scholarly journals Surgical Techniques for the Treatment of Temporal Lobe Epilepsy

2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Faisal Al-Otaibi ◽  
Saleh S. Baeesa ◽  
Andrew G. Parrent ◽  
John P. Girvin ◽  
David Steven
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Effective Treatment ◽  
Temporal Lobe ◽  
Surgical Techniques ◽  
Intractable Epilepsy ◽  
Extent Of Resection ◽  
Epileptogenic Zone ◽  
Precise Localization ◽  
Surgical Interventions ◽  
Resective Surgery

Temporal lobe epilepsy (TLE) is the most common form of medically intractable epilepsy. Advances in electrophysiology and neuroimaging have led to a more precise localization of the epileptogenic zone within the temporal lobe. Resective surgery is the most effective treatment for TLE. Despite the variability in surgical techniques and in the extent of resection, the overall outcomes of different TLE surgeries are similar. Here, we review different surgical interventions for the management of TLE.

scholarly journals Synaptic Reshaping and Neuronal Outcomes in the Temporal Lobe Epilepsy

2021 ◽  
Vol 22 (8) ◽  
pp. 3860
Author(s):  
Elisa Ren ◽  
Giulia Curia
Keyword(s):  
Animal Models ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Current Knowledge ◽  
Focal Epilepsy ◽  
Ex Vivo ◽  
Hippocampal Sclerosis ◽  
Control Group ◽  
Epileptogenic Zone ◽  
Epileptiform Discharges

Temporal lobe epilepsy (TLE) is one of the most common types of focal epilepsy, characterized by recurrent spontaneous seizures originating in the temporal lobe(s), with mesial TLE (mTLE) as the worst form of TLE, often associated with hippocampal sclerosis. Abnormal epileptiform discharges are the result, among others, of altered cell-to-cell communication in both chemical and electrical transmissions. Current knowledge about the neurobiology of TLE in human patients emerges from pathological studies of biopsy specimens isolated from the epileptogenic zone or, in a few more recent investigations, from living subjects using positron emission tomography (PET). To overcome limitations related to the use of human tissue, animal models are of great help as they allow the selection of homogeneous samples still presenting a more various scenario of the epileptic syndrome, the presence of a comparable control group, and the availability of a greater amount of tissue for in vitro/ex vivo investigations. This review provides an overview of the structural and functional alterations of synaptic connections in the brain of TLE/mTLE patients and animal models.

scholarly journals Electroencephalographic Features of Temporal Lobe Epilepsy

2010 ◽  
Vol 37 (4) ◽  
pp. 439-448 ◽  
Author(s):  
Mohammed M. Jan ◽  
Mark Sadler ◽  
Susan R. Rahey
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Surgical Management ◽  
Temporal Lobe ◽  
Seizure Onset ◽  
Resective Surgery ◽  
Accurate Localization ◽  
Epileptiform Discharges ◽  
Ictal Eeg ◽  
Temporal Lobe Seizures ◽  
Eeg Recordings

Electroencephalography (EEG) is an important tool for diagnosing, lateralizing and localizing temporal lobe seizures. In this paper, we review the EEG characteristics of temporal lobe epilepsy (TLE). Several “non-standard” electrodes may be needed to further evaluate the EEG localization, Ictal EEG recording is a major component of preoperative protocols for surgical consideration. Various ictal rhythms have been described including background attenuation, start-stop-start phenomenon, irregular 2-5 Hz lateralized activity, and 5-10 Hz sinusoidal waves or repetitive epileptiform discharges. The postictal EEG can also provide valuable lateralizing information. Postictal delta can be lateralized in 60% of patients with TLE and is concordant with the side of seizure onset in most patients. When patients are being considered for resective surgery, invasive EEG recordings may be needed. Accurate localization of the seizure onset in these patients is required for successful surgical management.

scholarly journals Localization of epileptogenic zone in temporal lobe epilepsy by ictal scalp EEG

