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1
Halász, Péter. "The medial temporal lobe epilepsy is a bilateral disease – novel aspects." Journal of Epileptology 24, no. 2 (December 1, 2016): 141–55. http://dx.doi.org/10.1515/joepi-2016-0010.
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SummaryIntroduction.Medial temporal lobe epilepsy (MTLE) is the most frequent form of epilepsy in adulthood. It is classified as local/regional epilepsy. However, there is increasing evidence of the involvement of both temporal lobes and this provides abundant arguments to question this view, and consider MTLE as one of the typical bilateral system epilepsies.Aim.To provide a contemporary review of medial temporal lobe epilepsy, discussing the bilateral aspects, with reference to epilepsy surgery.Methods.A literature review and a resume of the author’s own experiences with MTLE patients.Results.Recent electrophysiological and neuroimaging data provide convincing data supporting that MTLE is a bilateral disease. The uni-and bilateral features form a continuum and the participation rate of the two temporal lobes determine course and surgical perspective of the individual patient.Conclusions.The contradictory data of invasive presurgical evaluations of MTLE patients suggest that there need to identify further indicatory markers of bilaterality and thus change the presurgical evaluation from the non-invasive towards the invasive ways. The mechanisms of the interrelationship between the two temporal lobes in MTLE warrants further research.
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Karavayeva, Ye V., A. V. Ostrovskaya, and N. G. Katayeva. "Research of emotional personal sphere and coping strategies of persons with epilepsy." Bulletin of Siberian Medicine 10, no. 2 (April 28, 2011): 116–21. http://dx.doi.org/10.20538/1682-0363-2011-2-116-121.
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This work is devoted to identifying the relationship between disorders of emotional personal sphere of persons with temporal lobe epilepsy and their preferred coping strategies. The objects of the study were 40 people, including 20 patients with verified diagnosis of temporal lobe epilepsy who are treated at the neurological clinic of the Siberian State University. Clinical and psychological method of research included: the study of neurological status, multivariate Personality Inventory FPI, a scale assessing the level of situational anxiety, C. Spielberger and Y. Khanin, research methods coping strategies A. Lazarus. The results obtained in the present study results confirm the need for early detection of affective spectrum disorders in patients with temporal lobe epilepsy. Because of their availability and high levels of lead to a change in methods of coping with stress, this in turn leads to restrictions in the social sphere.
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Illman, Nathan A., Chris R. Butler, Celine Souchay, and Chris J. A. Moulin. "Déjà Experiences in Temporal Lobe Epilepsy." Epilepsy Research and Treatment 2012 (March 20, 2012): 1–15. http://dx.doi.org/10.1155/2012/539567.
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Historically, déjà vu has been linked to seizure activity in temporal lobe epilepsy, and clinical reports suggest that many patients experience the phenomenon as a manifestation of simple partial seizures. We review studies on déjà vu in epilepsy with reference to recent advances in the understanding of déjà vu from a cognitive and neuropsychological standpoint. We propose a decoupled familiarity hypothesis, whereby déjà vu is produced by an erroneous feeling of familiarity which is not in keeping with current cognitive processing. Our hypothesis converges on a parahippocampal dysfunction as the locus of déjà vu experiences. However, several other temporal lobe structures feature in reports of déjà vu in epilepsy. We suggest that some of the inconsistency in the literature derives from a poor classification of the various types of déjà experiences. We propose déjà vu/déjà vécu as one way of understanding déjà experiences more fully. This distinction is based on current models of memory function, where déjà vu is caused by erroneous familiarity and déjà vécu by erroneous recollection. Priorities for future research and clinical issues are discussed.
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Cascino, Gregory D. "Temporal Lobe Epilepsy: More than Hippocampal Pathology." Epilepsy Currents 5, no. 5 (September 2005): 187–89. http://dx.doi.org/10.1111/j.1535-7511.2005.00059.x.
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Voxel-based Morphometry of the Thalamus in Patients with Refractory Medial Temporal Lobe Epilepsy Bonilha L, Rorden C, Castellano G, Cendes F, Li LM Neuroimage 2005;25:1016–1021 Previous research has suggested that patients with refractory medial temporal lobe epilepsy (MTLE) show gray matter atrophy both within the temporal lobes and in the thalamus. However, these studies have not distinguished between different nuclei within the thalamus. We examined whether thalamic atrophy correlates with the nuclei's connections to other regions in the limbic system. T1-weighted MRI scans were obtained from 49 neurologically healthy control subjects and 43 patients diagnosed with chronic refractory MTLE that was unilateral in origin (as measured by ictal EEG and hippocampal atrophy observed on MRI). Measurements of gray matter concentration (GMC) were made by using automated segmentation algorithms. GMC was analyzed both voxel by voxel (preserving spatial precision) as well as using predefined regions of interest. Voxel-based morphometry revealed intense GMC reduction in the anterior portion relative to posterior thalami. Furthermore, thalamic atrophy was greater ipsilateral to the MTLE origin than on the contralateral side. Here we demonstrate that the thalamic atrophy is most intense in the thalamic nuclei that have strong connections with the limbic hippocampus. This finding suggests that thalamic atrophy reflects this region's anatomic and functional association with the limbic system rather than a general vulnerability to damage. Ipsilateral and Contralateral MRI Volumetric Abnormalities in Chronic Unilateral Temporal Lobe Epilepsy and Their Clinical Correlates Seidenberg M, Kelly KG, Parrish J, Geary E, Dow C, Rutecki P, Hermann B Epilepsia 2005;46:420–430 Purpose To assess the presence, extent, and clinical correlates of quantitative MR volumetric abnormalities in ipsilateral and contralateral hippocampus, and temporal and extratemporal lobe regions in unilateral temporal lobe epilepsy (TLE). Methods In total, 34 subjects with unilateral left ( n = 15) or right ( n = 19) TLE were compared with 65 healthy controls. Regions of interest included the ipsilateral and contralateral hippocampus as well as temporal, frontal, parietal, and occipital lobe gray and white matter. Clinical markers of neurodevelopmental insult (initial precipitating insult, early age of recurrent seizures) and chronicity of epilepsy (epilepsy duration, estimated number of lifetime generalized seizures) were related to MR volume abnormalities. Results Quantitative MR abnormalities extend beyond the ipsilateral hippocampus and temporal lobe with extratemporal (frontal and parietal lobe) reductions in cerebral white matter, especially ipsilateral but also contralateral to the side of seizure onset. Volumetric abnormalities in ipsilateral hippocampus and bilateral cerebral white matter are associated with factors related to both the onset and the chronicity of the patients’ epilepsy. Conclusions These cross-sectional findings support the view that volumetric abnormalities in chronic TLE are associated with a combination of neurodevelopmental and progressive effects, characterized by a prominent disruption in ipsilateral hippocampus and neural connectivity (i.e., white matter volume loss) that extends beyond the temporal lobe, affecting both ipsilateral and contralateral hemispheres. MR Volumetric Analysis of the Piriform Cortex and Cortical Amygdala in Drug-refractory Temporal Lobe Epilepsy Gonçalves Pereira PM, Insaustid R, Artacho-Pérulad E, Salmenperäe T, Kälviäinene R, Pitkänen A AJNR Am J Neuroradiol 2005;26:319–332 Purpose The assessment of patients with temporal lobe epilepsy (TLE) traditionally focuses on the hippocampal formation. These patients, however, may have structural abnormalities in other brain areas. Our purpose was to develop a method to measure the combined volume of the human piriform cortex and cortical amygdala (PCA) by using MRI and to investigate PCA atrophy. Methods The definition of anatomic landmarks on MRIs was based on histologic analysis of 23 autopsy control subjects. Thirty-nine adults with chronic TLE and 23 age-matched control subjects were studied. All underwent high-spatial-resolution MRI at 1.5 T, including a tilted T1-weighted 3D dataset. The PCA volumes were compared with the control values and further correlated with hippocampal, amygdale, and entorhinal cortex volumes. Results The normal volume was 530 ± 59 mm3 (422-644) (mean ± 1 SD [range]) on the right and 512 ± 60 mm3 (406-610) on the left PCA (no asymmetry, and no age or sex effect). The intraobserver and interobserver variability were 6% and 8%, respectively. In right TLE patients, the mean right PCA volume was 18% smaller than that in control subjects ( p < 0.001) and 15% smaller than in left TLE ( p < 0.001). In left TLE, the mean left PCA volume was 16% smaller than in control subjects ( p < 0.001) and 19% smaller than in right TLE ( p < 0.001). Overall, 18 (46%) of the 39 patients had a greater than 20% volume reduction in the ipsilateral PCA. Bilateral atrophy was found in 7 (18%) of 39. Patients with hippocampal volumes of at least 2 SDs below the control mean had an 18% reduction in the mean PCA volume compared with patients without hippocampal atrophy ( p < 0.001). Ipsilaterally, hippocampal ( r = 0.756, p < 0.01), amygdaloid ( r = 0.548, p < 0.01), and entorhinal ( r = 0.500, p < 0.01) volumes correlated with the PCA volumes. Conclusions The quantification of PCA volume with MRI showed that the PCA is extensively damaged in chronic TLE patients, particularly in those with hippocampal atrophy.
