation of an epileptogenic focus in the amygdala and anterior hippocampus, but interruption of pathways of seizure spread via the entorhinal cortex and the parahippocampal gyrus. The authors report a modification of a surgical technique for AH via the parahippocampal gyrus, in which excision is limited to the anterior hippocampus, amygdala and parahippocampal gyrus while preserving the fusiform gyrus and the rest of the temporal lobe. Because transparahippocampal AH avoids injury to the fusiform gyrus and the lateral temporal lobe, it can be performed without intracarotid sodium amobarbital testing of language dominance and language mapping. Thus the operation would be particularly suitable for pediatric patients in whom intraoperative language mapping before resection is difficult.

Original languageEnglish
Pages (from-to)1172-1176
Number of pages5
JournalJournal of neurosurgery
Volume85
Issue number6
DOIs
StatePublished - Dec 1996

Keywords

  • amygdalohippocampectomy
  • complex partial seizure
  • parahippocampal gyrus
  • subtemporal approach

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