Relationship of hippocampal sclerosis to duration and age of onset of epilepsy, and childhood febrile seizures in temporal lobectomy patients

1996 ◽  
Vol 24 (2) ◽  
pp. 119-126 ◽  
Author(s):  
Keith G. Davies ◽  
Bruce P. Hermann ◽  
F.Curtis Dohan ◽  
Kevin T. Foley ◽  
Andrew J. Bush ◽  
...  
Keyword(s):  
Age Of Onset ◽  
Hippocampal Sclerosis ◽  
Febrile Seizures ◽  
Temporal Lobectomy ◽  
Relationship Of

scholarly journals PHARMACORESISTENT TEMPORAL LOBE & EXTRA TEMPORAL EPILEPSY: OUTCOMES AFTER SURGERY.

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Govind Mangal ◽  
Uday Bhaumik ◽  
Giriraj Prajapati ◽  
Poojan Thakor
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Age Of Onset ◽  
Hippocampal Sclerosis ◽  
Temporal Lobectomy ◽  
Temporal Epilepsy ◽  
Post Surgery ◽  
Study Population ◽  
The Mean

Background: Our aim was to follow up patients postoperatively to identify seizure remission and relapse after surgery, to enable individuals considering surgery to make informed choices. Methods: Ninteen consecutive patients operated for drug resistant Temporal lobe & extra temporal lobe epilepsy between 2019 and 2020, at our centre. All the patients had at least one year post surgery follow-up. Results: The mean age of study population was 20.87 ± 10.08 years. The mean age of onset of epilepsy in study population was 14.9 ± 8 years. There were no acute post operative seizures. The most common histpathological finding was hippocampal sclerosis in 15 patients. The patients were followed up and 15 were in the class 1 of engel classification. 2 in class 2, rest had one each Conclusion: Following surgery approx half of patients were seizure free and Engel's favourable outcome was noted. The predictors of unfavourable outcome were younger age of onset and pronged duration and of epilepsy Keywords: Temporal lobe epilepsy, temporal lobectomy, amygdalohippocampectomy, outcome, extra temporal lobe epilepsy, extra temporal lobectomy

scholarly journals The Genetics of Temporal Lobe Epilepsy and Implications for Treatment

2007 ◽  
Vol 7 (4) ◽  
pp. 100-101
Author(s):  
Bassel W. Abou-Khalil
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Febrile Seizures ◽  
Temporal Lobectomy ◽  
Missense Mutations ◽  
Gene Encoding ◽  
Quantitative Mr Imaging ◽  
Quantitative Mr ◽  
Febrile Seizures Plus

Temporal Lobe Epilepsy and GEFS+ Phenotypes Associated with SCN1B Mutations. Scheffer IE, Harkin LA, Grinton BE, Dibbens LM, Turner SJ, Zielinski MA, Xu R, Jackson G, Adams J, Connellan M, Petrou S, Wellard RM, Briellmann RS, Wallace RH, Mulley JC, Berkovic SF. Brain 2007;130(Pt 1):100–109. SCN1B, the gene encoding the sodium channel β1 subunit, was the first gene identified for generalized epilepsy with febrile seizures plus (GEFS+). Only three families have been published with SCN1B mutations. Here, we present four new families with SCN1B mutations and characterize the associated phenotypes. Analysis of SCN1B was performed on 402 individuals with various epilepsy syndromes. Four probands with missense mutations were identified. Detailed electroclinical phenotyping was performed on all available affected family members including quantitative MR imaging in those with temporal lobe epilepsy (TLE). Two new families with the original C121W SCN1B mutation were identified; novel mutations R85C and R85H were each found in one family. The following phenotypes occurred in the six families with SCN1B missense mutations: 22 febrile seizures, 20 febrile seizures plus, five TLE, three other GEFS+ phenotypes, two unclassified and ten unaffected individuals. All individuals with confirmed TLE had the C121W mutation; two underwent temporal lobectomy (one with hippocampal sclerosis and one without) and both are seizure free. We confirm the role of SCN1B in GEFS+ and show that the GEFS+ spectrum may include TLE alone. TLE with an SCN1B mutation is not a contraindication to epilepsy surgery.