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Bintoro, Aris Catur, Muhamad Thohar Arifin, Harsono, Amin Husni, Surya Pratama Brilliantika, Yuriz Bakhtiar, Novita Ikbar Khairunnisa, et al. "Transcortical selective amygdalohippocampectomy for intractable mesial temporal lobe epilepsy: a review of outcomes in a single center." Bali Medical Journal 11, no. 3 (November 1, 2022): 1468–75. http://dx.doi.org/10.15562/bmj.v11i3.3475.
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Introduction: Various surgical procedures have been found to effectively treat intractable temporal lobe epilepsy (TLE), including transcortical selective amygdalohippocampectomy (SAH), which is intended to protect the temporal lobe and to prevent interference with vascular structure. This research analyzed the outcome of post-operative seizure-free with transcortical selective amygdalohippocampectomy for intractable mesial temporal lobe epilepsy patients in a minimum two-year follow-up after surgery. Methods: Data of one hundred ninety-two patients who had undergone transcortical selective amygdalohippocampectomy for non-lesional, medically intractable, temporal lobe epilepsy were analyzed. Result: The statistical analysis indicated that Focal to Bilateral Tonic-Clonic Seizure had a more significant outcome (p=0.019) than other seizures. In all research subjects, after three, six, and twelve years of follow-up, the chance for a seizure-free after surgery was respectively 93.2 percent, 67.9 percent, and 36.7 percent with a median average survival period for all subjects of 11.00 years (95 % CI: 8.55 – 13.44) Conclusions: Transcortical selective amygdalohippocampectomy is an effective therapy for intractable mesial temporal lobe epilepsy and provides a satisfactory outcome. The transcortical approach allows an appropriate operative field by careful dissection with limited retraction to eliminate the epileptogenic target while preventing damage to the underlying vascular and cortical structures.
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Scharfman, Helen E. "The Dentate Gyrus and Temporal Lobe Epilepsy: An “Exciting” Era." Epilepsy Currents 19, no. 4 (June 24, 2019): 249–55. http://dx.doi.org/10.1177/1535759719855952.
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This review describes developments in epilepsy research during the last 3 to 4 decades that focused on the dentate gyrus (DG) and its role in temporal lobe epilepsy (TLE). The emphasis is on basic research in laboratory animals and is chronological, starting with hypotheses that attracted a lot of attention in the 1980s. Then experiments are described that addressed the questions, as well as new methods that often made the experiments possible. In addition, where new questions arose and the implications for clinical epilepsy are discussed.
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Chow, Nelson, and Mark Krongold. "Machine Learning: Current Uses in Temporal Lobe Epilepsy." University of Western Ontario Medical Journal 87, no. 2 (March 12, 2019): 15–17. http://dx.doi.org/10.5206/uwomj.v87i2.1164.
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In the era of Big Data, finding patterns amidst large and/or complex datasets is a significant problem, particularly in medicine, such as in neuroscience and neuroimaging. Machine learning techniques are powerful tools with the ability to develop pattern recognition that, once trained, can be utilized to analyze large datasets in research as well as in clinical settings. Temporal lobe epilepsy is a very prominent neuroimaging research subject in which machine learning has been utilized, demonstrating some of its applications in automated labeling of diagnostic imaging, feature classification and feature extraction.
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Shuman, Tristan, Benjamin Amendolara, and Peyman Golshani. "Theta Rhythmopathy as a Cause of Cognitive Disability in TLE." Epilepsy Currents 17, no. 2 (March 2017): 107–11. http://dx.doi.org/10.5698/1535-7511.17.2.107.
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Memory difficulties are commonly associated with temporal lobe epilepsy (TLE) and cause significant disability. This article reviews the role of altered hippocampal theta oscillations and theta-gamma coupling as potential causes of memory disturbance in temporal lobe epilepsy, dissecting the potential mechanisms underlying these changes in large-scale neuronal synchronization. We discuss development of treatments for cognitive dysfunction directed at restoring theta rhythmicity and future directions for research.
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Carne, R. P., M. J. Cook, L. R. MacGregor, C. J. Kilpatrick, R. J. Hicks, and T. J. O’Brien. "“Magnetic Resonance Imaging Negative Positron Emission Tomography Positive” Temporal Lobe Epilepsy: FDG-PET Pattern Differs from Mesial Temporal Lobe Epilepsy." Molecular Imaging and Biology 9, no. 1 (December 19, 2006): 32–42. http://dx.doi.org/10.1007/s11307-006-0073-0.
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Alsemari, Abdulaziz, Faisal Al-Otaibi, Salah Baz, Ibrahim Althubaiti, Hisham Aldhalaan, David MacDonald, Tareq Abalkhail, et al. "Epilepsy Surgery Series: A Study of 502 Consecutive Patients from a Developing Country." Epilepsy Research and Treatment 2014 (January 30, 2014): 1–8. http://dx.doi.org/10.1155/2014/286801.
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Purpose. To review the postoperative seizure outcomes of patients that underwent surgery for epilepsy at King Faisal Specialist Hospital & Research Centre (KFSHRC). Methods. A descriptive retrospective study for 502 patients operated on for medically intractable epilepsy between 1998 and 2012. The surgical outcome was measured using the ILAE criteria. Results. The epilepsy surgery outcome for temporal lobe epilepsy surgery (ILAE classes 1, 2, and 3) at 12, 36, and 60 months is 79.6%, 74.2%, and 67%, respectively. The favorable 12- and 36-month outcomes for frontal lobe epilepsy surgery are 62% and 52%, respectively. For both parietal and occipital epilepsy lobe surgeries the 12- and 36-month outcomes are 67%. For multilobar epilepsy surgery, the 12- and 36-month outcomes are 65% and 50%, respectively. The 12- and 36-month outcomes for functional hemispherectomy epilepsy surgery are 64.2% and 63%, respectively. According to histopathology diagnosis, mesiotemporal sclerosis (MTS) and benign CNS tumors had the best favorable outcome after surgery at 1 year (77.27% and 84.3%, resp.,) and 3 years (76% and 75%, resp.,). The least favorable seizure-free outcome after 3 years occurred in cases with dual pathology (66.6%). Thirty-four epilepsy patients with normal magnetic resonance imaging (MRI) brain scans were surgically treated. The first- and third-year epilepsy surgery outcome of 17 temporal lobe surgeries were (53%) and (47%) seizure-free, respectively. The first- and third-year epilepsy surgery outcomes of 15 extratemporal epilepsy surgeries were (47%) and (33%) seizure-free. Conclusion. The best outcomes are achieved with temporal epilepsy surgery, mesial temporal sclerosis, and benign CNS tumor. The worst outcomes are from multilobar surgery, dual pathology, and normal MRI.
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SEIDENBERG, MICHAEL, ELIZABETH GEARY, and BRUCE HERMANN. "Investigating temporal lobe contribution to confrontation naming using MRI quantitative volumetrics." Journal of the International Neuropsychological Society 11, no. 4 (July 2005): 358–66. http://dx.doi.org/10.1017/s135561770505054x.
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Confrontation naming ability entails the operation of distinct cognitive operations and the integrity of a distributed neural network. Previous research has indicated a critical role for the left temporal lobe region in naming ability, but there is less agreement about the relative role of distinct temporal lobe regions. In the current paper, we used quantitative MR volumetrics to investigate the relative contribution of the hippocampus and extrahippocampal temporal lobe (segmented gray and white matter) volumes to confrontation naming performance in 53 patients with temporal lobe epilepsy. Findings showed (1) a stronger relationship for left temporal lobe volume than right temporal lobe volume in predicting naming performance; (2) both left temporal lobe white matter volume and left hippocampus volume contributed a significant amount of unique variance to spontaneous naming performance; and (3) left temporal lobe white matter volume but not left hippocampus volume predicted recognition naming performance. (JINS, 2005,11, 358–366.)
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Wicks, Robert T., Walter J. Jermakowicz, Jonathan R. Jagid, Daniel E. Couture, Jon T. Willie, Adrian W. Laxton, and Robert E. Gross. "Laser Interstitial Thermal Therapy for Mesial Temporal Lobe Epilepsy." Neurosurgery 79, suppl_1 (December 1, 2016): S83—S91. http://dx.doi.org/10.1227/neu.0000000000001439.
