scholarly journals Ictal semiology of epileptic seizures with insulo-opercular genesis

2021 ◽  
Author(s):  
Eva Martinez-Lizana ◽  
Armin Brandt ◽  
Niels A. Foit ◽  
Horst Urbach ◽  
Andreas Schulze-Bonhage
Keyword(s):  
Multivariate Analysis ◽  
Temporal Lobe ◽  
Degrees Of Freedom ◽  
Epileptic Seizures ◽  
Mesial Temporal Lobe Epilepsy ◽  
Chi Square ◽  
Depth Analysis ◽  
Therapeutic Procedures ◽  
Mesial Temporal Lobe ◽  
Syndrome Classification

Abstract Objective Epileptic seizures with insular genesis are often difficult to distinguish from those originating in the temporal lobe due to their complex and variable semiology. Here, we analyzed differentiating characteristics in the clinical spectrum of insulo-opercular seizures. Methods Ictal semiology in patients with a diagnosis of insulo-opercular epilepsy (IOE) based on imaging of epileptogenic lesions or electrophysiological evidence of an insulo-opercular seizure origin was retrospectively analyzed and compared to age-matched controls with mesial temporal lobe epilepsy (MTE). Results Forty-six IOE and 46 matched MTE patients were included. The most prominent ictal features in IOE were focal motor phenomena in 80.4% of these patients. Somatosensory sensations, version, tonic and clonic features, when present, were more frequent contralateral to the SOZ in MTE patients, while they occurred about equally often ipsilateral and contralateral to the SOZ in IOE patients. Ipsilateral manual automatisms were significantly more frequent in MTE patients than in IOE (p = 0.010). Multivariate analysis correctly identified IOE in 78.3% and MTE in 84.8% using five semiologic features (Chi-square = 53.79 with 5 degrees of freedom, p < 0.0001). A subanalysis comparing patients with purely insular lesions with MTE patients using only the earliest ictal signs showed that somatosensory sensations are significantly more frequent in insular epilepsy (p = 0.010), while automatisms were significantly more frequent in MTE patients (p = 0.06). Significance Our study represents the first in-depth analysis of ictal semiology in IOE compared to MTE. Use of these differentiating characteristics can serve for a correct syndrome classification and to steer appropriate diagnostic and local therapeutic procedures.

scholarly journals Menstrual cycle worsening of epileptic seizures in women with symptomatic focal epilepsy

2005 ◽  
Vol 63 (3b) ◽  
pp. 751-756 ◽  
Author(s):  
Ana Carolina Belini Bazán ◽  
Maria Augusta Montenegro ◽  
Fernando Cendes ◽  
Li Li Min ◽  
Carlos A.M. Guerreiro
Keyword(s):  
Menstrual Cycle ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Seizure Frequency ◽  
Focal Epilepsy ◽  
Epileptic Seizures ◽  
Mesial Temporal Lobe Epilepsy ◽  
Menstrual Cycles ◽  
Medical Appointment ◽  
Mesial Temporal Lobe

INTRODUCTION: Hormonal fluctuation is responsible for worsening of epileptic seizures during the menstrual cycle. OBJETIVE: To identify irregularities in the menstrual cycles of women with mesial temporal lobe epilepsy (MTLE) and extratemporal focal epilepsy (ETFE) and correlate the frequency of seizures during the menstrual cycles. METHOD: We evaluated prospectively women in the menacme with MTLE and ETFE. Calendars were provided for these patients, and they were asked to mark their seizure frequency according to the menses. Calendars were reviewed in each routine medical appointment. RESULTS: Thirty-nine patients with MTLE and 14 with ETFE were evaluated. We registered 211 cycles in the patients with MTLE and 49 in those with ETFE. Irregular menstrual cycles were found in 28 (28/39, 71.7%) patients with MTLE and 6 (6/14, 42.8%) with ETFE (p=0.052). Premenstrual seizure worsening was observed in 46 (21.8%) patients with MTLE and 9 (18.3%) with ETFE (p=0.596). Menstrual worsening was observed in 47 (22.2%) patients with MTLE and 15 (30.6%) with ETFE (p=0. 217). Ovulatory worsening was observed in 36 (17%) patients with MTLE and 13 (26.5%) with ETFE (p=0,126). Catamenial worsening was observed in 58 (27.4%) of the patients with MTLE and in 17 (34.7%) of the patients with ETFE (p=0.315). CONCLUSION: There was no difference between the group of patients with MTLE and ETFE regarding the frequency of irregular cycles and seizure worsening during the premenstrual, menstrual, catamenial or ovulatory periods.