Seizure ◽  
2002 ◽  
Vol 11 (3) ◽  
pp. 163-168 ◽  
Author(s):  
Yuzo Sakai ◽  
Hiromi Nagano ◽  
Ayumi Sakata ◽  
Sachiko Kinoshita ◽  
Naotaka Hamasaki ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epileptogenic Zone ◽  
Scalp Eeg

Association Between Anatomical Location of Surgically Induced Lesions and Postoperative Seizure Outcome in Temporal Lobe Epilepsy

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013033
Author(s):  
Ezequiel Gleichgerrcht ◽  
Daniel L. Drane ◽  
Simon Sean Keller ◽  
Kathryn A. Davis ◽  
Robert Gross ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Anterior Commissure ◽  
Piriform Cortex ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Anatomical Location ◽  
Surgical Interventions ◽  
Postoperative Seizure ◽  
Promising Source

Objective:To determine the association between surgical lesions of distinct grey and white structures and connections with favorable post-operative seizure outcomes.Methods:Patients with drug-resistant temporal lobe epilepsy (TLE) from three epilepsy centers were included. We employed a voxel-based and connectome-based mapping approach to determine the association between favorable outcomes and surgery-induced temporal lesions. Analyses were conducted controlling for multiple confounders, including total surgical resection/ablation volume, hippocampal volumes, side of surgery, and site where the patient was treated.Results:The cohort included 113 patients with TLE [54 women; 86 right-handed; 16.5 (SD = 11.9) age at seizure onset, 54.9% left] who were 61.1% free of disabling seizures (Engel class 1) at follow-up. Postoperative seizure freedom in TLE was associated with 1) surgical lesions that targeted the hippocampus as well as the amygdala-piriform cortex complex and entorhinal cortices; 2) disconnection of temporal, frontal, and limbic regions through loss of white matter tracts within the uncinate fasciculus, anterior commissure, and fornix; and 3) functional disconnection of the frontal (superior and middle frontal gyri, orbitofrontal region) and temporal (superior and middle pole) lobes.Conclusions:Better postoperative seizure freedom are associated with surgical lesions of specific structures and connections throughout the temporal lobes. These findings shed light on the key components of epileptogenic networks in TLE and constitute a promising source of new evidence for future improvements in surgical interventions.Classification of Evidence:This study provides Class II evidence that for patients with temporal lobe epilepsy, postoperative seizure freedom is associated with surgical lesions of specific temporal lobe structures and connections.

scholarly journals Enhancing Safety in Epilepsy Surgery (EASINESS): Study Protocol for a Retrospective, Multicenter, Open Registry

2021 ◽  
Vol 12 ◽  
Author(s):  
Richard Drexler ◽  
Sharona Ben-Haim ◽  
Christian G. Bien ◽  
Valeri Borger ◽  
Francesco Cardinale ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Reference Values ◽  
Surgical Techniques ◽  
Mesial Temporal Lobe Epilepsy ◽  
Diagnostic Tools ◽  
Surgical Data ◽  
Mesial Temporal Lobe

Introduction: Optimizing patient safety and quality improvement is increasingly important in surgery. Benchmarks and clinical quality registries are being developed to assess the best achievable results for several surgical procedures and reduce unwarranted variation between different centers. However, there is no clinical database from international centers for establishing standardized reference values of patients undergoing surgery for mesial temporal lobe epilepsy.Design: The Enhancing Safety in Epilepsy Surgery (EASINESS) study is a retrospectively conducted, multicenter, open registry. All patients undergoing mesial temporal lobe epilepsy surgery in participating centers between January 2015 and December 2019 are included in this study. The patient characteristics, preoperative diagnostic tools, surgical data, postoperative complications, and long-term seizure outcomes are recorded.Outcomes: The collected data will be used for establishing standardized reference values (“benchmarks”) for this type of surgical procedure. The primary endpoints include seizure outcomes according to the International League Against Epilepsy (ILAE) classification and defined postoperative complications.Discussion: The EASINESS will define robust and standardized outcome references after amygdalohippocampectomy for temporal lobe epilepsy. After the successful definition of benchmarks from an international cohort of renowned centers, these data will serve as reference values for the evaluation of novel surgical techniques and comparisons among centers for future clinical trials.Clinical trial registration: This study is indexed at clinicaltrials.gov (NT 04952298).

