SynthesisEpilepsia open2025
Impact of hippocampectomy on seizure freedom in temporal encephaloceles: A systematic review and individual participant data meta-analysis.
Synthesis in Epilepsia open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of hippocampectomy on seizure freedom in temporal encephaloceles: A systematic review and individual participant data meta-analysis.Epilepsia open · 2025Pooled it
- Awake resection of temporal encephalocele associated with drug-resistant epilepsy: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTemporal encephaloceles (TEs) are increasingly recognized as a cause of MRI-negative temporal lobe epilepsy (TLE). The optimal surgical approach for TE-related refractory epilepsy remains unclear, particularly regarding the necessity of excluding mesiotemporal structures such as the hippocampus, which may lead to worse neuropsychological outcomes. This study evaluates the impact of hippocampectomy on achieving seizure freedom in patients with TE-related epilepsy through a systematic review and individual participant data (IPD) meta-analysis.
methodsA systematic literature review was conducted across Medline, Google Scholar, Embase, and Web of Science, identifying studies reporting surgical outcomes in TE-related epilepsy. Studies were included if they provided at least 12 months of follow-up and reported seizure outcomes using Engel or ILAE classification. The primary outcome was postsurgical seizure freedom (Engel Class IA or ILAE Class 1). A mixed-effects logistic regression model was used to compare outcomes between patients who underwent hippocampectomy and those who did not. Heterogeneity was assessed using τ
resultsThe meta-analysis included 23 studies with a total of 155 surgically treated patients. The primary analysis did not identify a statistically significant difference in seizure freedom between patients who underwent hippocampectomy and those who did not (Risk Ratio [RR] = 0.66, 95% Confidence Interval [CI]: 0.29-1.52, p = 0.329). Other covariates, including sex, duration of epilepsy, presence of additional epileptogenic lesions, and the use of invasive presurgical evaluation, were not significant predictors of seizure freedom. The I SIGNIFICANCE: This IPD meta-analysis suggests that hippocompectomy does not significantly impact seizure freedom in patients with TE-related epilepsy and should not be part of a universal approach when determining the optimal surgical strategy. These results reinforce the need for an individualized approach, considering patient-specific factors to optimize surgical decision-making in TE-related epilepsy. PLAIN LANGUAGE SUMMARY: Temporal encephaloceles (TEs) can cause drug-resistant epilepsy, often requiring surgical management for seizure control. Given the variety of surgical techniques available, the optimal approach remains uncertain, particularly regarding the necessity of hippocampectomy, which may impact neuropsychological outcomes. This one-stage individual participant data meta-analysis found no significant difference in seizure freedom between patients who underwent hippocampectomy and those who did not. These findings suggest that hippocampectomy should not be routinely performed and highlight the importance of individualized surgical decision-making for patients with TEs.
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