Long-term seizure outcomes after pediatric temporal lobectomy: does brain MRI lesion matter?

2019 ◽  
Vol 24 (2) ◽  
pp. 200-208
Author(s):  
Ravindra Arya ◽  
Francesco T. Mangano ◽  
Paul S. Horn ◽  
Sabrina K. Kaul ◽  
Serena K. Kaul ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Hippocampal Sclerosis ◽  
Brain Mri ◽  
Temporal Lobectomy ◽  
Seizure Freedom ◽  
Seizure Onset

OBJECTIVEThere is emerging data that adults with temporal lobe epilepsy (TLE) without a discrete lesion on brain MRI have surgical outcomes comparable to those with hippocampal sclerosis (HS). However, pediatric TLE is different from its adult counterpart. In this study, the authors investigated if the presence of a potentially epileptogenic lesion on presurgical brain MRI influences the long-term seizure outcomes after pediatric temporal lobectomy.METHODSChildren who underwent temporal lobectomy between 2007 and 2015 and had at least 1 year of seizure outcomes data were identified. These were classified into lesional and MRI-negative groups based on whether an epilepsy-protocol brain MRI showed a lesion sufficiently specific to guide surgical decisions. These patients were also categorized into pure TLE and temporal plus epilepsies based on the neurophysiological localization of the seizure-onset zone. Seizure outcomes at each follow-up visit were incorporated into a repeated-measures generalized linear mixed model (GLMM) with MRI status as a grouping variable. Clinical variables were incorporated into GLMM as covariates.RESULTSOne hundred nine patients (44 females) were included, aged 5 to 21 years, and were classified as lesional (73%), MRI negative (27%), pure TLE (56%), and temporal plus (44%). After a mean follow-up of 3.2 years (range 1.2–8.8 years), 66% of the patients were seizure free for ≥ 1 year at last follow-up. GLMM analysis revealed that lesional patients were more likely to be seizure free over the long term compared to MRI-negative patients for the overall cohort (OR 2.58, p < 0.0001) and for temporal plus epilepsies (OR 1.85, p = 0.0052). The effect of MRI lesion was not significant for pure TLE (OR 2.64, p = 0.0635). Concordance of ictal electroencephalography (OR 3.46, p < 0.0001), magnetoencephalography (OR 4.26, p < 0.0001), and later age of seizure onset (OR 1.05, p = 0.0091) were associated with a higher likelihood of seizure freedom. The most common histological findings included cortical dysplasia types 1B and 2A, HS (40% with dual pathology), and tuberous sclerosis.CONCLUSIONSA lesion on presurgical brain MRI is an important determinant of long-term seizure freedom after pediatric temporal lobectomy. Pediatric TLE is heterogeneous regarding etiologies and organization of seizure-onset zones with many patients qualifying for temporal plus nosology. The presence of an MRI lesion determined seizure outcomes in patients with temporal plus epilepsies. However, pure TLE had comparable surgical seizure outcomes for lesional and MRI-negative groups.

scholarly journals Stereotactic EEG-guided radiofrequency thermocoagulation versus anterior temporal lobectomy for mesial temporal lobe epilepsy with hippocampal sclerosis: study protocol for a randomised controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yi-He Wang ◽  
Si-Chang Chen ◽  
Peng-Hu Wei ◽  
Kun Yang ◽  
Xiao-Tong Fan ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Controlled Trial ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporal Lobectomy ◽  
Anterior Temporal Lobectomy ◽  
Radiofrequency Thermocoagulation ◽  
Mesial Temporal Lobe ◽  
Randomised Controlled

