scholarly journals Role of Electroencephalography in Presurgical Evaluation of Temporal Lobe Epilepsy

2012 ◽  
Vol 2012 ◽  
pp. 1-18 ◽  
Author(s):  
Seetharam Raghavendra ◽  
Javeria Nooraine ◽  
Seyed M. Mirsattari
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Refractory Epilepsy ◽  
Therapeutic Option ◽  
Presurgical Evaluation ◽  
Video Eeg ◽  
Medically Refractory Epilepsy

Surgery remains a therapeutic option for patients with medically refractory epilepsy. Comprehensive presurgical evaluation includes electroencephalography (EEG) and video EEG in identifying patients who are likely to benefit from surgery. Here, we discuss in detail the utility of EEG in presurgical evaluation of patients with temporal lobe epilepsy along with illustrative cases.

Daytime Outpatient Versus Inpatient Video-EEG Monitoring for Presurgical Evaluation in Temporal Lobe Epilepsy

2002 ◽  
Vol 19 (3) ◽  
pp. 204-208 ◽  
Author(s):  
Carlos A. M. Guerreiro ◽  
Maria Augusta Montenegro ◽  
Eliane Kobayashi ◽  
Ana Lúcia A. Noronha ◽  
Marilisa M. Guerreiro ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Eeg Monitoring ◽  
Presurgical Evaluation ◽  
Video Eeg

scholarly journals Alternate Seizure Spread with Agenesis of the Corpus Callosum

2021 ◽  
Vol 11 (1) ◽  
pp. 100-105
Author(s):  
Lohit Velagapudi ◽  
Caio M. Matias ◽  
Timothy M. Ambrose ◽  
Michael R. Sperling ◽  
Maromi Nei ◽  
...  
Keyword(s):  
Corpus Callosum ◽  
Temporal Lobe Epilepsy ◽  
Cognitive Deficits ◽  
Surgical Approach ◽  
Refractory Epilepsy ◽  
Anterior Commissure ◽  
Brain Malformation ◽  
Developmental Defects ◽  
Medically Refractory Epilepsy

Agenesis of the corpus callosum is a brain malformation that can occur in isolation or in conjunction with other congenital or developmental defects. The clinical sequelae of this condition include epilepsy, cognitive deficits, developmental delay, and various neurological and psychiatric disorders. Here we present the case of a patient with congenital complete agenesis of the corpus callosum and medically refractory epilepsy who underwent stereoelectroencephalography. This identified a left frontal ictal focus and revealed that contralateral spread occurred though the anterior commissure, a rare and interesting occurrence. Left frontal resection resulted in significant improvement. This demonstrates the role of the anterior commissure in ictal spread and the potential for novel methods of seizure spread in patients with temporal lobe epilepsy that must be considered in a surgical approach.

Consequences of mesial temporal sparing temporal lobe surgery in medically refractory epilepsy

2021 ◽  
Vol 115 ◽  
pp. 107642
Author(s):  
Lilach Goldstein ◽  
Mitra Dehghan Harati ◽  
Kathryn Devlin ◽  
Joseph Tracy ◽  
Maromi Nei ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Refractory Epilepsy ◽  
Medically Refractory Epilepsy

A historical cohort of temporal lobe surgery for medically refractory epilepsy: a systematic review and meta-analysis to guide future nonrandomized controlled trial studies

2020 ◽  
Vol 133 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Anthony T. Lee ◽  
John F. Burke ◽  
Pranathi Chunduru ◽  
Annette M. Molinaro ◽  
Robert Knowlton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Refractory Epilepsy ◽  
Meta Analysis ◽  
Small Sample ◽  
Seizure Freedom ◽  
Level I ◽  
Study Designs ◽  
Medically Refractory Epilepsy