scholarly journals P.015 Mesial Temporal Sclerosis is a rare occurrence in Intractable Pediatric Temporal Lobe Epilepsies

2018 ◽  
Vol 45 (s2) ◽  
pp. S19-S19
Author(s):  
J Kassiri ◽  
T Rajapakse ◽  
L Schmitt ◽  
M Wheatley ◽  
B Sinclair
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Pediatric Patients ◽  
Focal Cortical Dysplasia ◽  
Surgical Pathology ◽  
Pediatric Epilepsy ◽  
Mesial Temporal Sclerosis ◽  
Surgical Interventions ◽  
Retrospective Cohort Studies ◽  
Magnetic Resonance Imaging Mri

Background: Temporal lobe epilepsy (TLE) accounts for approximately 20% of pediatric epilepsy cases. Of those, many are considered medically intractable and require surgical interventions. In this study, we hypothesized that mesial temporal sclerosis (MTS) was less common in patients who had undergone surgery for intractable pediatric TLE than in adult series. We further hypothesized that there was a radiological and pathological discordance in identifying the cause of pediatric TLE. Methods: We retrospectively reviewed the charts of pediatric patients with TLE who had undergone surgical treatments as part of the University of Alberta’s Comprehensive Epilepsy Program between 1988 and 2018. Along with preoperative magnetic resonance imaging (MRI) reports, post-surgical pathology results and seizure outcomes were studied Results: Of the 83 pediatric patients who had undergone temporal lobe epilepsy surgery, 28% had tumors, 22% had dual pathologies, 18% had MTS, 11% had focal cortical dysplasia, and 22% had other pathologies. In addition, for 36% of these patients, discordance between their pre-surgical MRI reports and post-surgical pathology reports were found. Conclusions: This was one of the largest retrospective cohort studies of pediatric patients who had undergone surgery for intractable TLE. This study showed that tumors, and not MTS, were the most common pathology in surgical pediatric TLE.

scholarly journals Absence of Temporal Lobe Epilepsy Pathology in Dogs with Medically Intractable Epilepsy

2002 ◽  
Vol 16 (1) ◽  
pp. 95-99 ◽  
Author(s):  
Paul S. Buckmaster ◽  
Mary O. Smith ◽  
Christine L. Buckmaster ◽  
Richard A. LeCouteur ◽  
F. Edward Dudek
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Intractable Epilepsy

scholarly journals Recent developments in cognitive fMRI for temporal lobe epilepsy

2019 ◽  
Vol 33 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Victor Schmidbauer ◽  
Silvia Bonelli
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Visual Memory ◽  
Imaging Modality ◽  
Memory Function ◽  
Brain Regions ◽  
Epileptogenic Zone ◽  
Brain Areas ◽  
Recent Developments ◽  
The Brain

AbstractEpilepsy is frequently accompanied by severe cognitive side effects. Temporal lobe epilepsy (TLE), and even successful surgical treatment, may affect cognitive function, in particular language as well as verbal and visual memory function. Epilepsy arising from the temporal lobe can be controlled surgically in up to 70% of patients. The goals of epilepsy surgery are to remove the brain areas generating the seizures without causing or aggravating neuropsychological deficits. This requires accurate localization of the brain areas generating the seizures (“epileptogenic zone”) and the areas responsible for motor and cognitive functions, such as language and memory (“essential brain regions”) during presurgical evaluation. In the past decades, functional magnetic resonance imaging (fMRI) has been increasingly used to noninvasively lateralize and localize not only primary motor and somatosensory areas, but also brain areas that are involved in everyday language and memory processes. The imaging modality also shows potential for predicting the effects of temporal lobe resection on language and memory function. Together with other MRI modalities, cognitive fMRI is a promising tool to improve surgical strategies tailored to individual patients with regard to functional outcome, by virtue of definition of epileptic cerebral areas that need to be resected and eloquent areas that need to be spared.The aim of this review is to provide an overview of recent developments and practical recommendations for the clinical use of cognitive fMRI in TLE.

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