Uncommon lesions in the medial temporal lobe presenting with intractable epilepsy

2016 ◽  
Vol 3 (1) ◽  
pp. 43
Author(s):  
Anant Mehrotra
Keyword(s):  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Intractable Epilepsy

scholarly journals Intractable Temporal Lobe Epilepsy (TLE) From Tuberculoma; Microneurosurgical Management of by Amygdalohippocampectomy with Lesionectomy Plus Standard Anterior Temporal lobectomy: A Case Report and Short Review of Literature

2019 ◽  
Vol 16 (2) ◽  
pp. 106-109
Author(s):  
Forhad Hossain Chowdhury ◽  
Mohammod Raziul Haque ◽  
AFM Momtazul Haque
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Venous Malformation ◽  
Intractable Epilepsy ◽  
Complex Partial Seizure ◽  
Temporal Lobectomy ◽  
Mesial Temporal Sclerosis ◽  
Low Grade ◽  
Presenting Symptoms

Patient presenting as a case of Temporal Lobe Epilepsy (TLE) are usually resistant to antiepileptic drugs and surgery is the treatment of choice. This type of epilepsy may be due to Mesial Temporal Sclerosis (MTS), tumors [i.e. low grade glioma, Arterio-venous Malformation (AVM) etc], trauma, infection (Tuberculosis) etc. Here we report a case of surgically treated TLE that was due to a large tuberculoma in medial temporal lobe. Intractable epilepsy caused by tuberculoma is rare. The only presenting symptoms was Complex partial seizure (Psychomotor epilepsy) for which the patient underwent scalp EEG (Electro Encephalography) and MRI (Magnetic resonance imaging) of brain. The patient was managed by amygdalohippocampectomy with lesionectomy plus standard anterior lobectomy. Postoperatively she was on anti-tubercular therapy and on carbamazepine. The case was seizure and disease free till last follow up. Journal of Surgical Sciences (2012) Vol. 16 (2) : 106-109

scholarly journals The critical role of the ventral temporal lobe in word retrieval

2021 ◽  
Author(s):  
Kathryn M Snyder ◽  
Kiefer James Forseth ◽  
Cristian Donos ◽  
Patrick S Rollo ◽  
Simon Fischer-Baum ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Critical Role ◽  
Temporal Cortex ◽  
Intractable Epilepsy ◽  
Significant Decline ◽  
Word Retrieval ◽  
Visual Object ◽  
Confrontation Naming

Deficits in word retrieval are a hallmark of a variety of neurological illnesses spanning from dementia to traumatic injuries. The role of the dominant temporal lobe in fluent naming has been characterized by lesional analyses, functional imaging, and intracranial recordings, but limitations of each of these measures preclude a clear assessment of which specific constituent of the temporal lobe is critical for naming. We studied a large cohort of patients undergoing surgical resections or laser ablations of the dominant temporal lobe for medically intractable epilepsy (n=95). These techniques are exceedingly effective for seizure control but often result in language declines, particularly in confrontation naming, which can be socio-economically disabling. We used a multivariate voxel-based lesion symptom mapping analysis to localize brain regions significantly associated with visual object naming deficits. We observed that posterior inferior temporal regions, centered around the middle fusiform gyrus, were significantly associated with a decline in confrontation naming. Furthermore, we found that the posterior margin of anterior temporal lobectomies was linearly correlated to a decline in visual naming with a clinically significant decline occurring once the resection extended 6 cm from the anterior tip of the temporal lobe. We integrated these findings with electrocorticography during naming in a subset of this population and found that the majority of cortical regions whose resection was associated with a significant decline overlapped with regions that were functionally most active prior to articulation. Importantly, these loci coincide with the sites of susceptibility artifacts during echo-planar imaging, which explains why this region has not previously been implicated. Taken together, these data highlight the crucial contribution of the posterior ventral temporal cortex in lexical access and its important role in the pathophysiology of anomia following temporal lobe resections. Surgical strategies, including the use of laser ablation to target the medial temporal lobe as well as microsurgical approaches, should attempt to preserve this region to mitigate postoperative language deficits.

