Selective amygdalohippocampectomy via the inferior temporal gyrus approach for treatment of mesial temporal lobe epilepsy

Objective To explore the surgical skills, therapeutic effects and complications of selective amygdalohippocampectomy via the inferior temporal gyrus approach for treatment of mesial temporal lobe epilepsy (MTLE). Methods Sixty-two patients with medically intractable MTLE underwent selective amygdalohippocampectomy. Temporal keyhole craniotomy was performed, and the mid-anterior segment of the inferior temporal gyrus was resected to access the anterolateral floor of the temporal horn. The mesial temporal structures such as the amygdale and the parahippocampal gyrus were selectively resected. Results All the patients were followed up for at least 2 years (range 24-80 months) after the surgery. Obvious improvement of the neuropsychological function was achieved in these patients after the operation, without serious surgical complications. Forty-five patients (72.6%) had Engel's Class Ⅰ, 12 (19.4%) had class Ⅱ, and 5 (8.0%) had class Ⅲ outcomes after the operation. Conclusion The inferior temporal gyms approach allows minimally invasive amygdalohippocampectomy that preserves both the optic radiation and the language area, and can be especially effective in patients with epileptic lesions limited to the mid-anterior temporal lobe. Key words: Amygdalohippocampectomy;  Inferior temporal gyrus;  Temporal lobe epilepsy