scholarly journals Early Ictal Recruitment of Midline Thalamus in Mesial Temporal Lobe Epilepsy

2019 ◽  
Author(s):  
Andrew Romeo ◽  
Alexandra T. Issa Roach ◽  
Emilia Toth ◽  
G. Chaitanya ◽  
Adeel Ilyas ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Evoked Potentials ◽  
Temporal Lobe ◽  
Opposite Direction ◽  
Mesial Temporal Lobe Epilepsy ◽  
Midline Thalamus ◽  
Temporal Lobe Seizures ◽  
Mesial Temporal Lobe ◽  
Stimulation Of

AbstractThe causal role of midline thalamus in the initiation and early organization of mesial temporal lobe seizures is studied. Three patients undergoing stereoelectroencephalography were enrolled for the placement of an additional depth electrode targeting the midline thalamus. The midline thalamus was recruited in all three patients at varying points of seizure initiation (0-13 seconds) and early propagation (9-60 seconds). Stimulation of either thalamus or hippocampus induced similar habitual seizures. Seizure-induced in the hippocampus rapidly recruited the thalamus. Evoked potentials demonstrated stronger connectivity from the hippocampus to the thalamus than in the opposite direction. The midline thalamus can be within the seizure initiation and symptomatogenic circuits.

scholarly journals Early ictal recruitment of midline thalamus in mesial temporal lobe epilepsy

2019 ◽  
Vol 6 (8) ◽  
pp. 1552-1558
Author(s):  
Andrew Romeo ◽  
Alexandra T. Issa Roach ◽  
Emilia Toth ◽  
Ganne Chaitanya ◽  
Adeel Ilyas ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Midline Thalamus ◽  
Mesial Temporal Lobe

scholarly journals Role of Diffusion Tensor Imaging In Intractable Unilateral Mesial Temporal Lobe Epilepsy

2017 ◽  
Vol 16 (06) ◽  
pp. 01-08
Author(s):  
Amarnath C ◽  
Bhoopathy R M ◽  
Suhasini B ◽  
Prem Chand ◽  
Gopinathan K ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Diffusion Tensor ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Lobe

Electrical Stimulation of Subiculum for the Treatment of Refractory Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis: A 2-Year Follow-Up Study

2020 ◽  
pp. 1-8
Author(s):  
Daruni Vázquez-Barrón ◽  
Manola Cuéllar-Herrera ◽  
Francisco Velasco ◽  
Ana Luisa Velasco
Keyword(s):  
Electrical Stimulation ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Open Label ◽  
Anticonvulsive Effect ◽  
Mesial Temporal Lobe ◽  
Stimulation Of

<b><i>Introduction:</i></b> Evidence has been provided that the subiculum may play an important role in the generation of seizures. Electrical stimulation at this target has been reported to have anticonvulsive effects in kindling and pilocarpine rat models, while in a clinical study of hippocampal deep brain stimulation (DBS), contacts closest to the subiculum were associated with a better anticonvulsive effect. <b><i>Objectives:</i></b> To evaluate the effect of electrical stimulation of the subiculum in patients with refractory mesial temporal lobe epilepsy (MTLE) who have hippocampal sclerosis (HS). <b><i>Methods:</i></b> Six patients with refractory MTLE and HS, who had focal impaired awareness seizures (FIAS) and focal to bilateral tonic-clonic seizures (FBTCS), had DBS electrodes implanted in the subiculum. During the first month after implantation, all patients were OFF stimulation, then they all completed an open-label follow-up of 24 months ON stimulation. DBS parameters were set at 3 V, 450 µs, 130 Hz, cycling stimulation 1 min ON, 4 min OFF. <b><i>Results:</i></b> There was a mean reduction of 49.16% (±SD 41.65) in total seizure number (FIAS + FBTCS) and a mean reduction of 67.93% (±SD 33.33) in FBTCS at 24 months. FBTCS decreased significantly with respect to baseline, starting from month 2 ON stimulation. <b><i>Conclusions:</i></b> Subiculum stimulation is effective for FBTCS reduction in patients with MTLE and HS, suggesting that the subiculum mediates the generalization rather than the genesis of mesial temporal lobe seizures. Better results are observed at longer follow-up times.

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