The goal of this retrospective study is to evaluate the long-term clinical outcomes and complications associated with amygdalo-hippocampectomy using the surgical technique developed by Pr. Coubes (Montpellier, FRANCE). The main questions it aims to answer are:
* What are the complications and evolution of clinical outcomes in patients treated with this technique for hippocampal sclerosis or other intern temporal diseases ? * What variables are associated with better seizure control following surgery?
Participants include 234 patients treated over the last 30 years at the CHU de Montpellier, FRANCE. The study will analyze clinical data, including seizure outcomes based on ILAE criteria, post-operative complications, and factors influencing recovery and reintegration into daily life.
Patients who had undergone an Amygdalo-Hippocampectomy according to the surgical procedure that we describe
Patients who did not have this exact procedure.
All the patients that have been followed in the University Hospital of Montpellier, France in the Epileptic Ward.
Cohort
Retrospective
Amygdalo-Hippocampectomy
Procedure/SurgeryThis technique is characterized by specific hallmarks that distinguish it from other approaches, including the Yasargil technique and newer minimally invasive methods. It integrates precise anatomical targeting with optimized surgical pathways to enhance outcomes in patients with those pathologies. The approach of the choroidal fissure will be explained in the article. By addressing limitations observed in traditional techniques, it aims to minimize neurological deficits while achieving better seizure control.
Post-Surgical Classification assessing epilepsy's control
The ILAE post-surgical classification system is used to categorize seizure outcomes after epilepsy surgery. It provides a standardized way to evaluate how effectively surgery controls seizures, enabling consistency in reporting and comparison of surgical outcomes across studies and clinical settings. In those cases of drug-resistance epilepsy, we will assess the epilepsy's control after the surgery. 1. Completely seizure free; no auras 2. Only auras; no other seizures 3. One to three seizure days per year 4. Four to 12 seizure days per year 5. Daily seizures 6. More than 100% increase of baseline ; auras
Post-operative complications : Infections
Each post-operative complications have been studied during the medical follow-up. It included the immediate post-operative complications such as presence of an infection.
Post-operative complications : Hematomas
Each post-operative complications have been studied during the medical follow-up. It included the immediate post-operative complications such as presence of hematoma.
Post-operative way of life
As part of this research on the surgery, the investigators are studying the post-surgical way of life of patients who have undergone this procedure. This includes evaluating various aspects of their daily functioning, such as autonomy, cognitive and psychiatric outcomes, social integration, and overall quality of life. By analyzing these factors, the investigators aim to better understand the long-term impact of hippocampectomy and identify potential areas for improving patient care and rehabilitation strategies.
Risk factors or predisposing factors of success or failure after Amygdalo-Hippocampectomy
Among the patients who underwent favourable and unfavourable evolutions, we will assess the risk factors and the predisposing factors such as febrile seizure, medical history, etiologic lesions.
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