scholarly journals Neuropsychological outcomes in epilepsy surgery patients with unilateral hippocampal sclerosis and good preoperative memory function

Epilepsia ◽  
2013 ◽  
Vol 54 (9) ◽  
pp. e131-e134 ◽  
Author(s):  
Sallie Baxendale ◽  
Pamela J. Thompson ◽  
Josemir W. Sander
Keyword(s):  
Epilepsy Surgery ◽  
Hippocampal Sclerosis ◽  
Memory Function ◽  
Neuropsychological Outcomes

scholarly journals The Role of KRAS Mutations in Cortical Malformation and Epilepsy Surgery: A Novel Report of Nevus Sebaceous Syndrome and Review of the Literature

2021 ◽  
Vol 11 (6) ◽  
pp. 793
Author(s):  
Chiara Pepi ◽  
Luca de Palma ◽  
Marina Trivisano ◽  
Nicola Pietrafusa ◽  
Francesca Romana Lepri ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Focal Cortical Dysplasia ◽  
Hippocampal Sclerosis ◽  
Brain Mri ◽  
Seizure Freedom ◽  
Histopathological Diagnosis ◽  
Cortical Malformation ◽  
Cognitive Improvement ◽  
Cortical Malformations ◽  
Nevus Sebaceous

The rare nevus sebaceous (NS) syndrome (NSS) includes cortical malformations and drug-resistant epilepsy. Somatic RAS-pathway genetic variants are pathogenetic in NS, but not yet described within the brain of patients with NSS. We report on a 5-year-old boy with mild psychomotor delay. A brown-yellow linear skin lesion suggestive of NS in the left temporo-occipital area was evident at birth. Epileptic spasms presented at aged six months. EEG showed continuous left temporo-occipital epileptiform abnormalities. Brain MRI revealed a similarly located diffuse cortical malformation with temporal pole volume reduction and a small hippocampus. We performed a left temporo-occipital resection with histopathological diagnosis of focal cortical dysplasia type Ia in the occipital region and hippocampal sclerosis type 1. Three years after surgery, he is seizure-and drug-free (Engel class Ia) and showed cognitive improvement. Genetic examination of brain and skin specimens revealed the c.35G > T (p.Gly12Val) KRAS somatic missense mutation. Literature review suggests epilepsy surgery in patients with NSS is highly efficacious, with 73% probability of seizure freedom. The few histological analyses reported evidenced disorganized cortex, occasionally with cytomegalic neurons. This is the first reported association of a KRAS genetic variant with cortical malformations associated with epilepsy, and suggests a possible genetic substrate for hippocampal sclerosis.

How Different Are the Patients With Bilateral Hippocampal Sclerosis From the Unilateral Ones Clinically?

2016 ◽  
Vol 48 (3) ◽  
pp. 209-216 ◽  
Author(s):  
Ebru Nur Vanli-Yavuz ◽  
Betul Baykan ◽  
Serra Sencer ◽  
Altay Sencer ◽  
Isin Baral-Kulaksizoglu ◽  
...  
Keyword(s):  
Mental Retardation ◽  
Status Epilepticus ◽  
Epilepsy Surgery ◽  
Hippocampal Sclerosis ◽  
Control Group ◽  
High Signal ◽  
Binary Logistic Regression Analysis ◽  
Laboratory Findings ◽  
Patients With Epilepsy ◽  
Febrile Status Epilepticus

Purpose. There is a lack of knowledge on consecutive patients with epilepsy associated with bilateral hippocampal sclerosis (BHS). We aimed to investigate the differentiating features of BHS in comparison with unilateral HS (UHS). Method. We investigated our database for patients with epilepsy fulfilling the major magnetic resonance imaging criteria for BHS; namely, presence of bilateral atrophy and high signal changes on T2 and FLAIR series in the hippocampi. UHS patients seen in past 2 years were included as the control group. Clinical, EEG, and other laboratory findings, data on treatment response and epilepsy surgery were investigated from their files. Results. A total of 124 patients (31 with BHS and 93 with UHS; 49 right-sided and 44 left-sided) were included. We found that 16.1% of the BHS and 18.3% of the UHS groups were not drug-refractory. A binary logistic regression analysis performed with significant clinical features disclosed that history of febrile status epilepticus, mental retardation, and status epilepticus were statistically more common in BHS group. Moreover, diagnosis of psychosis established by an experienced psychiatrist and slowing of the EEG background activity were both found significantly more frequent in BHS. 66.67% of the operated BHS patients showed benefit from epilepsy surgery. Conclusions. BHS is a heterogeneous group, showing significant differences such as increased frequencies of mental retardation, status epilepticus, febrile status epilepticus and psychosis, in comparison to UHS. In all, 16.1% of the BHS cases showed a benign course similar to the UHS group and some patients with drug-resistant epilepsy may show benefit from epilepsy surgery.