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Abstract Approximately one-third of patients with epilepsy do not achieve adequate seizure control through medical management alone. Mesial temporal lobe epilepsy (MTLE) is one of the most common forms of medically refractory epilepsy referred for surgical management. Stereotactic laser amygdalohippocampotomy using magnetic resonance-guided laser interstitial thermal therapy (MRg-LITT) is an important emerging therapy for MTLE. Initial published reports support MRg-LITT as a less invasive surgical option with a shorter hospital stay and fewer neurocognitive side effects compared with craniotomy for anterior temporal lobectomy with amygdalohippocampectomy and selective amygdalohippocampectomy. We provide a historical overview of laser interstitial thermal therapy development and the technological advancements that led to the currently available commercial systems. Current applications of MRg-LITT for MTLE, reported outcomes, and technical issues of the surgical procedure are reviewed. Although initial reports indicate that stereotactic laser amygdalohippocampotomy may be a safe and effective therapy for medically refractory MTLE, further research is required to establish its long-term effectiveness and its cost/benefit profile.
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Manna, Ida, Francesco Fortunato, Selene De Benedittis, Ilaria Sammarra, Gloria Bertoli, Angelo Labate, and Antonio Gambardella. "Non-Coding RNAs: New Biomarkers and Therapeutic Targets for Temporal Lobe Epilepsy." International Journal of Molecular Sciences 23, no. 6 (March 11, 2022): 3063. http://dx.doi.org/10.3390/ijms23063063.
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Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy; it is considered a network disorder associated with structural changes. Incomplete knowledge of the pathological changes in TLE complicates a therapeutic approach; indeed, 30 to 50% of patients with TLE are refractory to drug treatment. Non-coding RNAs (ncRNAs), acting as epigenetic factors, participate in the regulation of the pathophysiological processes of epilepsy and are dysregulated during epileptogenesis. Abnormal expression of ncRNA is observed in patients with epilepsy and in animal models of epilepsy. Furthermore, ncRNAs could also be used as biomarkers for the diagnosis and prognosis of treatment response in epilepsy. In summary, ncRNAs can represent important mechanisms and targets for the modulation of brain excitability and can provide information on pathomechanisms, biomarkers and novel therapies for epilepsy. In this review, we summarize the latest research advances concerning mainly molecular mechanisms, regulated by ncRNA, such as synaptic plasticity, inflammation and apoptosis, already associated with the pathogenesis of TLE. Moreover, we discuss the role of ncRNAs, such as microRNAs, long non-coding RNAs and circular RNAs, in the pathophysiology of epilepsy, highlighting their use as potential biomarkers for future therapeutic approaches.
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Weissberg, Itai, Aljoscha Reichert, Uwe Heinemann, and Alon Friedman. "Blood-Brain Barrier Dysfunction in Epileptogenesis of the Temporal Lobe." Epilepsy Research and Treatment 2011 (June 7, 2011): 1–10. http://dx.doi.org/10.1155/2011/143908.
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Epilepsy of the temporal lobe (TLE) is the most common form of focal epilepsy, and in adults, it most frequently develops after injury. However, the mechanisms by which a normal functioning brain turns into an epileptic one still remain obscure. Recent studies point to vascular involvement and particularly blood-brain barrier (BBB) dysfunction in the development of epilepsy. The BBB is a specialized structure which functions to control the neuronal extracellular milieu. BBB dysfunction is found in many diseases of the central nervous system, including stroke, traumatic injuries, tumors and infections. Interestingly, all these insults may initiate an epileptogenic process which eventually leads to spontaneous, recurrent seizures. This epileptogenic time frame usually lasts weeks, months, or even years in man, and days to weeks in rodents and may serve as a “window of opportunity” for the prevention of epilepsy. However, no prevention strategy exists, stressing the importance of research into the mechanisms of epileptogenesis. Here, we will underscore recent experiments suggesting that BBB dysfunction directly induces epileptogenesis. We will provide new evidence to support the hypothesis that BBB breakdown and specifically exposure of temporal lobe structures to the most common serum protein, albumin, is sufficient to induce epileptogenesis.
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Allebone, James, Richard Kanaan, and Sarah J. Wilson. "Systematic review of structural and functional brain alterations in psychosis of epilepsy." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 6 (December 23, 2017): 611–17. http://dx.doi.org/10.1136/jnnp-2017-317102.
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This systematic review critically assesses structural and functional neuroimaging studies of psychosis of epilepsy (POE). We integrate findings from 18 studies of adults with POE to examine the prevailing view that there is a specific relationship between temporal lobe epilepsy (TLE) and POE, and that mesial temporal lobe pathology is a biomarker for POE. Our results show: (1) conflicting evidence of volumetric change in the hippocampus and amygdala; (2) distributed structural pathology beyond the mesial temporal lobe; and (3) changes in frontotemporal functional network activation. These results provide strong evidence for a revised conceptualisation of POE as disorder of brain networks, and highlight that abnormalities in mesial temporal structures alone are unlikely to account for its neuropathogenesis. Understanding POE as a disease of brain networks has important implications for neuroimaging research and clinical practice. Specifically, we suggest that future neuroimaging studies of POE target structural and functional networks, and that practitioners are vigilant for psychotic symptoms in all epilepsies, not just TLE.
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Leach, James L., Reem Awwad, Hansel M. Greiner, Jennifer J. Vannest, Lili Miles, and Francesco T. Mangano. "Mesial temporal lobe morphology in intractable pediatric epilepsy: so-called hippocampal malrotation, associated findings, and relevance to presurgical assessment." Journal of Neurosurgery: Pediatrics 17, no. 6 (June 2016): 683–93. http://dx.doi.org/10.3171/2015.11.peds15485.
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OBJECTIVE Diagnostic criteria for hippocampal malrotation (HIMAL) on brain MRI typically include a rounded hippocampus, vertical collateral sulcus, and architectural blurring. Relationship to epileptogenesis remains speculative, and usefulness for surgical guidance is unknown. The study was performed to determine the prevalence of hippocampal rotational anomalies in a cohort of pediatric patients with intractable epilepsy undergoing evaluation for surgery and to determine the significance of this finding in the context of surgical planning. METHODS Forty-eight surgically treated children with intractable epilepsy were compared with matched healthy subjects; reviewers were blinded to surgical side. Each temporal lobe was evaluated for rounded hippocampus, blurring, vertical collateral sulcus, wide choroidal fissure, enlarged temporal horn, low fornix, hippocampal signal, and findings of hippocampal sclerosis. A mesial temporal lobe (MTL) score was calculated by summing the number of features, and the collateral sulcus angle (CSA) was measured in each temporal lobe. Surgical side, pathological diagnosis, and imaging findings elsewhere in the brain were tabulated. Presence of HIMAL, associated imaging features, and MTL score were compared between sides, between epilepsy and control groups, in relationship to side of surgery, and in relationship to postoperative outcome. RESULTS Only 3 epilepsy patients (6.2%) and no controls exhibited all 3 features of HIMAL (p = 0.12). Eight of 48 (16.7%) epilepsy versus 2 of 48 (4.6%) control subjects had both a rounded hippocampus and vertical collateral sulcus (suggesting HIMAL) (p = 0.045). In control and epilepsy subjects, most findings were more prevalent on the left, and the left CSA was more vertical (p < 0.0001). Epilepsy subjects had higher MTL scores (z = −2.95, p = 0.002) and more acute CSAs (p = 0.04) than controls. Only lateralizing raw MTL score had a significant association with surgical side (p = 0.03, OR 7.33); however, this was not significant when hippocampal sclerosis cases were excluded. HIMAL findings were more prevalent and MTL scores were higher in patients with resections involving the temporal lobes. On group analysis, HIMAL findings did not predict eventual surgical side and did not predict outcome, although the numbers are small. In 4 patients the abnormally rotated hippocampus was resected and showed hippocampal sclerosis and/or dysplastic changes on histopathology. All of these patients had a good outcome after surgery. CONCLUSIONS While increased in prevalence in children with intractable epilepsy, imaging findings of HIMAL did not have preoperative lateralizing utility in this group. Findings of HIMAL (including round hippocampus, architectural blurring, and vertical collateral sulcus) did not predict outcome after surgery, although the small number of patients with these findings limits evaluation. In the small number of patients in which the malrotated hippocampus was removed, outcome was good. Further research is needed to continue to define this association in children with intractable epilepsy, focusing on a temporal lobe cohort.
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Jaimes-Bautista, Amanda G., Mario Rodríguez-Camacho, Iris E. Martínez-Juárez, and Yaneth Rodríguez-Agudelo. "Semantic Processing Impairment in Patients with Temporal Lobe Epilepsy." Epilepsy Research and Treatment 2015 (July 16, 2015): 1–8. http://dx.doi.org/10.1155/2015/746745.
