scholarly journals A Review of the Epidemiology of Temporal Lobe Epilepsy

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Jose F. Téllez-Zenteno ◽  
Lizbeth Hernández-Ronquillo
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Current Knowledge ◽  
Population Based ◽  
Common Type ◽  
Mesial Temporal Sclerosis ◽  
Healthy Individuals ◽  
Tertiary Referral ◽  
Future Studies ◽  
Temporal Epilepsy

Partial-onset epilepsies account for about 60% of all adult epilepsy cases, and temporal lobe epilepsy (TLE) is the most common type of partial epilepsy referred for epilepsy surgery and often refractory to antiepileptic drugs (AEDs). Little is known about the epidemiology of TLE, because it requires advanced neuroimaging, positive EEG, and appropriate clinical semiology to confirm the diagnosis. Moreover, recently recognized incidentally detected mesial temporal sclerosis in otherwise healthy individuals and benign temporal epilepsy indicate that the true epidemiology of TLE is underestimated. Our current knowledge on the epidemiology of TLE derives from data published from tertiary referral centers and/or inferred from population-based studies dealing with epilepsy. This article reviews the following aspects of the epidemiology of TLE: definitions, studies describing epidemiological rates, methodological observations, the interpretation of available studies, and recommendations for future studies.

scholarly journals Temporal Lobe Epilepsy Surgery Failures: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Adil Harroud ◽  
Alain Bouthillier ◽  
Alexander G. Weil ◽  
Dang Khoa Nguyen
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Sclerosis ◽  
Temporal Region ◽  
Incomplete Resection ◽  
Epileptogenic Zone ◽  
Temporal Epilepsy ◽  
Dual Pathology ◽  
Seizure Relapse ◽  
Temporal Structures

Patients with temporal lobe epilepsy (TLE) are refractory to antiepileptic drugs in about 30% of cases. Surgical treatment has been shown to be beneficial for the selected patients but fails to provide a seizure-free outcome in 20–30% of TLE patients. Several reasons have been identified to explain these surgical failures. This paper will address the five most common causes of TLE surgery failure (a) insufficient resection of epileptogenic mesial temporal structures, (b) relapse on the contralateral mesial temporal lobe, (c) lateral temporal neocortical epilepsy, (d) coexistence of mesial temporal sclerosis and a neocortical lesion (dual pathology); and (e) extratemporal lobe epilepsy mimicking TLE or temporal plus epilepsy. Persistence of epileptogenic mesial structures in the posterior temporal region and failure to distinguish mesial and lateral temporal epilepsy are possible causes of seizure persistence after TLE surgery. In cases of dual pathology, failure to identify a subtle mesial temporal sclerosis or regions of cortical microdysgenesis is a likely explanation for some surgical failures. Extratemporal epilepsy syndromes masquerading as or coexistent with TLE result in incomplete resection of the epileptogenic zone and seizure relapse after surgery. In particular, the insula may be an important cause of surgical failure in patients with TLE.

scholarly journals COMPARISION OF QUANTITATIVE AND QUALITITATIVE ASSESSMENT OF MRI IN DIAGNOSING HIPOCAMPAL ATROPHY AMONG CASES OF TEMPORAL EPILEPSY.

2019 ◽  
Vol 26 (07) ◽  
pp. 1009-1013
Author(s):  
Abdul Raouf ◽  
Saba Jehangir ◽  
Asma Shoukat ◽  
Muhammad Ahsan
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Visual Assessment ◽  
The Body ◽  
Temporal Lobectomy ◽  
Radiology Department ◽  
Mesial Temporal Sclerosis ◽  
Hippocampal Atrophy ◽  
Temporal Epilepsy ◽  
Coronal Section

