扁桃体海馬切除、扁桃体海馬切除術

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/11/10 01:57:10」(JST)

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Hippocampi

Amygdalae

Amygdalohippocampectomy is a surgical procedure for the treatment of epilepsy. It consists of the removal of the hippocampus, which has a role in memory, spatial awareness, and navigation,^[1] and the amygdalae, which have a role in the processing and memory of emotional reactions,^[2] both structures forming part of the limbic system of the brain.

Amygdalohippocampectomy is used only when all other treatment options have failed to resolve the epilepsy. It is an effective treatment for most patients. However, possible adverse side effects include impaired memory and defects in visual perception.

Procedure

The amygdalohippocampectomy is indicated when the focal point of the seizures can be anatomically localized to the hippocampus and amygdala. Normally, to be considered for this procedure, one must have failed all first-line treatments.^[3] The selective amygdalohippocampectomy will remove only the offending portions of the hippocampus and amygdala.^[4] When data from studies of the electrophysiology and neuropathy vis-à-vis temporal lobe epilepsy determines this area to be the origin of seizure activity, the removal of the hippocampus and amygdala is usually indicated. Computer imaging is sometimes used to guide this procedure.^[2] Patients continue normal activity after approximately six to eight weeks.

Statistics and side effects

Of 376 patients who had the amygdalohippocampectomy procedure performed, compared to other types of temporal lobe resections, two thirds of this population were reported free of disabling seizures.^[5] Some patients report defects in visual perception^[6] and impaired memory function.^[7]

References

^ Ekstrom, AD; Kahana M.J.; Caplan J.B.; Fields T.A.; Isham E.A.; Newman E.L.; Fried I. (2003). "Cellular networks underlying human spatial navigation". Nature. 425 (6954): 184–188. doi:10.1038/nature01964. PMID 12968182. Retrieved 2007-02-11.
^ ^a ^b Olivier A (2000). "Transcortical selective amygdalohippocampectomy in temporal lobe epilepsy". Can J Neurol Sci. 27 Suppl 1: S68–76; discussion S92–6. PMID 10830331.
^ Smith KA, Detwiler PW, Porter RW (1999). "Surgical Treatment of Intractable Epilepsy". BNI Quarterly. 15 (1). Archived from the original on 27 July 2006.
^ Bate H, Eldridge P, Varma T, Wieshmann UC (January 2007). "The seizure outcome after amygdalohippocampectomy and temporal lobectomy". Eur. J. Neurol. 14 (1): 90–4. doi:10.1111/j.1468-1331.2006.01565.x. PMID 17222120.
^ Engel J, Wiebe S, French J, et al. (25 February 2003). "Practice parameter: Temporal lobe and localized neocortical resections for epilepsy". Neurology. 60 (4): 538–47. doi:10.1212/01.WNL.0000055086.35806.2D. PMID 12601090.
^ Dr Novak Klaus; K Kircher; A Reitner; C Baumgartner; T Czech (2005). "Visual Field Defects After Selective Transsylvian Amygdalohippocampectomy" (PDF). 14th Meeting of the World Society for Stereotactic and Functional Neurosurgery.
^ Gleissner U, Helmstaedter C, Schramm J, Elger CE (2002). "Memory outcome after selective amygdalohippocampectomy: a study in 140 patients with temporal lobe epilepsy". Epilepsia. 43 (1): 87–95. doi:10.1046/j.1528-1157.2002.24101.x. PMID 11879392.

English Journal

Surgical treatment for mesial temporal lobe epilepsy associated with hippocampal sclerosis.

Mathon B1, Bédos Ulvin L2, Adam C2, Baulac M2, Dupont S2, Navarro V2, Cornu P3, Clemenceau S3.
Revue neurologique.Rev Neurol (Paris).2015 Mar 3. pii: S0035-3787(15)00587-1. doi: 10.1016/j.neurol.2015.01.561. [Epub ahead of print]
INTRODUCTION: Hippocampal sclerosis is the most common cause of pharmacoresistant epilepsy amenable for surgical treatment and seizure control. The aim of this article is to review and evaluate the published literature related to the outcome of the surgical treatment of mesial temporal lobe epilepsy
PMID 25746582

Selective amygdalohippocampectomy versus standard temporal lobectomy in patients with mesiotemporal lobe epilepsy and unilateral hippocampal sclerosis: post-operative facial emotion recognition abilities.

Wendling AS1, Steinhoff BJ2, Bodin F3, Staack AM4, Zentner J5, Scholly J6, Valenti MP7, Schulze-Bonhage A8, Hirsch E9.
Epilepsy research.Epilepsy Res.2015 Mar;111:26-32. doi: 10.1016/j.eplepsyres.2015.01.002. Epub 2015 Jan 16.
Surgical treatment of mesial temporal lobe epilepsy (mTLE) patients involves the removal either of the left or the right hippocampus. Since the mesial temporal lobe is responsible for emotion recognition abilities, we aimed to assess facial emotion recognition (FER) in two homogeneous patient cohort
PMID 25769370

Complications of epilepsy surgery in Sweden 1996-2010: a prospective, population-based study.

Bjellvi J1, Flink R, Rydenhag B, Malmgren K.
Journal of neurosurgery.J Neurosurg.2015 Mar;122(3):519-25. doi: 10.3171/2014.9.JNS132679. Epub 2014 Oct 31.
OBJECT Detailed risk information is essential for presurgical patient counseling and surgical quality assessments in epilepsy surgery. This study was conducted to investigate major and minor complications related to epilepsy surgery in a large, prospective series. METHODS The Swedish National Epilep
PMID 25361484

Japanese Journal

てんかん外科における海馬周辺の解剖と手術(<特集>側頭葉とその周辺の解剖と手術I-第25回微小脳神経外科解剖セミナー合同セッションより-)

岩崎真樹,冨永悌二
脳神経外科ジャーナル 21(8), 610-617, 2012-08-20
海馬切除はてんかん外科において最も汎用される手技の一つである.本稿では経シルビウス裂的選択的扁桃体海馬切除術を中心に扁桃体海馬切除に必要な解剖を概説した.シルビウス裂を剥離してから島限を切開し,側頭葉上面に平行に吸引を進めると側脳室が開放される,シルビウス裂を大きく開放し中大脳動脈に可動性をもたせることで,海馬の大きな視野が得られる.扁桃体を切除する際は鉤回の軟膜越しに前脈絡動脈の走行を必ず確認す …
NAID 110009480320

The Modified Anterior Temporal Lobectomy plus Amygdalohippocampectomy:Guidelines and Lessons Learned

Hung Tzu Wen,Albert L. Rhoton Jr.,Luiz Henrique Martins Castro,Manoel Jacobsen Teixeira
Japanese Journal of Neurosurgery 21(9), 700-711, 2012
… Objective : The authors intend to demonstrate the currently used technique of anterior temporal lobectomy plus amygdalohippocampectomy for treating refractory temporal epilepsy as developed by the lead author (HTW). …
NAID 130001928954

8. (1)Microsurgical Anatomy of the Temporal Lobe Applied to Amygdalohippocampectomy(PS2-1 The 25th Microneurosurgical Anatomy Seminar "Anatomy and Surgery in the Temporal Lobe and its Surrounding Tissues",Plenary Session,Professional Spirit and Research Mind of Neurosurgeons,The 31st Annual Meeting of The Japanese Congress of Neurological Surgeons)