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The impairment in episodic memory system is the best-known cognitive deficit in patients with temporal lobe epilepsy (TLE). Recent studies have shown evidence of semantic disorders, but they have been less studied than episodic memory. The semantic dysfunction in TLE has various cognitive manifestations, such as the presence of language disorders characterized by defects in naming, verbal fluency, or remote semantic information retrieval, which affects the ability of patients to interact with their surroundings. This paper is a review of recent research about the consequences of TLE on semantic processing, considering neuropsychological, electrophysiological, and neuroimaging findings, as well as the functional role of the hippocampus in semantic processing. The evidence from these studies shows disturbance of semantic memory in patients with TLE and supports the theory of declarative memory of the hippocampus. Functional neuroimaging studies show an inefficient compensatory functional reorganization of semantic networks and electrophysiological studies show a lack of N400 effect that could indicate that the deficit in semantic processing in patients with TLE could be due to a failure in the mechanisms of automatic access to lexicon.
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Liberato, José, Lívea Godoy, Alexandra Cunha, Marcia Mortari, Rene de Oliveira Beleboni, Andréia Fontana, Norberto Lopes, and Wagner dos Santos. "Parawixin2 Protects Hippocampal Cells in Experimental Temporal Lobe Epilepsy." Toxins 10, no. 12 (November 22, 2018): 486. http://dx.doi.org/10.3390/toxins10120486.
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Epilepsy is considered as one of the major disabling neuropathologies. Almost one third of adult patients with temporal lobe epilepsy (TLE) do not respond to current antiepileptic drugs (AEDs). Additionally, most AEDs do not have neuroprotective effects against the inherent neurodegenerative process underlying the hippocampal sclerosis on TLE. Dysfunctions in the GABAergic neurotransmission may contribute not only to the onset of epileptic activity but also constitute an important system for therapeutic approaches. Therefore, molecules that enhance GABA inhibitory effects could open novel avenues for the understanding of epileptic plasticity and for drug development. Parawixin2, a compound isolated from Parawixia bistriata spider venom, inhibits both GABA and glycine uptake and has an anticonvulsant effect against a wide range of chemoconvulsants. The neuroprotective potential of Parawixin2 was analyzed in a model of TLE induced by a long-lasting Status Epilepticus (SE), and its efficiency was compared to well-known neuroprotective drugs, such as riluzole and nipecotic acid. Neuroprotection was assessed through histological markers for cell density (Nissl), astrocytic reactivity (GFAP) and cell death labeling (TUNEL), which were performed 24 h and 72 h after SE. Parawixin2 treatment resulted in neuroprotective effects in a dose dependent manner at 24 h and 72 h after SE, as well as reduced reactive astrocytes and apoptotic cell death. Based on these findings, Parawixin2 has a great potential to be used as a tool for neuroscience research and as a probe to the development of novel GABAergic neuroprotective agents.
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Hatton, Sean N., Khoa H. Huynh, Leonardo Bonilha, Eugenio Abela, Saud Alhusaini, Andre Altmann, Marina K. M. Alvim, et al. "White matter abnormalities across different epilepsy syndromes in adults: an ENIGMA-Epilepsy study." Brain 143, no. 8 (August 1, 2020): 2454–73. http://dx.doi.org/10.1093/brain/awaa200.
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Abstract The epilepsies are commonly accompanied by widespread abnormalities in cerebral white matter. ENIGMA-Epilepsy is a large quantitative brain imaging consortium, aggregating data to investigate patterns of neuroimaging abnormalities in common epilepsy syndromes, including temporal lobe epilepsy, extratemporal epilepsy, and genetic generalized epilepsy. Our goal was to rank the most robust white matter microstructural differences across and within syndromes in a multicentre sample of adult epilepsy patients. Diffusion-weighted MRI data were analysed from 1069 healthy controls and 1249 patients: temporal lobe epilepsy with hippocampal sclerosis (n = 599), temporal lobe epilepsy with normal MRI (n = 275), genetic generalized epilepsy (n = 182) and non-lesional extratemporal epilepsy (n = 193). A harmonized protocol using tract-based spatial statistics was used to derive skeletonized maps of fractional anisotropy and mean diffusivity for each participant, and fibre tracts were segmented using a diffusion MRI atlas. Data were harmonized to correct for scanner-specific variations in diffusion measures using a batch-effect correction tool (ComBat). Analyses of covariance, adjusting for age and sex, examined differences between each epilepsy syndrome and controls for each white matter tract (Bonferroni corrected at P < 0.001). Across ‘all epilepsies’ lower fractional anisotropy was observed in most fibre tracts with small to medium effect sizes, especially in the corpus callosum, cingulum and external capsule. There were also less robust increases in mean diffusivity. Syndrome-specific fractional anisotropy and mean diffusivity differences were most pronounced in patients with hippocampal sclerosis in the ipsilateral parahippocampal cingulum and external capsule, with smaller effects across most other tracts. Individuals with temporal lobe epilepsy and normal MRI showed a similar pattern of greater ipsilateral than contralateral abnormalities, but less marked than those in patients with hippocampal sclerosis. Patients with generalized and extratemporal epilepsies had pronounced reductions in fractional anisotropy in the corpus callosum, corona radiata and external capsule, and increased mean diffusivity of the anterior corona radiata. Earlier age of seizure onset and longer disease duration were associated with a greater extent of diffusion abnormalities in patients with hippocampal sclerosis. We demonstrate microstructural abnormalities across major association, commissural, and projection fibres in a large multicentre study of epilepsy. Overall, patients with epilepsy showed white matter abnormalities in the corpus callosum, cingulum and external capsule, with differing severity across epilepsy syndromes. These data further define the spectrum of white matter abnormalities in common epilepsy syndromes, yielding more detailed insights into pathological substrates that may explain cognitive and psychiatric co-morbidities and be used to guide biomarker studies of treatment outcomes and/or genetic research.
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Scherer, E. A., D. L. G. Gitaí, J. Brusco, A. K. B. Lucio-Eterovic, V. D. S. S. Andrade, C. G. Carlotti Junior, J. E. C. Hallak, J. P. Leite, and J. E. Moreira. "Neurotransmitters related to depression and psychosis in patients with temporal lobe epilepsy." European Psychiatry 26, S2 (March 2011): 909. http://dx.doi.org/10.1016/s0924-9338(11)72614-1.
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IntroductionEpilepsy affects between 1 and 2% of the world population. Drug refractoriness is common and about 40% of patients suffer from psychiatric disorders.ObjectiveKnowing noradrenaline, dopamine, serotonin and substance P receptors’ role in hippocampi removed from people with temporal lobe epilepsy (TLE) with or without psychiatric comorbidity.AimsTo assess whether there are differences in different neurotransmitters’ roles in TLE with or without psychiatric comorbidity.MethodTacMan real-time PCR assay to quantify the receptors’ mRNA in 48 TLE patients without (Epilepsy-24) or with psychosis (Psychosis-10) or depression (Depression-14) and 8 necropsies (Controls).ResultsAD2A and AD2C showed differences and more expression in the Epilepsy group when compared with Control and Psychosis. AD2A showed significance in the Antiepileptic variable, a substance that activates AD2A in the hippocampus. AD2A and AD2C without difference for Epilepsy and Depression indicate a two-way relation or common pathogenesis between these illnesses; and their minor expression in the Psychosis group suggests different adrenergic mechanisms connected with psychosis and epilepsy. D2 showed a significant difference in the Psychiatric Diagnosis Subtype and Epileptic Seizures frequency, probably due to chronicity and number of depressive episodes. The role of 5-HT2A in TLE is indicated by its greater expression in the Epilepsy group when compared with the Control, with significance for the Epileptic Seizures frequency. No significant results were found for D4, 5-HT1A, 5-HT2C and NK1.ConclusionProspective research with complementary methods (immunohistochemistry, in situ hybridization, electronic microscopy and neuroimaging) is suggested to identify, locate and visualize the receptors’ distribution.
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Danzer, Steve C. "Adult Neurogenesis in the Development of Epilepsy." Epilepsy Currents 19, no. 5 (August 13, 2019): 316–20. http://dx.doi.org/10.1177/1535759719868186.
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Compelling evidence indicates that hippocampal dentate granule cells are generated throughout human life and into old age. While animal studies demonstrate that these new neurons are important for memory function, animal research also implicates these cells in the pathogenesis of temporal lobe epilepsy. Several recent preclinical studies in rodents now suggest that targeting these new neurons can have disease-modifying effects in epilepsy.
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Smith, Cassandra, Amal Soomro, Jessie Li, Madison Norman, Abigail Rose, and Eliezer Schwartz. "A-133 Assessing Cognitive Performance in Bilingual Children with Refractory Temporal Lobe Epilepsy: A Systematic Review." Archives of Clinical Neuropsychology 37, no. 6 (August 17, 2022): 1287. http://dx.doi.org/10.1093/arclin/acac060.133.