Failure of low-dose radiosurgery to control temporal lobe epilepsy

2001 ◽  
Vol 95 (5) ◽  
pp. 883-887 ◽  
Author(s):  
Kensuke Kawai ◽  
Ichiro Suzuki ◽  
Hiroki Kurita ◽  
Masahiro Shin ◽  
Nobutaka Arai ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Intractable Epilepsy ◽  
Temporal Lobectomy ◽  
Parahippocampal Gyrus ◽  
Target Area ◽  
Anterior Temporal Lobectomy ◽  
Content Type ◽  
Optimal Target

✓ Radiosurgical treatment of intractable epilepsy has emerged as a noninvasive alternative to resection. Although gamma knife surgery (GKS) reportedly is effective when the radiation dose is sufficient to cause a destructive reaction in the targeted medial temporal lobe, the optimal target area and dose distribution are largely unknown. Some investigators have suggested that focused irradiation from a nondestructive dose is also effective. In this article the authors report two cases of medial temporal lobe epilepsy in which the patients underwent GKS performed using a 50% marginal dose of 18 Gy covering the amygdala, hippocampal head and body, and parahippocampal gyrus. In both cases this procedure failed to control seizures. Both patients became seizure free after undergoing anterior temporal lobectomy 30 and 16 months, respectively, after radiosurgery.

scholarly journals High-resolution depth electrode localization and imaging in patients with pharmacologically intractable epilepsy

2008 ◽  
Vol 108 (4) ◽  
pp. 812-815 ◽  
Author(s):  
Arne Ekstrom ◽  
Nanthia Suthana ◽  
Eric Behnke ◽  
Noriko Salamon ◽  
Susan Bookheimer ◽  
...  
Keyword(s):  
High Resolution ◽  
Human Brain ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Intractable Epilepsy ◽  
Parahippocampal Gyrus ◽  
Depth Electrodes ◽  
Clinical Diagnoses ◽  
Therapeutic Procedures ◽  
Electrode Localization

✓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.

scholarly journals Autonoetic Consciousness in Autobiographical Memories after Medial Temporal Lobe Resection

2008 ◽  
Vol 19 (1-2) ◽  
pp. 19-22 ◽  
Author(s):  
M. Noulhiane ◽  
P. Piolino ◽  
D. Hasboun ◽  
S. Clemenceau ◽  
M. Baulac ◽  
...  
Keyword(s):  
Autobiographical Memory ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Memory Task ◽  
Intractable Epilepsy ◽  
Temporal Lobe Resection ◽  
Patient Groups ◽  
Left And Right ◽  
Autonoetic Consciousness ◽  
Multiple Trace Theory

This study aims to investigate autonoetic consciousness associated with episodic autobiographical memory in patients who had undergone unilateral medial temporal lobe resection for intractable epilepsy. Autonoetic consciousness, defined as the conscious feeling of mentally travelling back in time to relive a specific event, was assessed using the Remember/Know (R/K) paradigm across different time periods as proposed in the autobiographical memory task developed by Piolino et al. (TEMPau task). Results revealed that the two patient groups (left and right temporal resection) gave reduced sense of reliving (R) responses and more familiarity (K) responses than healthy controls. This poor autonoetic consciousness was highlighted when patients were asked to justify their Remember responses by recalling sensory-perceptive, affective or spatiotemporal specific details across all life periods. These results support the bilateral MTL contribution to episodic autobiographical memory covering the entire lifespan, which is consistent with the multiple trace theory of MTL function [7,9]. This study also demonstrates the bilateral involvement of MTL structures in recalling specific details of personal events characterized by autonoetic consciousness.

Children show adult-like hippocampal pattern separation for familiar but not novel events

2020 ◽  
Author(s):  
Susan L. Benear ◽  
Elizabeth A. Horwath ◽  
Emily Cowan ◽  
M. Catalina Camacho ◽  
Chi Ngo ◽  
...  
Keyword(s):  
Episodic Memory ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Developmental Change ◽  
Pattern Separation ◽  
Developmental Changes ◽  
Similarity Analysis ◽  
Separation Processes ◽  
Parahippocampal Cortex ◽  
Pattern Similarity

The medial temporal lobe (MTL) undergoes critical developmental change throughout childhood, which aligns with developmental changes in episodic memory. We used representational similarity analysis to compare neural pattern similarity for children and adults in hippocampus and parahippocampal cortex during naturalistic viewing of clips from the same movie or different movies. Some movies were more familiar to participants than others. Neural pattern similarity was generally lower for clips from the same movie, indicating that related content taxes pattern separation-like processes. However, children showed this effect only for movies with which they were familiar, whereas adults showed the effect consistently. These data suggest that children need more exposures to stimuli in order to show mature pattern separation processes.

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