OBJECTIVERecent trials for temporal lobe epilepsy (TLE) highlight the challenges of investigating surgical outcomes using randomized controlled trials (RCTs). Although several reviews have examined seizure-freedom outcomes from existing data, there is a need for an overall seizure-freedom rate estimated from level I data as investigators consider other methods besides RCTs to study outcomes related to new surgical interventions.METHODSThe authors performed a systematic review and meta-analysis of the 3 RCTs of TLE in adults and report an overall surgical seizure-freedom rate (Engel class I) composed of level I data. An overall seizure-freedom rate was also collected from level II data (prospective cohort studies) for validation. Eligible studies were identified by filtering a published Cochrane meta-analysis of epilepsy surgery for RCTs and prospective studies, and supplemented by searching indexed terms in MEDLINE (January 1, 2012–April 1, 2018). Retrospective studies were excluded to minimize heterogeneity in patient selection and reporting bias. Data extraction was independently reverified and pooled using a fixed-effects model. The primary outcome was overall seizure freedom following surgery. The historical benchmark was applied in a noninferiority study design to compare its power to a single-study cohort.RESULTSThe overall rate of seizure freedom from level I data was 72.4% (55/76 patients, 3 RCTs), which was nearly identical to the overall seizure-freedom rate of 71.7% (1325/1849 patients, 18 studies) from prospective cohorts (z = 0.134, p = 0.89; z-test). Seizure-freedom rates from level I and II studies were consistent over the years of publication (R2< 0.01, p = 0.73). Surgery resulted in markedly improved seizure-free outcomes compared to medical management (RR 10.82, 95% CI 3.93–29.84, p < 0.01; 2 RCTs). Noninferiority study designs in which the historical benchmark was used had significantly higher power at all difference margins compared to using a single cohort alone (p < 0.001, Bonferroni’s multiple comparison test).CONCLUSIONSThe overall rate of seizure freedom for temporal lobe surgery is approximately 70% for medically refractory epilepsy. The small sample size of the RCT cohort underscores the need to move beyond standard RCTs for epilepsy surgery. This historical seizure-freedom rate may serve as a useful benchmark to guide future study designs for new surgical treatments for refractory TLE.

P384 The role of sleep spindles in overnight verbal memory consolidation in temporal lobe epilepsy patients

2017 ◽  
Vol 128 (9) ◽  
pp. e302-e303
Author(s):  
Márta Virág ◽  
Róbert Bódizs ◽  
Ferenc Gombos ◽  
Anna Kelemen ◽  
Dániel Fabó
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Memory Consolidation ◽  
Verbal Memory ◽  
Sleep Spindles

scholarly journals Somatosensory aura in mesial temporal lobe epilepsy: semiologic characteristics, MRI findings and differential diagnosis with parietal lobe epilepsy

2006 ◽  
Vol 12 (3) ◽  
pp. 155-160 ◽  
Author(s):  
Márcio Andriani Rahal ◽  
Gerardo Maria de Araújo Filho ◽  
Luís Otávio Sales Ferreira Caboclo ◽  
Vivianne Pellegrino Rosa ◽  
Ricardo da Silva Centeno ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Parietal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Sclerosis ◽  
Presurgical Evaluation ◽  
Mri Findings ◽  
Tingling Sensation ◽  
Mesial Temporal Lobe ◽  
Prevalent Symptom

INTRODUCTION: Somatosensory auras (SSAs) are more usually described in patients with parietal lobe epilepsy (PLE), producing more commonly a localized cutaneous tingling sensation, involving hands and fingers followed by tonic or clonic focal seizures. These usually originate in the contralateral hemisphere. Etiology includes dysplasias, tumours, ischemic or postencephalitic gliosis. However, other focal epilepsies, such as frontal and temporal, may also originate SSAs. Although this type of aura is reported as rare in patients with mesial temporal lobe epilepsy (MTLE), this association has not been systematically studied. OBJECTIVES: The aim of this article was to describe the cases of four patients with refractory MTLE and SSAs, reporting their clinical characteristics and MRI findings. We discuss the localizing and lateralizing value of SSAs, particularly in the context of MTLE. METHODS AND RESULTS: Four patients with refractory MTLE and SSAs followed-up in the outpatient's clinic at the Epilepsy Section, Universidade Federal de São Paulo, were submitted to presurgical evaluation and corticoamygdalohippocampectomy. MRI in all cases showed unilateral mesial temporal sclerosis (MTS). Regarding seizure semiology, tingling sensation involving the upper extremity was the most prevalent symptom. Three of the four patients had SSAs contralateral to the MTS. Following the SSAs all patients most of the time presented other symptoms such as autonomic or psychic auras evolving to psychomotor seizures. After surgical treatment, two of the patients presented infrequent auras, and two were rendered seizure-free. CONCLUSION: Although rare, SSAs can be present in MTLE. The characteristics of autonomic or psychic auras, psychomotor seizures, neuropsychological deficits, and typical neurophysiologic and MRI findings may help differentiate patients with MTLE from those with PLE.

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