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Abstract Objective: The effects of bilingualism on cognitive profiles in children with pre-surgical temporal lobe epilepsy (TLE) have not been well-addressed. The goal of this systematic review was to assess the state of knowledge on cognitive performance in bilingual children with refractory TLE. Data Selection: An extensive literature search using PubMed, Wiley, and ScienceDirect/Elsevier research databases yielded 326 articles on cognitive performance of children with TLE using the following search terms: temporal lobe epilepsy in bilingual children, temporal lobe epilepsy, bilingualism, bilingual, children. Of these, only 3 met inclusion/exclusion criteria set prior to initiating the literature search. Data Synthesis: Findings from the systematic review were mixed. Although some studies found that bilingual children with refractory TLE perform similarly to healthy controls and monolingual TLE children on measures of executive functioning and working memory. Other studies found that bilingualism no longer served as a protective factor for cognitive performance, specifically executive functioning, after accounting for the presence of TLE. Conclusion: Neuropsychology is an integral part of TLE rehabilitation programs to provide comprehensive evaluations of patients with epilepsy and increase quality of life outcomes. Bilingualism may be a protective factor due to reorganization of executive functioning networks that promote cognitive reserve. However, the current review highlights the need for further study of cognitive profiles of bilingual children with TLE, as executive functioning may be uniquely impacted.
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Al-Joudi, Haya F., Lina Mincari, Salah Baz, Michael Nester, Najla Al-Marzouki, Tariq Abalkhail, Noha Aljehani, Camellia Al-Ibrahim, and Jason Brandt. "Standardization of an Arabic-Language Neuropsychological Battery for Epilepsy Surgical Evaluations." Journal of the International Neuropsychological Society 25, no. 7 (May 14, 2019): 761–71. http://dx.doi.org/10.1017/s1355617719000432.
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AbstractObjectives: This study provides a standardized Arabic language neuropsychological test battery and tests its ability to distinguish patients with left and right hemisphere epileptic foci who are candidates for surgical resection. Methods: An Arabic language battery of 15 tests was developed based on the neuropsychological test battery used at the Johns Hopkins Hospital for surgical evaluation of patients undergoing temporal lobe resection. With modifications where culturally required, 11 tests were translated to Arabic by the principal investigator and back-translated by two bilingual health professionals; four tests were available in Arabic and added to the battery. The battery was administered to 21 Arabic-speaking patients with left temporal epileptic foci, 21 with right temporal epileptic foci, and 46 neurologically and psychiatrically healthy adults. Results: Nearly all the Arabic test versions were capable of differentiating healthy controls and the temporal lobe epilepsy (TLE) groups. Tests known to distinguish left and right temporal lobectomy candidates, such as wordlist memory and prose recall, were able to do so as accurately as the English versions. Also, a roughly “culturally free” task (the Baltimore Board) and a newly developed version of the Boston Naming Test demonstrated some sensitivity to left temporal lobe involvement. Conclusions: Arabic-language neuropsychological tests for epilepsy surgical evaluations are made available, demonstrate cultural sensitivity and clinical validity, and require further psychometric property and normative research. (JINS, 2019, 25, 761–771)
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Alshahrani, A., and Seyed Mirsattari. "P.034 Temporal lobe epilepsy associated with autoimmune conditions: a review." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 49, s1 (June 2022): S16—S17. http://dx.doi.org/10.1017/cjn.2022.136.
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Background: Epilepsy mediated by immune cells must be identified early since immunotherapy has been associated with better clinical outcomes. This provides an overview of autoimmune TLE, emphasizing recent developments in its pathophysiology, imaging, and therapeutic interventions. Methods: Web-based research using advanced features of databases. Results: Epilepsy caused by immune dysfunction leads to inflammation of the brain. Inflammation play a role in the development of seizures. Proinflammatory molecules found to be overexpressed in neurons and glia of individuals with DRE, provoke a proinflammatory cytokines in the plasma and CSF. Autoimmune epilepsy is characterized by focal seizures refractory to ASMs accompanied by other neurological manifestations, as described by clinical scoring systems.Scoring systems are available to identify patients who are likely to be positive. The MRI findings include signal hyperintensities in the affected brain regions. EEG performed to exclude nonconvulsive seizures. Seizures resulting from autoimmune encephalitis are caused by antibodies to surface antigens and intracellular antigenes. Conclusions: Pathogenesis proposed to involve antibody-mediated ictogenesis. Immunotherapy is effective in autoimmune encephalitis with a positive prognosis if detected early. Limbic encephalitis has been shown to have a detrimental effect on cognition, mood, and behavior. Neuropsychology is an important outcome criterion for tracking disease progression and treatment success.
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Zheng, Yongsu, Nian Wei, Jian Wang, Hui Dai, and Zucai Xu. "Anti-Hu-related epilepsy diagnosed after surgical management." Journal of International Medical Research 48, no. 8 (August 2020): 030006052094791. http://dx.doi.org/10.1177/0300060520947914.
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Autoimmune epilepsy (AE) refers to epilepsy mediated by autoantibodies or immune cells, and a large proportion of drug-resistant epilepsy cases are classified as AE. AE lacks standardized management guidelines. At present, little research has been conducted on the effectiveness of surgical treatment of AE. This paper reports a patient whose surgical treatment was ineffective before AE was diagnosed and who improved after immunotherapy. A literature review was conducted to examine the progress of surgical treatment of epilepsy, the relationship of temporal lobe epilepsy to neuronal antibodies, surgical and prognostic factors, research progress on the anti-Hu antibody, and treatment of autoimmune encephalitis to provide a clinical reference.
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JIANG, TING, HONGYU LONG, YAN MA, LILI LONG, YI LI, FENG LI, PINTING ZHOU, CHUNYUN YUAN, and BO XIAO. "Altered expression of pannexin proteins in patients with temporal lobe epilepsy." Molecular Medicine Reports 8, no. 6 (October 18, 2013): 1801–6. http://dx.doi.org/10.3892/mmr.2013.1739.
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Chamberlain, Marc C., and Gary A. Press. "Temporal lobe ganglioglioma in refractory epilepsy: CT and MR in three cases." Journal of Neuro-Oncology 9, no. 1 (August 1990): 81–87. http://dx.doi.org/10.1007/bf00167073.
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Ekstrom, Arne, Nanthia Suthana, Eric Behnke, Noriko Salamon, Susan Bookheimer, and Itzhak Fried. "High-resolution depth electrode localization and imaging in patients with pharmacologically intractable epilepsy." Journal of Neurosurgery 108, no. 4 (April 2008): 812–15. http://dx.doi.org/10.3171/jns/2008/108/4/0812.
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✓Localization and targeting of depth electrodes in specific regions of the human brain is critical for accurate clinical diagnoses and treatment as well as for neuroscientific electrophysiological research. By using high-resolution magnetic resonance imaging combined with 2D computational unfolding, the authors present a method that improves electrode localization in the medial temporal lobe. This method permits visualization of electrode placements in subregions of the hippocampus and parahippocampal gyrus, allowing for greater specificity in relating electrophysiological and anatomical features in the human medial temporal lobe. Such methods may be extended to therapeutic procedures targeting specific neuronal circuitry in subfields of structures deep in the human brain.
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Geraldi, Camila de Vasconcelos, Sara Escorsi-Rosset, Pamela Thompson, Ana C. Gargaro Silva, and Américo Ceiki Sakamoto. "Potential role of a cognitive rehabilitation program following left temporal lobe epilepsy surgery." Arquivos de Neuro-Psiquiatria 75, no. 6 (June 2017): 359–65. http://dx.doi.org/10.1590/0004-282x20170050.
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ABSTRACT Research into memory and epilepsy has focused on measuring problems and exploring causes with limited attention directed at the role of neuropsychological rehabilitation in alleviating post-operative memory difficulties. Objectives To assess the effects of a memory rehabilitation program in patients with left temporal lobe epilepsy following surgery. Methods Twenty-four patients agreed to participate and 18 completed the study; nine received memory rehabilitation while nine had no input and were designated as controls. Verbal learning efficiency, naming abilities, memory subjective ratings, ecological activity measures and a language fMRI paradigm were used as outcome measures. Results Improved verbal learning and naming test performance, increase in memory strategy use and improved self-perception were observed following the rehabilitation. Changes in fMRI activation patterns were seen in the rehabilitation group over the long term. Conclusion The findings support the potential role of a cognitive rehabilitation program following left temporal lobe surgery.
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Mushehian, Marianna, and Tetyana Litovchenko. "ANALYSIS OF PECULIARITIES OF EPILEPTIC SEIZURES AND STRUCTURAL DAMAGES OF BRAIN IN PATIENTS WITH ISCHEMIC STROKE." ScienceRise, no. 5 (October 31, 2020): 46–53. http://dx.doi.org/10.21303/2313-8416.2020.001454.
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The aim of the research: epilepsy on the background of ischemic stroke.
