{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T09:40:01Z","timestamp":1749807601953,"version":"3.41.0"},"reference-count":57,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Temporal encephaloceles (TEs) are increasingly recognized as a cause of MRI\u2010negative temporal lobe epilepsy (TLE). The optimal surgical approach for TE\u2010related 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\u2010related epilepsy through a systematic review and individual participant data (IPD) meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature review was conducted across Medline, Google Scholar, Embase, and Web of Science, identifying studies reporting surgical outcomes in TE\u2010related epilepsy. Studies were included if they provided at least 12\u2009months of follow\u2010up 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\u2010effects logistic regression model was used to compare outcomes between patients who underwent hippocampectomy and those who did not. Heterogeneity was assessed using <jats:italic>\u03c4<\/jats:italic><jats:sup>2<\/jats:sup> and <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The meta\u2010analysis 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]\u2009=\u20090.66, 95% Confidence Interval [CI]: 0.29\u20131.52, <jats:italic>p<\/jats:italic>\u2009=\u20090.329). 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 <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistic indicated moderate heterogeneity (54.68%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This IPD meta\u2010analysis suggests that hippocompectomy does not significantly impact seizure freedom in patients with TE\u2010related 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\u2010specific factors to optimize surgical decision\u2010making in TE\u2010related epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>Temporal encephaloceles (TEs) can cause drug\u2010resistant 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\u2010stage individual participant data meta\u2010analysis 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\u2010making for patients with TEs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.70036","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T13:44:11Z","timestamp":1744292651000},"page":"796-808","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of hippocampectomy on seizure freedom in temporal encephaloceles: A systematic review and individual participant data meta\u2010analysis"],"prefix":"10.1002","volume":"10","author":[{"given":"Panagiota\u2010Eleni","family":"Tsalouchidou","sequence":"first","affiliation":[{"name":"Epilepsy Center Hessen, Department of Neurology Philipps University Marburg  Marburg Germany"},{"name":"Second Department of Neurology, Attikon University Hospital National and Kapodistrian University of Athens  Athens 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Physics in Imaging and Therapy (ADMIT) TH Mittelhessen University of Applied Sciences  Giessen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/FOC.2008.25.12.E11"},{"issue":"8","key":"e_1_2_11_3_1","first-page":"1468","article-title":"Detection and characteristics of temporal encephaloceles in patients with refractory epilepsy","volume":"39","author":"Campbell ZM","year":"2018","journal-title":"Am J 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