Studies in hippocampal slices and rodent models provided preclinical support for electrical neuromodulation of the hippocampus. The hippocampus is an appealing target for stereotactic neuromodulation techniques, being a frequent target for stereotactic implantation of recording depth electrodes by epilepsy surgeons. 79 Thus, availability of a treatment that can decrease seizure frequency in MTLE to a similar degree as ablative or resective procedures but that preserves interictal function would represent a major advance in the surgical treatment of epilepsy.
In fact, open resection is associated with a high rate of lateral temporal lobe dysfunction regardless of approach, such as naming or object recognition deficits. However, hippocampal resection or ablation may be contraindicated in patients with dominant-onset MTLE with preserved verbal memory and/or dominant temporal lobe function, patients with bilateral mesial temporal onset, or those with recurrent MTLE contralateral to a prior resection. Patients with mesial temporal lobe epilepsy (MTLE), the most common form of drug-resistant epilepsy, have a high rate of seizure freedom 75 after amygdalohippocampal resection, 3,5,8,76 whether by anterior temporal lobectomy (approximately 75%) or selective amygdalohippocampectomy (approximately 72%), or by stereotactic ablation (radiofrequency or laser 77,78). Richard Winn MD, in Youmans and Winn Neurological Surgery, 2017 Hippocampus
0 kommentar(er)