Studied problem: improve of diagnosis of epilepsy on the background of ischemic stroke by establishing the clinical features of epileptic seizures and by detection of brain structural damages
The main scientific results: a cross-sectional randomized cohort comparative study with retrospective and prospective stages was performed in 60 patients (men and women) with ischemic stroke aged 65 [57.0; 74.0] years, in 30 of which epileptic seizures were detected. The predominance of generalized single (66.7±38.5 %) variants was found in the structure of epileptic seizures in patients with acute cerebrovascular pathology. A higher frequency of generalized variants of seizures in patients over 60 years of age (maximum at 61–70 years, at descending – 71–80 years, over 80 years) has been revealed. The descending distribution of localization frequency of brain lesions (detected with MRI, CT) in patients with epileptic seizures after ischemic stroke is as follows: dilation of the subarachnoid space (93.3±24.1 %), dilation of the brain ventricles (83.3±34.0 %), subcortical ganglia (76.7±37.0 %), right hemisphere or temporal lobe (60.0±37.9 %), subcortex (56.7±37.3 %), frontal lobe (50.0±35.4 %), left hemisphere or diffuse-atrophic changes in the cortical region (43.3±32.6 %), temporal lobe (20.0±17.9 %), occipital lobe (16.7±15.2 %).
The area of practical use of the research results: clinical medicine, especially neurology.
Innovative technological product: methodology of diagnosis of epilepsy on the background of ischemic stroke.
Scope of the innovative technological product: the evaluation of seizures and brain’s structural damages in patients with ischemic stroke with the development of epileptic seizures may be a means of improving the diagnosis of epilepsy on the background of cerebrovascular disease.
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Illman, Nathan A., Steven Kemp, Céline Souchay, Robin G. Morris, and Chris J. A. Moulin. "Assessing a Metacognitive Account of Associative Memory Impairments in Temporal Lobe Epilepsy." Epilepsy Research and Treatment 2016 (September 19, 2016): 1–11. http://dx.doi.org/10.1155/2016/6746938.
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Previous research has pointed to a deficit in associative recognition in temporal lobe epilepsy (TLE). Associative recognition tasks require discrimination between various combinations of words which have and have not been seen previously (such as old-old or old-new pairs). People with TLE tend to respond to rearranged old-old pairs as if they are “intact” old-old pairs, which has been interpreted as a failure to use a recollection strategy to overcome the familiarity of two recombined words into a new pairing. We examined this specific deficit in the context of metacognition, using postdecision confidence judgements at test. We expected that TLE patients would show inappropriate levels of confidence for associative recognition. Although TLE patients reported lower confidence levels in their responses overall, they were sensitive to the difficulty of varying pair types in their judgements and gave significantly higher confidence ratings for their correct answers. We conclude that a strategic deficit is not at play in the associative recognition of people with TLE, insofar as they are able to monitor the status of their memory system. This adds to a growing body of research suggesting that recollection is impaired in TLE, but not metacognition.
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Sheilabi, Mariam A., Louise Y. Takeshita, Edward J. Sims, Francesco Falciani, and Alessandra P. Princivalle. "The Sodium Channel B4-Subunits are Dysregulated in Temporal Lobe Epilepsy Drug-Resistant Patients." International Journal of Molecular Sciences 21, no. 8 (April 22, 2020): 2955. http://dx.doi.org/10.3390/ijms21082955.
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Temporal lobe epilepsy (TLE) is the most common type of partial epilepsy referred for surgery due to antiepileptic drug (AED) resistance. A common molecular target for many of these drugs is the voltage-gated sodium channel (VGSC). The VGSC consists of four domains of pore-forming α-subunits and two auxiliary β-subunits, several of which have been well studied in epileptic conditions. However, despite the β4-subunits’ role having been reported in some neurological conditions, there is little research investigating its potential significance in epilepsy. Therefore, the purpose of this work was to assess the role of SCN4β in epilepsy by using a combination of molecular and bioinformatics approaches. We first demonstrated that there was a reduction in the relative expression of SCN4B in the drug-resistant TLE patients compared to non-epileptic control specimens, both at the mRNA and protein levels. By analyzing a co-expression network in the neighborhood of SCN4B we then discovered a linkage between the expression of this gene and K+ channels activated by Ca2+, or K+ two-pore domain channels. Our approach also inferred several potential effector functions linked to variation in the expression of SCN4B. These observations support the hypothesis that SCN4B is a key factor in AED-resistant TLE, which could help direct both the drug selection of TLE treatments and the development of future AEDs.
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Shankar, V., R. Kumar, R. Adhityan, A. K. Karthikayan, A. Shinto, S. Jayaraman, S. Muthukani, et al. "Efficacy of Frameless Radiosurgical Entorhino-Amygdalohippocampectomy for Pharmacoresistant Medial Temporal Lobe Epilepsy." International Journal of Radiation Oncology*Biology*Physics 111, no. 3 (November 2021): e76. http://dx.doi.org/10.1016/j.ijrobp.2021.07.439.
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Wiebe, Samuel, and Nathalie Jette. "Randomized Trials and Collaborative Research in Epilepsy Surgery: Future Directions." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 33, no. 4 (November 2006): 365–71. http://dx.doi.org/10.1017/s031716710000531x.
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Background:Although randomized controlled trials (RCTs) are the gold standard for evaluating therapeutic interventions, surgical RCTs are particularly challenging and few have been done in the field of epilepsy surgery. We assess the level of RCT activity in epilepsy surgery and propose feasible alternatives to develop sustainable research initiatives in this area.Methods:We undertook a systematic review of the world literature to assess the level of RCT activity in epilepsy surgery. Previous personal experience with RCTs in epilepsy surgery and examples of successful Canadian multicentre research networks were reviewed to propose initiatives for sustainable, valid research in epilepsy surgery.Results:We identified 12 RCTs in epilepsy surgery, including 692 patients, of whom 416 were involved in vagus nerve stimulation, 16 in various brain electrostimulation procedures, 180 in comparisons of different surgical techniques, and 80 in a comparison of medical versus surgical therapy. Most studies were of short duration (median = 3 months, range 3-12 months). In the area of resective surgery, only temporal lobe epilepsy has been subjected to any type of RCT comparison. All RCTs have been done within the last 13 years. There were no multicentre Canadian surgical studies.Conclusion:The adoption of RCTs in epilepsy surgery has been slow and difficult worldwide. Because of its universal health care system and its well established epilepsy surgery centres, Canada is in a strong position to create a national epilepsy surgery research initiative capable of undertaking high quality, sustainable research in epilepsy surgery.
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Ulitin, A. Yu, A. V. Vasilenko, A. V. Ivanenko, P. D. Bubnova, Z. M. Rasulov, I. A. Sokolov, M. A. Bulaeva, and A. E. Vershinin. "Neurophysiological and morphological features of the formation of the pathological hippocampal system in structural epilepsy (Literature review)." Russian Journal for Personalized Medicine 2, no. 1 (April 5, 2022): 83–92. http://dx.doi.org/10.18705/2782-3806-2022-2-1-83-92.
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Modern scientific research shows that often violations of the structure and function of the hippocampus can lead to the onset of epilepsy. The hippocampal formation and the amygdala are important anatomical structures involved in the development of local discharges of epileptiform activity and temporal lobe epilepsy. It accounts for up to 25 % of all epileptic syndromes, and among locally caused symptomatic epilepsy — up to 60–70 %. At the same time, temporal lobe epilepsy is considered as a pathology with an initial imbalance of excitatory and inhibitory mechanisms of the neocortex, which occurs under the influence of various endoand exogenous factors during early embryogenesis. The scientific literature presents various pathophysiological theories of exactly how the hippocampus is involved in the development of epileptic seizures. Anatomically, the hippocampus has a relatively poor blood supply, and inhibitory interneurons are deep intraparenchymal structures, making them more susceptible to factors such as hypoxia, ischemia, and oxidative stress. This article addresses issues related not only to changes in the structure and function of the hippocampus, but also aspects of neu rophysiological diagnosis and prognosis. In addition, an evidence base is provided on the possibility of achieving remission of seizures after the use of neurosurgical methods of treatment.
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Phi, Ji Hoon, Seung-Ki Kim, Byung-Kyu Cho, Seo Young Lee, Su Yeon Park, Sung-joon Park, Sang Kun Lee, Ki Joong Kim, and Chun Kee Chung. "Long-term surgical outcomes of temporal lobe epilepsy associated with low-grade brain tumors." Cancer 115, no. 24 (December 15, 2009): 5771–79. http://dx.doi.org/10.1002/cncr.24666.
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Abel, Taylor J., Royce W. Woodroffe, Kirill V. Nourski, Toshio Moritani, Aristides A. Capizzano, Patricia Kirby, Hiroto Kawasaki, Matthew Howard, and Mary Ann Werz. "Role of the temporal pole in temporal lobe epilepsy seizure networks: an intracranial electrode investigation." Journal of Neurosurgery 129, no. 1 (July 2018): 165–73. http://dx.doi.org/10.3171/2017.3.jns162821.
