What is Amygdalohippocampectomy: Overview, Benefits, and Expected Results

التعريف والنظرة العامة

Amygdalohippocampectomy is a surgical procedure that removes the amygdala and hippocampus, which are parts of the brain found in the temporal lobe that forms part of the limbic system.

Both the hippocampus and amygdala play a significant role in body control and memory. As such, the surgery itself is risky and considered only when other methods of treatment fail to address epilepsy. One of the possible serious complications is memory dysfunction.

من يجب أن يخضع للنتائج المتوقعة

In general, a hippocampus removal surgery is performed on patients who have been diagnosed with epilepsy. Epilepsy and seizures are usually used interchangeably or together. Although they are very similar, they are also different. Seizure describes the sudden increase of electrical or neural activity in the brain, and it is considered as just one event. Epilepsy, on the other hand, occurs if more than one seizure is happening in the brain. Simply put, a person can have a seizure without being diagnosed as epileptic, while epileptic individuals experience seizures.

There are many types of epilepsy, but amygdalohippocampectomy is recommended for patients whose seizures originate in the temporal lobe, specifically the medial structure. This can be verified by different imaging tests on the brain such as an MRI.

Seizures can differ greatly from one individual to another, and it is possible for a patient to have varied manifestations.

The outlook of the procedure as far as controlling the epilepsy is concerned is good. In one of the neurological studies on the different approaches for hippocampus resection, half of the patients reported not having seizures for at least five years, depending on the approach and how much of the mesial structure has been removed.

كيف يعمل هذا الإجراء؟

Neurosurgeons can implement different techniques to perform amygdalohippocampectomy and they can be generally classified as selective since only the affected tissues are removed, sparing the brain from as much damage as possible. Surgeons also used tools such as neuronavigation system for accuracy and guidance.

During surgery, the patient is administered with general anaesthesia with his vital signs monitored throughout the procedure. The head is tilted, and except for the part where the incision is made, the rest is covered with a surgical drape.

The periosteum and dura are accessed until the surgeon reaches the temporal gyrus. In the cortical approach, the incision for the entry point should not go beyond 3.5 cm from the temporal lobe. In the Transylvanian approach, the surgeon passes through the Sylvian fissure and an incision of 15 mm is made in the temporal stem. The uncus is removed first followed by the amygdala and the hippocampus.

After the procedure, all the incisions are closed, and the patient stays in the hospital for a few days for close monitoring and immediate follow-up.

المخاطر والمضاعفات المحتملة

One of the biggest risks of the hippocampus removal is the recurrence of seizures, which happens when some parts of the hippocampus and amygdala are not removed. This may mean the patient has to go through another round of surgery. Because of the delicateness of the procedure, some parts of the brain may be affected and become damaged. Depending on the procedure, the patient may develop vascular spasm, injury, brain hemorrhage, and infection. Some may experience problems with their vision or poor memory.

مراجع:

• Wiebe S, Blume WT, Girvin JP, Eliasziw M,. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med. 2001 Aug 2. 345(5):311-8.

• Spencer DD, Spencer SS, Mattson RH, Williamson PD, Novelly RA.Access to the posterior medial temporal lobe structures in the surgical treatment of temporal lobe epilepsy. Neurosurgery. 1984 Nov. 15(5):667-71.[Medline]

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**What is⁤ Amygdalohippocampectomy? Comprehensive⁤ Overview**



**Introduction:**

Amygdalohippocampectomy (AH) is a ⁢surgical procedure that involves removing specific areas of the⁣ brain, including‌ the amygdala and hippocampus. These‍ structures are‌ involved ⁢in emotional processing and ‌memory formation.



**Overview of Amygdalohippocampectomy:**



* **Definition:** AH is the surgical excision of the amygdala and⁤ hippocampus, typically ‍done to ⁢treat ⁣severe epilepsy or​ other neurological conditions.

* **Procedure:** Surgeons⁤ typically use minimally invasive ⁢techniques ‍to‌ access the ‌brain and remove⁣ the ⁤affected ⁤tissues. The surgery is usually performed under general anesthesia.

* **Goal:** The ⁤goal of AH is‌ to reduce seizures by‌ removing the areas of the brain responsible for triggering them.



**Benefits of Amygdalohippocampectomy:**



* ⁤**Seizure Control:** AH can significantly reduce ‌or eliminate seizures in up to 70% of patients‌ with drug-resistant epilepsy.

*⁣ **Improved Quality‍ of Life:** Reduced seizure frequency and severity can significantly improve patient’s quality of⁣ life by ‌reducing anxiety, social ⁤isolation, and​ cognitive difficulties.

* **Cognitive Preservation:** Modern surgical⁤ techniques aim ‌to preserve memory and other cognitive functions,​ minimizing potential postoperative deficits.



**Expected ​Results:**



*​ **Seizure Outcomes:** The⁣ success of AH in controlling seizures depends on the underlying cause of epilepsy​ and ⁢the extent of the⁣ surgery.

* **Memory Function:** AH may result‌ in ⁣temporary memory impairments, especially in the short ⁣term. However, most patients recover their memory ‌function ‌within a year.

* **Cognitive Changes:** Some⁢ patients may experience​ mild cognitive changes ⁢after AH, but severe deficits are uncommon.



**Additional⁢ Information:**



* **Candidates for AH:** AH is typically considered for patients with drug-resistant epilepsy who ​have failed to⁢ respond‍ to multiple medications.

* **Risks ‍of AH:** The risks⁣ of AH ​include bleeding, infection, and temporary ⁤neurological deficits. The specific risks are‍ discussed with patients before surgery.

* **Recovery ⁢Time:** ⁤Recovery time after AH varies ⁤depending on the individual. Most patients require a​ hospital ⁢stay ​of a​ few days and may experience ⁤some postoperative discomfort ​and‌ cognitive difficulties.



**Conclusion:**

Amygdalohippocampectomy⁣ is ​a surgical treatment option for severe epilepsy that has the⁣ potential to significantly reduce⁣ seizures and improve quality of life. While it can have certain risks and potential cognitive changes, modern surgical techniques aim to minimize these effects and preserve ⁣cognitive ⁤function. Patients considering‌ AH ​should consult with experienced neurologists and surgeons⁣ to fully understand⁢ the procedure and potential ⁣outcomes.