Microsurgery for the treatment of epilepsy secondary to hippocampal lesions

WANG Jun; WANG Yunjie; OU Shaowu; QIU Bo; XING Deguang; WU Pengfei; DU Jiang

Abstract：Objective The different surgical approaches and outcomes of microsurgery for the treatment of epilepsy secondary to hippocampal lesions are discussed.Methods A retrospective analysis of the clinical data, pathological results, surgical methods and outcomes was performed in 48 epileptic cases secondary to hippocampal lesions.Results The pathological results confirmed 23 cases of gliomas, 15 cases of vascular malformations, and 10 cases of hippocampus sclerosis.Selective resection of lesions and surrounding tissues was performed in 23 patients, while standard anterior temporal lobectomy and amygdalohippocampectomy with resection of lesions and surrounding tissues were performed in 25 patients, respectively.Forty-two patients were followed up and the mean duration of follow-up was 23.5 months.Thirty-four (81%) of 42 patients were in Engel 1 at 6 months'follow-up, 7(16.7%) in Engel 2, and 1 (2.3%) in Engel 3.The rates of epilepsy freedom (Engel 1) in the two groups were 80%(16/20) and 81.8% (18/22), respectively, and there was no statistical difference.Conclusion Microsurgery should be considered as the optimal treatment for the epilepsy secondary to hippocampal lesions.The surgical approaches and methods can be determined by the specific properties of different lesions.