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OBJECTIVEA convergence of clinical research suggests that the temporal pole (TP) plays an important and potentially underappreciated role in the genesis and propagation of seizures in temporal lobe epilepsy (TLE). Understanding its role is becoming increasingly important because selective resections for medically intractable TLE spare temporopolar cortex (TPC). The purpose of this study was to characterize the role of the TPC in TLE after using dense electrocorticography (ECoG) recordings in patients undergoing invasive monitoring for medically intractable TLE.METHODSChronic ECoG recordings were obtained in 10 consecutive patients by using an array customized to provide dense coverage of the TP as part of invasive monitoring to localize the epileptogenic zone. All patients would eventually undergo cortico-amygdalohippocampectomy. A retrospective review of the patient clinical records including ECoG recordings, neuroimaging studies, neuropathology reports, and clinical outcomes was performed.RESULTSIn 7 patients (70%), the TP was involved at seizure onset; in 7 patients (70%), there were interictal discharges from the TP; and in 1 case, there was early spread to the TP. Seizure onset in the TP did not necessarily correlate with preoperative neuroimaging abnormalities of the TP.CONCLUSIONSThese data demonstrate that TPC commonly plays a crucial role in temporal lobe seizure networks. Seizure onset from the TP would not have been predicted based on available neuroimaging data or interictal discharges. These findings illustrate the importance of thoroughly considering the role of the TP prior to resective surgery for TLE, particularly when selective mesial resection is being considered.
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Gersner, Roman, Lindsay M. Oberman, Maria J. Sanchez, Nicolas Chiriboga, Harper L. Kaye, Alvaro Pascual-Leone, Abraham Zangen, and Alexander Rotenberg. "Preliminary Report of the Safety and Tolerability of 1 Hz Repetitive Transcranial Magnetic Stimulation in Temporal Lobe Epilepsy." Journal of Central Nervous System Disease 14 (January 2022): 117957352210885. http://dx.doi.org/10.1177/11795735221088522.
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Background: Low frequency (≤1 Hz) repetitive transcranial magnetic stimulation (rTMS) has been shown to suppress cortical excitability and is beginning to be trialed for the treatment of refractory epilepsy. Purpose As a step toward a larger trial, the current pilot study was aimed to test the tolerability and safety of temporal lobe rTMS using H-coil for the treatment of temporal lobe epilepsy (TLE). Research Design: 1800 pulses of active or sham rTMS were applied 5 days a week for 2 weeks over the temporal lobe of the affected hemisphere. Results: Nine participants were enrolled and randomized to verum or sham stimulation. One participant dropped out from the sham group after 5 rTMS sessions. In-session, 3 patients had typical seizures during sham stimulation. One patient had seizures also during active stimulation (albeit fewer than during sham). Minor reported adverse events during stimulation otherwise included transient neck pain and headache, and were reported in equal numbers in both groups. Major adverse events were not reported. Our results indicate that H-coil rTMS was well-tolerated. Conclusion: Given the relatively high prevalence of individuals with TLE who are treatment-resistant and the preliminary results of this study, we suggest that a larger safety and efficacy trial of 1 Hz rTMS for the treatment of TLE is warranted.
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Flint, Alice E., Mitch G. Waterman, Poppy Siddell, Alexandra L. Houston, Gayatri Vadlamani, Paul Chumas, and Matthew C. H. J. Morrall. "Assessing evidence quality in research reporting neurocognitive outcomes following paediatric temporal lobe surgery for epilepsy." Epilepsy Research 154 (August 2019): 116–23. http://dx.doi.org/10.1016/j.eplepsyres.2019.03.013.
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Yang, Xinglong, Baiyuan Yang, Haonan Li, and Hui Ren. "Upregulation of Rho7 in the temporal lobe tissue of humans with intractable epilepsy." Molecular Medicine Reports 16, no. 6 (October 13, 2017): 9613–19. http://dx.doi.org/10.3892/mmr.2017.7787.
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Okta Silfina, Redha, Hermina Sukmaningtyas, and Rini Indrati. "Detection of Mesial Temporal Lobe Epilepsy in MRI Sequence T2 Flair MRI Image Using Computer Aided Diagnosis (CAD)." E3S Web of Conferences 202 (2020): 15010. http://dx.doi.org/10.1051/e3sconf/202020215010.
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Epilepsy is a serious disorder in the brain. One of the most frequently found is temporal lobe epilepsy. This type of epilepsy is mainly caused by hippocampal sclerosis and treatment is often refractory so it needs surgery, this epilepsy is called mesial temporal lobe epilepsy (MTLE). MRI features for hippocampal sclerosis seen visually are a decrease in T1-weighted intensity and an increase in T2-weighted intensity. T2WI and T2 FLAIR are the sequences most often assessed for the diagnosis of hippocampal sclerosis. The assessment carried out by the practitioner to see the increase in intensity of the sequence is done visually. Visual assessment has flaws because of the limited vision and subjectivity of the practitioner, thereby producing several opinions to determine the level of intensity of the sequence. In this study a Computer Aided Diagnosis (CAD) method is proposed to assess quantitatively by assessing the intensity that exists in the FLAIR T2 sequence. This research uses Computer Aided Diagnosis (CAD) with computer programming, Image processing as a tool to find the intensity value and get a cut-off point value > 825, from this result then conduct a test by measuring the sensitivity value (90%), specificity (69%), positive predictive value (80%), negative predictive value (83%) and accuracy (81%). The of area under the curve is 0.8119, with the average ability to determine the pain is not sick is 0.71 -0.91. The results of this study indicate that Computer Aided Diagnosis (CAD) is able to detect hippocampal sclerosis in ELTM well.
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YAMANO, Mitsuhiko, Naoki AKAMATSU, and Sadatoshi TSUJI. "Advances in Research on Cognitive Function Related to Temporal Lobe Epilepsy: Focus on Social Cognitive Function." Journal of UOEH 34, no. 3 (2012): 245–58. http://dx.doi.org/10.7888/juoeh.34.245.
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Lester, David. "Rage Dyscontrol and Suicide: An Extension of Nell's Ideas." South African Journal of Psychology 22, no. 1 (March 1992): 27–28. http://dx.doi.org/10.1177/008124639202200105.
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Nell recently described the rage dyscontrol syndrome, and the present paper explores whether this syndrome may have relevance for the description of suicidal individuals. Evidence was found from research that several of the characteristics of the rage dyscontrol syndrome (temporal lobe epilepsy, paroxysmal EEGs, learning disabilities, impulsiveness, assaultive behaviour, psychiatrically disturbed parents, and experience of physical abuse) have been found to characterize some suicidal people. Suggestions were made for research to explore the relevance of the rage dyscontrol syndrome for understanding suicidal behaviour.
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Shen, Erica, Alireza Shams, Xianyuan Song, and Ahmad Daher. "BIOM-25. ADULT GANGLIOGLIOMA: A 4-PATIENT CASE SERIES WITH MOLECULAR PROFILING." Neuro-Oncology 23, Supplement_6 (November 2, 2021): vi16. http://dx.doi.org/10.1093/neuonc/noab196.056.
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Abstract Accounting for only 2% of all primary brain tumors, ganglioglioma is a rare neoplasm that most frequently arises in the temporal lobe in children or young adults. Ganglioglioma is the most common epilepsy-associated neoplasm and is typically composed of dysplastic ganglion cells and neoplastic glial cells. Recent publications have revealed that the activating p.V600E mutation in the BRAF oncogene is seen in 20-60% of gangliogliomas. However, the genetic landscape of ganglioglioma requires further elucidation, especially in gangliogliomas that arise from outside of the temporal lobe in adults. In this case series, we describe the genetic mutations of adult gangliogliomas originating outside of the temporal lobe in four patients aged 21 to 56 years. Targeted next generation sequencing via the MSK-IMPACT panel covering ~ 500 actionable mutations was used in all cases. None of the cases had the BRAF p.V600E mutation. Case 1 describes a left cerebellar cystic ganglioglioma with NTRK2 fusion mutation (NTRK2-DST) and a tumor mutation burden (TMB) = 0 mutation/megabase (mut/Mb). Case 2 describes a right parietal lobe cystic ganglioglioma with a BRAF-CLEC2Linversion mutation and TMB = 0 mut/Mb. Case 3 describes a cerebellar vermis ganglioglioma with a BRAF fusion mutation (BRAF-KIAA1549) and TMB = 0 mut/Mb. The last case describes a right cerebellopontine angle ganglioglioma with a MAP2K1 splicing mutation and TMB = 0.9 mut/Mb. To the best of our knowledge, the mutations identified in this case series have not been previously described in adult brain gangliogliomas. The BRAF-KIAA1549 fusion mutation has been found in spinal cord gangliogliomas, but not in brain gangliogliomas. MAP2K1 splicing mutations, unlike MAP2K1 in-frame deletions, have not been found in gangliogliomas. Finally, a different NTRK2 mutation (NTRK2-TLE4) has been described in a pediatric ganglioglioma, but NTRK2-DST has not been found in any adult gangliogliomas.