Mesial temporal sclerosis (MTS) is the most common pathology in patients undergoing anterior temporal lobectomy. Magnetic resonance imaging (MRI) is valuable in detecting MTS. Reduced hippocampal volume and elevated T2 signal are associated with MTS, and both quantitative T2 and volumetric measurementshave been associated with hippocampal cellular loss that characterizes this condition. Objectives: To determine the accuracy of hippocampal quantitative (T2 relaxometric) assessment in diagnosing hippocampal atrophy in patients with temporal lobe epilepsy by comparing it with qualitative (visual) assessment on MRI. Study Design: Cross sectional study. Setting: Radiology department of Allied Hospital Faisalabad. Period: 12 months from theapproval from Sep, 2016 to Dec, 2017. Subjects & Methods: After taking permission from hospital ethical committee, and written informed consent, patients with history of temporal lobe epilepsy and EEG findings consistent with temporal lobe epilepsy were examined on 1.5 Tesla Achieva philips scanner, visual assessment and T2 relaxometry. Section of the hippocampus head was defined as the first in which it was possible to see the temporal horn of the lateral ventricle and therefore to appropriately separate the hippocampal formation from the amygdala. The body of the hippocampus defined in the fourth coronal section after the region of interest of the hippocampus head, and the tail was defined in the third coronal section after the hippocampus body, in which it is also possible to visualize the quadrigeminal plate (section of 5mm).Visually the images were assessed and MRI examination was done. All the data was collected on a performa. Results: We concluded that the frequency of accuracy of hippocampal quantitative (t2 relaxometric) assessment in diagnosing hippocampal atrophy in patients with temporal lobe epilepsy by comparing it with qualitative (visual) assessment on MRIis high but needs validation through some-other studies. Conclusion: We concluded that the frequency of accuracy of hippocampal quantitative (t2 relaxometric) assessment in diagnosing hippocampal atrophy in patients with temporal lobe epilepsy by comparing it with qualitative (visual) assessment on MRI is high but needs validation through some-other studies. 

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 Extrahippocampal temporal lobe atrophy in temporal lobe epilepsy and mesial temporal sclerosis

Brain ◽  
2001 ◽  
Vol 124 (1) ◽  
pp. 167-175 ◽  
Author(s):  
N. F. Moran ◽  
L. Lemieux ◽  
N. D. Kitchen ◽  
D. R. Fish ◽  
S. D. Shorvon
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Sclerosis ◽  
Lobe Atrophy

Parameters of autonomic regulation in patients with focal frontal and temporal epilepsy

2021 ◽  
Vol 29 (1) ◽  
pp. 45-53
Author(s):  
Julia I. Medvedeva ◽  
Roman A. Zorin ◽  
Vladimir A. Zhadnov ◽  
Michael M. Lapkin
Keyword(s):  
Regression Analysis ◽  
Temporal Lobe Epilepsy ◽  
Evoked Potentials ◽  
Temporal Lobe ◽  
Focal Epilepsy ◽  
Autonomic Regulation ◽  
Control Group ◽  
Temporal Epilepsy ◽  
Logit Regression ◽  
Autonomic Support

Aim. This study aimed to investigate the mechanisms of autonomic regulation and autonomic support in focal frontal and temporal lobe epilepsy. Materials and Methods. Thirty-six individuals were examined (19 men and 17 women; mean age 33.71.4 years) in the control group (without history of epileptic seizures) and 68 patients (32 men and 36 women, 34.11.5 years) with focal epilepsy (36 patients with frontal lobe epilepsy, of which 32 had temporal lobe epilepsy). Physiological parameters of heart rate variability and of skin sympathetic evoked potentials were evaluated. Results. Predomination of sympathetic influences in both groups of patients was found. According to the analysis of skin sympathetic evoked potentials, a high activity of the suprasegmental autonomic centers was determined in patients with epilepsy. Based on the results of the correlation analysis, the initial state in patients with temporal lobe epilepsy was characterized by greater intrasystemic tension that reflects the high level of physiological costs. The logit regression analysis model makes it possible to distribute patients with focal epilepsy into groups with different disease courses on the basis of the parameters of the autonomic support of the activity. Conclusion. In patients with focal epilepsy, predomination of sympathetic influences was observed, as well as greater activity of the suprasegmental centers of the autonomic regulation. Intrasystemic ratios of autonomic regulation parameters demonstrate an increase in the intrasystemic tension and a limitation of functional reserves in patients with temporal lobe epilepsy. A complex of parameters of autonomic support allows, based on the logit regression analysis, to distribute patients into groups with different courses of focal epilepsy.

