HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Egan, R. A. Articles by Salinsky, M. Search for Related Content PubMed PubMed Citation Articles by Egan, R. A. Articles by Salinsky, M.

Visual field deficits in conventional anterior temporal lobectomy versus amygdalohippocampectomy

From the Casey Eye Institute (Dr. Egan); the Devers Eye Institute (Dr. Shults); The Neurological Clinic (Dr. So); and the Departments of Neurosurgery (Drs. Burchiel and Kellogg) and Neurology (Dr. Salinsky), Oregon Health Sciences University, Portland.

Address correspondence and reprint requests to Dr. R.A. Egan, Casey Eye Institute, 3375 SW Terwilliger Blvd., Portland, OR 97201; e-mail: eganr{at}ohsu.edu

OBJECTIVE: To evaluate and identify the incidence of visual field defects (VFD) after anterior temporal lobectomy (ATL) versus amygdalohippocampectomy (AH). VFD occur frequently after ATL and are usually superotemporal quadrantanopias. Little is known about the incidence of VFD after AH and this surgical method offers the possibility of a seizure-free survival without visual loss.

METHODS: Patients with similar characteristics were examined. All patients had intractable seizures and mesial temporal sclerosis, small tumors localized to only the uncus, amygdala, or hippocampus, or no known pathology. Postoperative kinetic field testing using the I4e isopter on a Goldmann perimeter was performed 30 days or more after surgery.

RESULTS: Of 29 patients examined, 14 underwent AH and 15 had ATL. Four of 14 AH patients (28%) had a VFD at 10 degrees from center and 11/14 (78%) had VFD at 40 degrees. One of 15 ATL patients (7%) had a VFD at 10 degrees from center and 11/15 (73%) had VFD at 40 degrees. There was no significant difference between surgery types.

CONCLUSIONS: AH in this study was associated with a significant number of VFD. No significant difference was found between the frequency of VFD produced from AH and ATL. The mechanism of injury is due to direct trauma to the optic radiations while accessing the mesial temporal structures. Because all patients in the study were asymptomatic for VFD, it remains to be determined whether these VFD are clinically significant.

This article has been cited by other articles:

				T. Taoka, M. Sakamoto, H. Nakagawa, H. Nakase, S. Iwasaki, K. Takayama, K. Taoka, T. Hoshida, T. Sakaki, and K. Kichikawa Diffusion Tensor Tractography of the Meyer Loop in Cases of Temporal Lobe Resection for Temporal Lobe Epilepsy: Correlation between Postsurgical Visual Field Defect and Anterior Limit of Meyer Loop on Tractography AJNR Am. J. Neuroradiol., August 1, 2008; 29(7): 1329 - 1334. [Abstract] [Full Text] [PDF]

				J. J. S. Barton, R. Hefter, B. Chang, D. Schomer, and F. Drislane The field defects of anterior temporal lobectomy: a quantitative reassessment of Meyer's loop Brain, September 1, 2005; 128(9): 2123 - 2133. [Abstract] [Full Text] [PDF]

				H Clusmann, T Kral, E Fackeldey, I Blumcke, C Helmstaedter, J von Oertzen, H Urbach, and J Schramm Lesional mesial temporal lobe epilepsy and limited resections: prognostic factors and outcome J. Neurol. Neurosurg. Psychiatry, November 1, 2004; 75(11): 1589 - 1596. [Abstract] [Full Text] [PDF]