J Neurol Neurosurg Spine | Volume 3, Issue 1 | Review Article | Open Access

Temporal Lobectomy: Is Hippocampectomy Necessary for an Optimal Outcome

Arun-Angelo Patil1*, Andrea J Chamczuk1, Britney Bell2 and Santi Karnam2

1Division of Neurosurgery, Creighton University Medical Center, Omaha, Nebraska 68131, USA
2Creighton University School of Medicine, Omaha, Nebraska 68131, USA

*Correspondance to: Arun-Angelo Patil 

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Abstract

Hippocampectomy is a standard part of temporal lobectomy; because, hippocampus play an important role in epileptogenesis and seizure propagation. However, hippocampus is responsible for creating and retrieving memories and organizing auditory and visual information. Therefore, standard temporal lobectomy can result in memory loss and social, emotional, vocational, linguistic and psychiatric complications. In addition, hippocampus, is the main source of stem cells; which are essential for the ongoing repair process of the brain. In light of these facts, an alternative option should be considered. One such technique is known as Multiple Hippocampal Transection (MHT). This procedure involves transection of the horizontal fibers in the hippocampus, which play an important part in synchronizing seizure activity within the hippocampus. The stem cells and fimbria are however preserved. This overcomes some of the drawbacks of hippocampectomy. Recently publications have two papers that have long term follow up of patients who had MHT, Multiple Subpial Transections (MST) over the neo cortex and minimal cortical resection at the temporal tip; if the intra-operative EEG recording shoed persistence of epileptogenic activity after MST. Both of them reported seizure outcome better than standard temporal lobectomy. In addition, verbal memory was either preserved or got better. Further studies therefore are therefore required to definitively determine the value of MHT; and to determine if hippocampectomy is really required.

Keywords:

Temporal lobe epilepsy; Multiple subpial transection; Multiple hippocampal transection; Hippocampectomy

Citation:

Patil A-A, Chamczuk AJ, Bell B, Karnam S. Temporal Lobectomy: Is Hippocampectomy Necessary for an Optimal Outcome. J Neurol Neurosurg Spine. 2018; 3(1): 1011.

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