Long-term seizure, cognitive, and psychiatric outcome following trans–middle temporal gyrus amygdalohippocampectomy and standard temporal lobectomy

Object Previous comparisons of standard temporal lobectomy (STL) and selective amygdalohippocampectomy (SelAH) have been limited by inadequate long-term follow-up, variable definitions of favorable outcome, and inadequate consideration of psychiatric comorbidities. Methods The authors performed a retrospective analysis of seizure, cognitive, and psychiatric outcomes in a noncontemporaneous cohort of 69 patients with unilateral refractory temporal lobe epilepsy and MRI evidence of mesial temporal sclerosis after either an STL or an SelAH and examined seizure, cognitive, and psychiatric outcomes. Results The mean duration of follow-up for STL was 9.7 years (range 1–18 years), and for trans–middle temporal gyrus SelAH (mtg-SelAH) it was 6.85 years (range 1–15 years). There was no significant difference in seizure outcome when “favorable” was defined as time to loss of Engel Class I or II status; better seizure outcome was seen in the STL group when “favorable” was defined as time to loss of Engel Class IA st...