scholarly journals Spontaneous EEG-Functional MRI in Mesial Temporal Lobe Epilepsy: Implications for the Neural Correlates of Consciousness

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Zheng Wang ◽  
Loretta Norton ◽  
R. Matthew Hutchison ◽  
John R. Ives ◽  
Seyed M. Mirsattari
Keyword(s):  
Temporal Lobe ◽  
Animal Studies ◽  
Brain Activity ◽  
Epileptic Seizures ◽  
Mesial Temporal Lobe Epilepsy ◽  
Unified Framework ◽  
Epileptiform Discharges ◽  
Interictal Epileptiform Discharges ◽  
Mesial Temporal Lobe ◽  
Hemodynamic Processes

The combination of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) has been shown to have great potential for providing a greater understanding of normal and diseased states in both human and animal studies. Simultaneous EEG-fMRI is particularly well suited for the study of epilepsy in that it may reveal the neurobiology of ictal and interictal epileptiform discharges and noninvasively localize epileptogenic foci. Spontaneous, coherent fluctuations of neuronal activity and the coupled hemodynamic responses have also been shown to provide diagnostic markers of disease, extending our understanding of intrinsically structured ongoing brain activity. Following a short summary of the hardware and software development of simultaneous EEG-fMRI, this paper reviews a unified framework of integrating neuronal and hemodynamic processes during epileptic seizures and discusses the role and impact of spontaneous activity in the mesial temporal lobe epilepsies with particular emphasis on the neural and physiological correlates of consciousness.

scholarly journals Reversible MRI abnormalities in mesial temporal lobe epilepsy: a case report

2013 ◽  
Vol 7 (3) ◽  
pp. 77-84
Author(s):  
Chiara Pizzanelli ◽  
Lorenzo Caciagli ◽  
Veronica Bartolami ◽  
Filippo Sean Giorgi ◽  
Ilaria Pesaresi ◽  
...  
Keyword(s):  
Case Report ◽  
Temporal Lobe ◽  
Epileptic Seizures ◽  
Mesial Temporal Lobe Epilepsy ◽  
Epileptic Activity ◽  
Imaging Method ◽  
Antiepileptic Therapy ◽  
Apparent Diffusion ◽  
Mesial Temporal Lobe

The question regarding  the existence of abnormalities in the neuroimaging exams immediately after status epilecticus or epileptic seizures, but showing complete reversibility after a proper antiepileptic therapy, has long been debated. The first reports attempting to demonstrate their existence date back to the 1980s, and relied upon computed tomography as the imaging method of choice. After the introduction of MRI, a more appropriate characterization of these abnormalities was obtained along with the description of their most frequent features: (a) T2 signal hyperintensity in the white matter and, occasionally, (b) reduced apparent diffusion coefficient (ADC) and increased signal in DWI sequences.The MRI abnormalities induced by epileptic activity pose a broad differential diagnosis including infections, inflammatory autoimmune encephalopathies, neoplasms. It remains a diagnosis of exclusion and requires proper diagnostic iter in order to reduce the risk of misdiagnosis and unnecessary intervention.In this case report, a thorough presentation will be outlined about MRI alterations in the left mesial temporal lobe, which resulted completely reversible after a proper antiepileptic therapy.

scholarly journals Emotional declarative memory assessment of patients with mesial temporal lobe epilepsy and patients submitted to mesial temporal lobectomy

2010 ◽  
Vol 68 (5) ◽  
pp. 737-743 ◽  
Author(s):  
Lara De Vecchi Machado ◽  
Jean Edith Frank ◽  
Carlos Tomaz
Keyword(s):  
Working Memory ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Declarative Memory ◽  
Epileptic Seizures ◽  
Emotional Memory ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporal Lobectomy ◽  
Surgical Removal ◽  
Mesial Temporal Lobe

Epileptic seizures generate cognitive and behavioral impacts in individuals who suffer from epilepsy. Declarative memory is one of the cognitive functions that can be affected by epileptic seizures. The main objective of this work was to investigate neurocognitive function, especially the emotional working memory of patients with unilateral mesial temporal lobe epilepsy, and that of patients submitted to unilateral mesial temporal lobectomy. A face recognition test that can simultaneously recruit the frontal lobe (working memory) and mesial temporal lobe (emotional memory) was used to investigate emotional working memory. Our findings showed that the epilepsy factor significantly compromised the performance in the emotional memory test. On the other hand, surgical removal of the epileptic focus promoted an improvement in the emotional working memory of these patients, in addition to the significantly decrease in the number of seizures.

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