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Ma, L., P. K. Sneed, A. B. Hwang, M. Descovich, I. J. Barani, M. W. McDermott, and N. M. Barbaro. "Quality Assurance of Multi-institutional Trial of Gamma Knife Radiosurgery of Mesial Temporal Lobe Epilepsy." International Journal of Radiation Oncology*Biology*Physics 78, no. 3 (November 2010): S287. http://dx.doi.org/10.1016/j.ijrobp.2010.07.683.
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Jain, Puneet, George Tomlinson, Carter Snead, Beate Sander, and Elysa Widjaja. "Systematic review and network meta-analysis of resective surgery for mesial temporal lobe epilepsy." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 11 (May 16, 2018): 1138–44. http://dx.doi.org/10.1136/jnnp-2017-317783.
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ObjectiveTo evaluate the effectiveness of anterior temporal lobectomy (ATL) versus selective amygdalohippocampectomy (SAH) on seizure-free outcome in patients with temporal lobe epilepsy, using both direct and indirect evidence from the literature.MethodsMEDLINE, Embase and Cochrane databases were searched for original research articles and systematic reviews comparing ATL versus SAH, and ATL or SAH versus medical management (MM). The outcome was seizure freedom at 12 months of follow-up or longer. Direct pairwise meta-analyses were conducted, followed by a random-effect Bayesian network meta-analysis (NMA) combining direct and indirect evidence.ResultsTwenty-eight articles were included (18 compared ATL vs SAH, 1 compared ATL vs SAH vs MM, 8 compared ATL vs MM, and 1 compared SAH vs MM). Direct pairwise meta-analyses showed no significant differences in seizure-free outcome of ATL versus SAH (OR 1.14, 95% CI 0.93 to 1.39; p=0.201), but the odds of seizure-free outcome were higher for ATL versus MM (OR 29.16, 95% CI 10.44 to 81.50; p<0.00001), and SAH versus MM (OR 28.42, 95% CI 10.17 to 79.39; p<0.00001). NMA also showed that the odds of seizure-free outcome were no different in ATL versus SAH (OR 1.15, 95% credible interval (CrI) 0.84–1.15), but higher for ATL versus MM (OR 27.22, 95% CrI 15.38–27.22), and SAH versus MM (OR 23.57, 95% CrI 12.67–23.57). There were no significant differences between direct and indirect comparisons (all p>0.05).ConclusionDirect evidence, indirect evidence and NMA did not identify a difference in seizure-free outcome of ATL versus SAH.
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Stanek, Kelly M., Yong D. Park, Anthony M. Murro, Debra Moore-Hill, and Fernando Vale. "A-282 Verbal Fluencies are Differentially Associated with Processing Speed in Temporal Lobe Epilepsy." Archives of Clinical Neuropsychology 37, no. 6 (August 17, 2022): 1433. http://dx.doi.org/10.1093/arclin/acac060.282.
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Abstract Objective: The current study sought to better understand the impact of processing speed on pre-surgical assessment of verbal fluencies in temporal lobe epilepsy (TLE) by examining whether processing speed is differentially related to category and letter fluencies across patients with left and right unilateral TLE. Method: The retrospective data sample included 36 adults aged 17-60 (56% female) with cryptogenic TLE and both video EEG evidence for unilateral seizure focus (right TLE n =16; left TLE n=20) and confirmed left hemisphere language dominance, who had undergone pre-surgical neuropsychological evaluation including assessment of category fluency (Animal Naming), letter fluency (FAS), and processing speed (Coding). Primary partial correlation analyses controlled for age and years of education. Results: After controlling for demographic variables in each of the following analyses, there was a statistically significant relationship between Coding and Animal Naming (r=.47, p<.01) but not FAS in the full sample of TLE patients. Similarly in the left TLE group, there was a statistically significant relationship between Coding and Animal Naming (r=.47, p<.05) but not FAS. In the right TLE group, neither Animal Naming nor FAS were statistically significantly related to Coding. Conclusion: Results suggest that processing speed may have a greater influence on measurement of category as opposed to letter fluency in individuals with left TLE but not right TLE. While further research in larger samples is indicated, a better understanding of these relationships is important in assessing the lateralizing/localizing value of semantic and phonemic fluencies in pre-surgical neurocognitive profiles of patients with unilateral TLE with impaired processing speed.
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Widjaja, Elysa, Puneet Jain, Lindsay Demoe, Astrid Guttmann, George Tomlinson, and Beate Sander. "Seizure outcome of pediatric epilepsy surgery." Neurology 94, no. 7 (January 29, 2020): 311–21. http://dx.doi.org/10.1212/wnl.0000000000008966.
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ObjectiveThis systematic review and meta-analyses assessed seizure outcome following pediatric epilepsy surgery.MethodsMEDLINE, EMBASE, and Cochrane were searched for pediatric epilepsy surgery original research from 1990 to 2017. The outcome was seizure freedom at 12 months or longer follow-up. Using random-effects models, the effect sizes for controlled studies, uncontrolled studies on surgery locations (temporal lobe [TL], extratemporal lobe [ETL], or hemispheric surgery), pathologies, nonlesional epilepsy, and incomplete resection were estimated. Meta-regression assessed the relationship between age at surgery, age at seizure onset, and seizure outcome. Random-effects network meta-analysis was conducted for surgery locations.ResultsTwo hundred fifty-eight studies were included. Surgery achieved higher seizure freedom than medical therapy (odds ratio [OR] = 6.49 [95% confidence interval [CI]: 2.87–14.70], p < 0.001). Seizure freedom declined over time after surgery, from 64.8% (95% CI: 51.2%–76.4%; p = 0.034) at 1 year, to 60.3% (95% CI: 52.9%–67.4%; p = 0.007) at 5 years, and to 39.7% (95% CI: 28.4%–52.2%, p = 0.106) at 10 years. Seizure freedom was (1) highest for hemispheric surgery, followed by TL and ETL surgery, and (2) highest for tumor and lower for malformations of cortical development. Seizure freedom was lower for nonlesional than lesional epilepsy (OR = 0.54 [95% CI: 0.34, 0.88], p = 0.013) and incomplete than complete resection (OR = 0.13 [95% CI: 0.08, 0.21], p < 0.001). Age at surgery and age at seizure onset were associated with seizure freedom for mixed pathologies and surgery locations and TL surgery.ConclusionEpilepsy surgery was more effective than medical therapy to control seizures. Understanding seizure outcomes of different surgery locations, pathologies, nonlesional epilepsy, and incomplete resection will assist with presurgical counseling.
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YANG, KANG, JING SU, ZENGCHUN HU, RUI LANG, XU SUN, XINYU LI, DONG WANG, MINGHAI WEI, and JIAN YIN. "Triple pathology in patients with temporal lobe epilepsy: A case report and review of the literature." Experimental and Therapeutic Medicine 6, no. 4 (July 19, 2013): 925–28. http://dx.doi.org/10.3892/etm.2013.1228.
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Kandratavicius, Ludmyla, Mariana Raquel Monteiro, Jaime Eduardo Hallak, Carlos Gilberto Carlotti, Joao Alberto Assirati, and Joao Pereira Leite. "Microtubule-Associated Proteins in Mesial Temporal Lobe Epilepsy with and without Psychiatric Comorbidities and Their Relation with Granular Cell Layer Dispersion." BioMed Research International 2013 (2013): 1–11. http://dx.doi.org/10.1155/2013/960126.
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Background. Despite strong association between epilepsy and psychiatric comorbidities, biological substrates are unknown. We have previously reported decreased mossy fiber sprouting in mesial temporal lobe epilepsy (MTLE) patients with psychosis and increased in those with major depression. Microtubule associated proteins (MAPs) are essentially involved in dendritic and synaptic sprouting.Methods. MTLE hippocampi of subjects without psychiatric history, MTLE + major depression, and MTLE + interictal psychosis derived from epilepsy surgery and control necropsies were investigated for neuronal density, granular layer dispersion, and MAP2 and tau immunohistochemistry.Results. Altered MAP2 and tau expression in MTLE and decreased tau expression in MTLE with psychosis were found. Granular layer dispersion correlated inversely with verbal memory scores, and with MAP2 and tau expression in the entorhinal cortex. Patients taking fluoxetine showed increased neuronal density in the granular layer and those taking haloperidol decreased neuronal density in CA3 and subiculum.Conclusions. Our results indicate relations between MAPs, granular layer dispersion, and memory that have not been previously investigated. Differential MAPs expression in human MTLE hippocampi with and without psychiatric comorbidities suggests that psychopathological states in MTLE rely on differential morphological and possibly neurochemical backgrounds. This clinical study was approved by our institution’s Research Ethics Board (HC-FMRP no. 1270/2008) and is registered under the Brazilian National System of Information on Ethics in Human Research (SISNEP) no. 0423.0.004.000-07.