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Multiple hippocampal transection (MHT) is one of the novel surgical techniques in epilepsy surgery. MHT was devised to preserve cognitive functions, particularly verbal memory. Resection of the hippocampus would not be indicated for mesial temporal lobe epilepsy without obvious atrophy of the hippocampus or without any decline in verbal memory. MHT is normally carried out with electrocorticography (ECoG) of the hippocampus. ECoG typically shows large and positive biphasic spikes. After incision of the alveus, a ring transector is used for MHT. The spikes on ECoG disappear with five to six transections in successful cases. Excellent results for both seizure freedom and stable memory function were reported so far. However, the number of cases treated with MHT is still small. Therefore, accumulation of more cases and longer follow-up time are mandatory to establish MHT as one of the standard procedures in epilepsy surgery.

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Multiple Hippocampal Transection for the Preservation of Verbal Memory

  • 章节

  • 发表日期：

    2026年

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  • Takamichi Yamamoto,
  • Tomohiro Yamazoe,
  • Hiroshi Kawaji

摘要

Multiple hippocampal transection (MHT) is one of the novel surgical techniques in epilepsy surgery. MHT was devised to preserve cognitive functions, particularly verbal memory. Resection of the hippocampus would not be indicated for mesial temporal lobe epilepsy without obvious atrophy of the hippocampus or without any decline in verbal memory. MHT is normally carried out with electrocorticography (ECoG) of the hippocampus. ECoG typically shows large and positive biphasic spikes. After incision of the alveus, a ring transector is used for MHT. The spikes on ECoG disappear with five to six transections in successful cases. Excellent results for both seizure freedom and stable memory function were reported so far. However, the number of cases treated with MHT is still small. Therefore, accumulation of more cases and longer follow-up time are mandatory to establish MHT as one of the standard procedures in epilepsy surgery.