Die »selektive Amygdala-Hippokampektomie« als chirurgische Behandlungsmethode der mediobasal-limbischen Epilepsie

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Abstract
Indications, techniques and preliminary results on a new microsurgical method of treatment of patients with drug resistant psychomotor epilepsy, in whom mesiobasal temporal lobe epilepsy was diagnosed, are reported. The most important reason for surgical intervention in our series of 27 patients was their epileptic condition. In 12 of the patients a tumor of the amygdala and/or hippocampal formation was suspected or was proven pre-operatively. In 13 cases the amygdala and/or hippocampus was delineated as the epileptogenic area by long-term performed stereo-EEG. The indications for operation in the other 2 was based on the pattern of the attacks and the surface EEG findings. Preliminary results of this selective surgical procedure are very promising and show this type of psychomotor epilepsy can be treated more successfully in this way than by classical removal of the temporal lobe or by stereotaxic surgical methods: To date 6-73 (.hivin.x = 21) mo. follow up, 22 patients are free of seizures. The postoperative neuropsychological controls show better functional results in this series than in the group with large temporal resections. In more than half of the cases a clear cut general improvement in intellectual performance tests was found. Learning and memory impairments are much less pronounced or even undetectable.