RESUMEN
Objective To observe the outcomes of seizure control by three different surgical approaches,hippocampal transection,anterior temporal lobectomy and selective amygdalo-hippocampectomy,for the treatment of intractable medial temporal epilepsy,and explore their influences in the impairments of cognitive and memorial functions.Methods Twenty-nine patients with intractable medial temporal epilepsy,admitted to our hospital from January 2012 to October 2015,were chosen in our study;8 patients accepted hippocampal transection,10 accepted anterior temporal lobectomy and 11 accepted selective amygdalo-hippocampectomy.Seizure controls after treatment with these 3 approaches were compared and results of neuropsychological examinations (verbal intelligence quotient [VIQ],performance intelligence quotient [PIQ],full intelligence quotient [FIQ] and memory quotient [MQ]) were compared before and after operation.Results The effective rates of seizure controls were all higher than 80％ and seizure free rate was about 60％ in the 3 groups;Engel grading showed no significant differences among the three groups (P＞0.05).Results of all the neuropsychological examinations in the hippocampal transection group before and after operation had no significant differences (P＞0.05);however,all results in the anterior temporal lobectomy group after operation were significantly declined as compared with those before operation (P＜0.05);and PIQ,FIQ and MQ scores in the selective amygdalo-hippocampectomy group after operation were significantly lower as compared with those before operation (P＜0.05).Conclusions Hippocampal transection will not cause significant damage in intelligence and memory functions.As compared with both anterior temporal lobectomy and selective amygdalo-hippocampectomy,hippocampal transection can have good seizure control and preserve memory function.