• Miroslav Kalina, Roman Lisck, Zdenek Vojtech, Eva Adámková, Tomás Procházka, Iva Marecková, and Vilidald Vladyka.
• Na Homolce Hospital Epilepsy Center, Prague, Czech Republic. miroslav.kilina@homolka.cz
• Epileptic Disord. 2007 Dec 1; 9 Suppl 1: S68-74.

ObjectivesMinimally invasive procedures for treating temporal lobe epilepsy have been investigated recently, namely stereotactic and gamma knife amygdalohippocampectomy (AHE). However, the results are not fully satisfactory. Our aim was to evaluate efficacy and side-effects of stereotactic AHE mimicking the neurosurgical procedure in terms of extent of the lesion.Methods16 consecutive patients were assessed using VEEG, MRI, FDG-PET and WADA test. All had definite pharmacoresistant medial temporal lobe epilepsy. The stereotactic AHE was performed on the Leksell stereotactic system. All lesions exceeded 40 mm along the long axis of the hippocamus.ResultsSeizure outcome was favourable on one year follow-up: 12 patients (75%) were seizure-free (Engel I), three (19%) were Engel II, and one (6%) was Engel III. Side-effects were mild, lasting up to 7 days: cephalea, meningeal syndrome with sterile CSF in three subjects, and CSF leak lasting up to 3 days in seven subjects.ConclusionStereotactic AHE encompassing sufficient volume of the amygdalohippocampal complex appears to be safe, effective, and free from long-term side-effects.

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