The objective of this thesis work was to examine the “best” neurosurgical method, between selective amygdalohippocampectomy (SAH) and anterior temporal lobectomy (ATL) in the context of pharmacoresistant mesial temporal lobe epilepsy with unilateral hippocampal sclerosis. In order to execute this study, three criteria were taken into account: seizure freedom, the effect on memory and facial emotion recognition capacities (FER).These criteria were studied after a long-term delay of 7 years after the resection. Hence, two populations of patients suffering from temporal lobe epilepsy that were either treated in Germany and the others had received surgery in France. All were selected retrospectively and both groups were supposed to be homogenous due to strong selection criteria. The results showed a better outcome for the most selective method, concerning the impact on memory, however there was no significant reduction of seizures.The implication of the temporal pole in the capacities of short-term memory and working memory was shown, with patients from the SAH group showing superior postoperative performances when compared with performances of the ATL group. Concerning emotions, a unilateral lesion is related to deficits of FER independently of the neurosurgical method applied.Therefore this study shows a better outcome for the selective method, since it allows for reduced damage concerning mnesic functions on a very long-term postoperative follow-up.
Are mnesic and emotional deficits in mesial temporal lobe epilepsy related to the extent of the surgical resection ?