Epileptic Disorders

, Volume 13, Issue 3, pp 284–290 | Cite as

Superselective anterior temporal resection in mesial temporal lobe epilepsy

  • Joacir Graciolli Cordeiro
  • Kathrin Wagner
  • Michael Trippel
  • Josef Zentner
  • Andreas Schulze-Bonhage
Clinical Commentary


We report the case of a patient with pharmacoresistant mesial temporal lobe epilepsy presenting psychomotor seizures with onset at early childhood. MRI showed a blurred internal structure of the right hippocampus and right mammillary body atrophy. Neuropsychological testing revealed deficits in selective attention and visual planning. Non-invasive recordingwas not sufficient to precisely detect the seizure onset zone. Invasive recording showed seizure onset in the temporo-polar neocortex, with spread to the amygdalum and hippocampus. A superselective resection of the temporal pole and amygdalum was performed with preservation of the hippocampus. Histology revealed the presence of focal cortical dysplasia (Palmini type Ib). Seizure frequency was reduced after surgery, and seizure freedom for two years was achieved with optimisation of the antiepileptic drug regime. Memory functions were preserved, and selective attention and visual planning improved following limited resection. This case suggests that, in selected cases, highly targeted resections with preservation of memory-relevant structures may be the best choice considering both seizure control and unimpaired cognitive functioning.

Key words

epilepsy surgery resection mesial temporal lobe epilepsy focal cortical dysplasia 


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Copyright information

© John Libbey Eurotext and Springer 2011

Authors and Affiliations

  • Joacir Graciolli Cordeiro
    • 1
    • 2
    • 5
  • Kathrin Wagner
    • 3
  • Michael Trippel
    • 1
  • Josef Zentner
    • 4
  • Andreas Schulze-Bonhage
    • 3
  1. 1.Department of Stereotactic NeurosurgeryUniversity Hospital FreiburgFreiburgGermany
  2. 2.Department of Neurosurgery, Hospital de ClínicasFederal University of ParanáParanáBrazil
  3. 3.Epilepsy CenterUniversity Hospital FreiburgFreiburgGermany
  4. 4.Department of General NeurosurgeryUniversity Hospital FreiburgFreiburgGermany
  5. 5.Department of Stereotactic NeurosurgeryUniklinikFreiburg im BreisgauGermany

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