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.

scholarly journals Elevated IL-6 and IL-1β are associated with temporal lobe epilepsy: A study in Chinese patients

2018 ◽  
Vol 16 ◽  
pp. 205873921877893 ◽  
Author(s):  
Li Xia ◽  
Song-Qing Pan ◽  
Qiu-Min Zhang ◽  
Qin Zhou ◽  
Lu Xia ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Chinese Patients ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Temporal Epilepsy ◽  
Tnf Α ◽  
Plasma Cytokines ◽  
Proinflammatory Molecules ◽  
Positive Correlations

Activation of proinflammatory cytokines in seizures has been well characterized. However, role of cytokines in epilepsy and association with different clinical phenotype has not been well investigated. Reports on possible link between proinflammatory molecules and epilepsy are very limited. In this study, we performed a hospital-based case control study to investigate the association of plasma cytokines and their expression with different clinical categories of epilepsy. Patients admitted to Neurology Department of Renmin Hospital were enrolled in this study after clinical investigations. In all, 92 patients with temporal lobe epilepsy (TLE) and 45 with extra-temporal lobe epilepsy (XTLE) were included in this study. Furthermore, we included 86 healthy controls from the similar geographical population. Plasma levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-1β were quantified by enzyme-linked immunosorbent assay (ELISA). All plasma cytokines were elevated in TLE and XTLE compared to healthy controls ( P < 0.0001). Furthermore, IL-6 and IL-1β were significantly higher in TLE when compared to extra-temporal epilepsy. Incidentally, no difference in mean plasma TNF-α levels was noticed among TLE and XTLE. Positive correlations were observed between all plasma proinflammatory molecules (TNF-α, IL-6, and IL-1β) investigated in this study. Epilepsy patients displayed higher proinflammatory molecules, namely, IL-6, IL-1β, and TNF-α. Plasma IL-6 and IL-1β can be use as biomarkers for differentiation of TLE from XTLE.

scholarly journals Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy

2015 ◽  
Vol 74 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Fábio A. Nascimento ◽  
Luana Antunes Maranha Gatto ◽  
Carlos Silvado ◽  
Maria Joana Mäder-Joaquim ◽  
Marlus Sidney Moro ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporal Lobectomy ◽  
Mesial Temporal Sclerosis ◽  
Anterior Temporal Lobectomy ◽  
Selective Amygdalohippocampectomy ◽  
Significant Difference ◽  
Mesial Temporal Lobe ◽  
Neuropsychological Outcomes

ABSTRACT Objective To contribute our experience with surgical treatment of patients with mesial temporal lobe epilepsy (mTLE) undergoing anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SelAH). Method This is a retrospective observational study. The sample included patients with medically refractory mTLE due to unilateral mesial temporal sclerosis who underwent either ATL or SelAH, at Hospital de Clinicas – UFPR, from 2005 to 2012. We report seizure outcomes, using Engel classification, cognitive outcomes, using measurements of verbal and visuospatial memories, as well as operative complications. Result Sixty-seven patients (33 ATL, 34 SelAH) were studied; median follow-up was 64 months. There was no statistically significant difference in seizure or neuropsychological outcomes, although verbal memory was more negatively affected in ATL operations on patients’ dominant hemispheres. Higher number of major complications was observed in the ATL group (p = 0.004). Conclusion Seizure and neuropsychological outcomes did not differ. ATL appeared to be associated with higher risk of complications.

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