EXTENT OF MEDIAL TEMPORAL RESECTION ON OUTCOME FROM ANTERIOR TEMPORALLOBECTOMY - A RANDOMIZED PROSPECTIVE-STUDY

WE REPORT A prospective, randomized, blinded clinical trial comparing seizure and neuropsychological outcomes from anterior temporal lobecto mies between two groups of patients. One group (n = 34) underwent hipp ocampal resection posteriorly to the anterior edge of the cerebral ped uncle (partial hippocampectomy). In the other group (n = 36), the hipp ocampus was removed further to the level of the superior colliculus (t otal hippocampectomy). The amount of lateral cortical resection was th e same between groups. Patients were followed-up for seizure outcome a nd neuropsychological morbidity. At 1 year postoperatively, the total hippocampectomy group had a statistically superior seizure outcome com pared with the partial hippocampectomy group (69 versus 38% seizure-fr ee), and examination of time to first seizure (survival analysis) reve aled significantly superior outcomes associated with total hippocampec tomy. There was no increased neuropsychological morbidity associated w ith the more extensive hippocampal resection.