VISUAL FIELD DEFECTS IN SELECTIVE AMYGDALOHIPPOCAMPECTOMY FOR HIPPOCAMPAL SCLEROSIS

Neurosurgery ◽  
2008 ◽  
Vol 63 (3) ◽  
pp. 507-515 ◽  
Author(s):  
S. Naz Yeni ◽  
Necmettin Tanriover ◽  
Özlem Uyanik ◽  
Mustafa Onur Ulu ◽  
Çiğdem Özkara ◽  
...  
Keyword(s):  
Visual Field ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Hippocampal Sclerosis ◽  
Visual Field Defects ◽  
Selective Amygdalohippocampectomy ◽  
Temporal Horn ◽  
Visual Field Deficits ◽  
Meyer’S Loop

ABSTRACT OBJECTIVE Meyer's loop, the most vulnerable part of the optic radiations during approaches to the temporomedial region, extends to the tip of the temporal horn and is often encountered in epilepsy surgery. The risk of damaging Meyer's loop during transsylvian selective amygdalohippocampectomy peaks while accessing the temporal horn through its roof by opening the inferior limiting sulcus of the insula. In this prospective study, we sought to evaluate and identify the incidence of visual field deficits in a homogeneous group of patients who had temporal lobe epilepsy with hippocampal sclerosis and who underwent transsylvian selective amygdalohippocampectomy. METHODS We studied 30 patients who were referred for epilepsy surgery for intractable complex partial and/or secondary generalized seizures and evaluated according to a noninvasive protocol. All patients underwent selective amygdalohippocampectomy for temporal lobe epilepsy with hippocampal sclerosis using the standard transsylvian approach. Visual field deficits were examined preoperatively in 30 patients, by either a confrontation method (n = 18) or standard Goldmann perimetry (n = 12) and postoperatively in all patients using standard Humphrey digital perimetry. RESULTS Visual field examination was normal in all patients before surgery. Humphrey perimetric measurement revealed visual field deficits in 11 patients (36.6%) after surgery. CONCLUSION We have shown that there is a considerable risk of having visual field deficits after standard transsylvian selective amygdalohippocampectomy owing to the interruption of the anterior bundle of the optic radiation fibers, which most likely occurs while opening the temporal horn through the inferior limiting sulcus of the insula.

scholarly journals Seizure Freedom After Epilepsy Surgery and Higher Baseline Cognition May Be Associated With a Negatively Correlated Epilepsy Network in Temporal Lobe Epilepsy

2021 ◽  
Vol 14 ◽  
Author(s):  
Elliot G. Neal ◽  
Mike R. Schoenberg ◽  
Stephanie Maciver ◽  
Yarema B. Bezchlibnyk ◽  
Fernando L. Vale
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Memory Function ◽  
Brain Regions ◽  
Seizure Freedom ◽  
Epileptogenic Zone ◽  
Temporal Lobes ◽  
Scalp Eeg ◽  
The Brain

Background: Brain regions positively correlated with the epileptogenic zone in patients with temporal lobe epilepsy vary in spread across the brain and in the degree of correlation to the temporal lobes, thalamus, and limbic structures, and these parameters have been associated with pre-operative cognitive impairment and seizure freedom after epilepsy surgery, but negatively correlated regions have not been as well studied. We hypothesize that connectivity within a negatively correlated epilepsy network may predict which patients with temporal lobe epilepsy will respond best to surgery.Methods: Scalp EEG and resting state functional MRI (rsfMRI) were collected from 19 patients with temporal lobe epilepsy and used to estimate the irritative zone. Using patients’ rsfMRI, the negatively correlated epilepsy network was mapped by determining all the brain voxels that were negatively correlated with the voxels in the epileptogenic zone and the spread and average connectivity within the network was determined.Results: Pre-operatively, connectivity within the negatively correlated network was inversely related to the spread (diffuseness) of that network and positively associated with higher baseline verbal and logical memory. Pre-operative connectivity within the negatively correlated network was also significantly higher in patients who would go on to be seizure free.Conclusion: Patients with higher connectivity within brain regions negatively correlated with the epilepsy network had higher baseline memory function, narrower network spread, and were more likely to be seizure free after surgery.

An Evidence-Based Checklist To Evaluate Neuropsychological Outcomes after Epilepsy Surgery (P01.045)

Neurology ◽  
2012 ◽  
Vol 78 (Meeting Abstracts 1) ◽  
pp. P01.045-P01.045
Author(s):  
M. Hrabok ◽  
J. Dykeman ◽  
E. Sherman ◽  
S. Wiebe
Keyword(s):  
Epilepsy Surgery ◽  
Evidence Based ◽  
Neuropsychological Outcomes

TEMPORAL GAP BETWEEN THE DIAGNOSIS OF DRUG RESISTANT TEMPORAL LOBE EPILEPSY ASSOCIATED WITH HIPPOCAMPAL SCLEROSIS AND INDICATION OF EPILEPSY SURGERY

2020 ◽  
pp. 174-175
Author(s):  
Bárbara Pina Aiello ◽  
Brenno Tavares de Vasconcelos Brandão ◽  
Claudia Cecília da Silva Rêgo ◽  
Valeria Coelho Santa Rita Pereira ◽  
Tiago Silva Aguiar ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Hippocampal Sclerosis ◽  
Drug Resistant

Improving neuropsychological outcomes of epilepsy surgery

2008 ◽  
Vol 13 (1) ◽  
pp. 5-6 ◽  
Author(s):  
Bruce P. Hermann ◽  
David W. Loring
Keyword(s):  
Epilepsy Surgery ◽  
Neuropsychological Outcomes

Temporal lobe epilepsy due to hippocampal sclerosis in pediatric candidates for epilepsy surgery

Neurology ◽  
2001 ◽  
Vol 56 (12) ◽  
pp. 1643-1649 ◽  
Author(s):  
A. Mohamed ◽  
E. Wyllie ◽  
P. Ruggieri ◽  
P. Kotagal ◽  
T. Babb ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Hippocampal Sclerosis
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