16 Amygdalohippocampectomy
16.1 Symptoms and Signs
Seizures
Temporary confusion
Staring spell
Loss of consciousness/awareness
Fear, anxiety, or deja vu
16.2 Surgical Pathology
Cranial benign/malignant neurological disorder
Cranial benign/malignant trauma
Cranial benign/malignant developmental disorder
16.3 Diagnostic Modalities
Physical examination
Neurological examination
Blood test
Electroencephalogram (EEG) of brain
High-density EEG of brain
PET scan of brain
CT scan of brain (see ▶Fig. 16.1)
Fig. 16.1 Preoperative CT scan revealed right amygdalohippocampal lesion (a cavernoma) in a middle-aged patient with temporal lobe seizures (a). The cavernoma was removed via a pterional approach and an amygdalohippocampectomy was performed (b). Clinical features and surgical results. In: Yasargil M, Curcic M, Teddy P, et al, eds. Microneurosurgery, Vol. III B. AVM of the Brain, Clinical Considerations, General and Special Operative Techniques, Surgical Results, Nonoperated Cases, Cavernous and Venous Angiomas, Neuroanesthesia. 1st ed. Thieme; 1998
MRI of brain
Functional MRI (fMRI) of brain
Statistical parametric mapping (SPM) of brain
Curry analysis
Magnetoencephalography (MEG) of brain
Single photon emission computed tomography (SPECT) of brain
Grid and strip electrode placement
Strips: 1 × 4 to 2 × 8 electrodes
Grids: 4 × 4 to 8 × 8 electrodes (16 to 64 contacts, respectively)
16.4 Differential Diagnosis
Generalized seizure
Absence seizure (petit mal; brief loss of awareness)
Tonic seizure (muscle stiffening, falling)
Atonic seizure (loss of muscle control, collapse)
Clonic seizure (repeated jerking muscle movements)
Myoclonic seizure (sudden brief jerks of arms and legs)
Tonic-clonic seizure (grand mal; abrupt loss of consciousness, body stiffening and shaking, loss of bladder control, biting of tongue)
Focal seizure
Without loss of consciousness (alter emotions or change perception of environment, involuntary jerking of body part, spontaneous sensory tingling, dizziness, and flashing lights)
With impaired awareness (staring into space, performing repetitive movements like hand rubbing or walking in circles)
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