Absolute spike frequency and etiology predict the surgical outcome in epilepsy due to amygdala lesions

Csilla Gyimesi, Heinz Pannek, Friedrich G. Woermann, Alaa Eldin Elsharkawy, Maria Tomka-Hoffmeister, Simone Hortsmann, Jörg Aengenendt, Reka A. Horvath, Reinhard Schulz, Matthias Hoppe, Jozsef Janszky, Alois Ebner

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4 Citations (Scopus)

Abstract

Purpose: To identify surgical prognostic factors for temporal lobe epilepsy (TLE) due to amygdala lesions. Methods: We included 42 patients (mean age: 31.4 ± 11) who underwent presurgical evaluation including long-term video-EEG and in whom the high-resolution MRI showed amygdala lesions without hippocampal abnormalities. All patients had apical temporal lobe resection without hippocampectomy. We distinguished patients with frequent spikes (spike frequency ≥ 60/h) and with non-frequent spikes (< 60. spikes/h). Results: At the 2-year postoperative evaluation, 30 patients (71%) were seizure-free. The presence of infrequent spikes (p= 0.013), tumor on the MRI (p= 0.027), and no epilepsy history in the family (p= 0.027) were independently associated with 2-year seizure-free outcome. Of 33 patients with infrequent spikes, 79% became seizure-free, while of 9 patients with frequent spikes only 4 had a favorable surgical outcome (44%). Conclusion: In TLE patients due to amygdala lesions, high spike frequency and family history of epilepsy predicted an unfavorable, while tumoral etiology a favorable outcome after apical temporal lobe resection without hippocampectomy. Seventy-one percent of patients with amygdalar epilepsy who underwent this novel type of epilepsy surgery became seizure-free. This is comparable with results of " classical" anterior temporal lobe resections where hippocampus is NOT spared. Moreover, the surgical outcome may be predictable.

Original languageEnglish
Pages (from-to)177-182
Number of pages6
JournalEpilepsy Research
Volume92
Issue number2-3
DOIs
Publication statusPublished - Dec 1 2010

Keywords

  • Amygdala
  • Apical temporal lobe resection
  • Epilepsy surgery prognosis
  • Familial epilepsy
  • Spike frequency

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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    Gyimesi, C., Pannek, H., Woermann, F. G., Elsharkawy, A. E., Tomka-Hoffmeister, M., Hortsmann, S., Aengenendt, J., Horvath, R. A., Schulz, R., Hoppe, M., Janszky, J., & Ebner, A. (2010). Absolute spike frequency and etiology predict the surgical outcome in epilepsy due to amygdala lesions. Epilepsy Research, 92(2-3), 177-182. https://doi.org/10.1016/j.eplepsyres.2010.09.005