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Título

Temporal Lobe Epilepsy with Mesial Hippocampal Sclerosis (TLE-HS): Literature Review

Resumo

Introduction:Temporal Lobe Epilepsy (TLE) is the most common focal epilepsy in adults. Hippocampal sclerosis is associated with TLE and is present in 70-80% of cases. This is an epileptic syndrome commonly associated with drug-resistant epilepsies, and represents one of the most frequent indications for surgery for epilepsy.Objective:To understand the current scenario of TLE-HS.Materials and Methods:This is an integrative literature review with descriptive character, of articles indexed in the Medical Literature Analysis And Retrieval System Online MEDLINE/Pubmed, Latin American and Caribbean Literature in Health Sciences LILACS, and Scientic databases Electronic Library Online (SciELO), researched in the period between october 2021 and March 2022.Results:Initially, 136 articles were found in the databases, which after reading, 32 articles were selected in the research that corresponded to the proposed objective.Conclusions:Attention to the treatment of mesial temporal lobe epilepsy associated with hippocampal sclerosis remains of special interest due to its high prevalence and frequent resistance to antiepileptic drugs. Thus, surgery should be considered in these patients. The preoperative evaluation is responsible for determining the brain area where the crises originate and the precaution of a safe resection without postoperative sequelae. It is a multidisciplinary process that involves the performance of structural tests, functional tests, video-EEG monitoring and psychosocial assessment. The main data to consider are magnetic resonance, interpreted in the context of clinical data and EEG. Surgical treatment for drug-resistant mesial temporal lobe epilepsy with hippocampal sclerosis (ELT-HS) is the most effective alternative, although the literature reports seizure recurrence in 30% of patients treated surgically. Among the standard techniques for patients refractory to clinical treatment, the anterior temporal lobectomy (ATL) stands out. The analyzed studies demonstrate to be the most effective treatment for the control of crises. This technique consists of removing the anterior portion of the temporal lobe, removing structures such as the amygdala, hippocampus and temporal neocortex. The ATL surgical technique is a consolidated and effective procedure, with minimal mortality after the surgical procedure. The surgical treatment of TLE-HS has been shown to be effective for the complete resolution of crises in most patients.

Palavras Chave

Temporal lobe epilepsy, Hippocampal Sclerosis, Epilepsy.