Abstract Introduction In this report, we aim to describe the design for the randomised controlled trial of Stereotactic electroencephalogram (EEG)-guided Radiofrequency Thermocoagulation versus Anterior Temporal Lobectomy for Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (STARTS). Mesial temporal lobe epilepsy (mTLE) is a classical subtype of temporal lobe epilepsy that often requires surgical intervention. Although anterior temporal lobectomy (ATL) remains the most popular treatment for mTLE, accumulating evidence has indicated that ATL can cause tetartanopia and memory impairments. Stereotactic EEG (SEEG)-guided radiofrequency thermocoagulation (RF-TC) is a non-invasive alternative associated with lower seizure freedom but greater preservation of neurological function. In the present study, we aim to compare the safety and efficacy of SEEG-guided RF-TC and classical ATL in the treatment of mTLE. Methods and analysis STARTS is a single-centre, two-arm, randomised controlled, parallel-group clinical trial. The study includes patients with typical mTLE over the age of 14 who have drug-resistant seizures for at least 2 years and have been determined via detailed evaluation to be surgical candidates prior to randomisation. The primary outcome measure is the cognitive function at the 1-year follow-up after treatment. Seizure outcomes, visual field abnormalities after surgery, quality of life, ancillary outcomes, and adverse events will also be evaluated at 1-year follow-up as secondary outcomes. Discussion SEEG-guided RF-TC for mTLE remains a controversial seizure outcome but has the advantage for cognitive and visual field protection. This is the first RCT studying cognitive outcomes and treatment results between SEEG-guided RF-TC and standard ATL for mTLE with hippocampal sclerosis. This study may provide higher levels of clinical evidence for the treatment of mTLE. Trial registration ClinicalTrials.gov NCT03941613. Registered on May 8, 2019. The STARTS protocol has been registered on the US National Institutes of Health. The status of the STARTS was recruiting and the estimated study completion date was December 31, 2021.

Extratemporal ictal clinical features in hippocampal sclerosis: Their relationship to the degree of hippocampal volume loss and to the outcome of temporal lobectomy

Epilepsia ◽  
2008 ◽  
Vol 49 (8) ◽  
pp. 1333-1339 ◽  
Author(s):  
Paolo Borelli ◽  
Simon D. Shorvon ◽  
John M. Stevens ◽  
Shelagh J. Smith ◽  
Catherine A. Scott ◽  
...  
Keyword(s):  
Clinical Features ◽  
Hippocampal Sclerosis ◽  
Hippocampal Volume ◽  
Temporal Lobectomy ◽  
Volume Loss

The Risk of Seizure Recurrence After a First Unprovoked Afebrile Seizure in Childhood: An Extended Follow-up

PEDIATRICS ◽  
1996 ◽  
Vol 98 (2) ◽  
pp. 216-225 ◽  
Author(s):  
Shlomo Shinnar ◽  
Anne T. Berg ◽  
Solomon L. Moshe ◽  
Christine O'Dell ◽  
Marta Alemany ◽  
...  
Keyword(s):  
Risk Factors ◽  
Age Of Onset ◽  
Multivariable Analysis ◽  
Cumulative Risk ◽  
Febrile Seizures ◽  
Recurrence Risk ◽  
Early Recurrence ◽  
Seizure Recurrence ◽  
Unprovoked Seizure ◽  
History Of

Objective. To assess the long-term recurrence risks after a first unprovoked seizure in childhood. Methods. In a prospective study, 407 children who presented with a first unprovoked seizure were then followed for a mean of 6.3 years from the time of first seizure. Results. One hundred seventy-one children (42%) experienced subsequent seizures. The cumulative risk of seizure recurrence was 29%,37%,42%, and 44% at 1,2,5, and 8 years, respectively. The median time to recurrence was 5.7 months, with 53% of recurrences occurring within 6 months, 69% within 1 year, and 88% within 2 years. Only 5 recurrences (3%) occurred after 5 years. On multivariable analysis, risk factors for seizure recurrence included a remote symptomatic etiology, an abnormal electroencephalogram (EEG), a seizure occurring while asleep, a history of prior febrile seizures, and Todd's paresis. In cryptogenic cases, the risk factors were an abnormal EEG and an initial seizure during sleep. In remote symptomatic cases, risk factors were a history of prior febrile seizures and age of onset younger than 3 years. Risk factors for late recurrences (after 2 years) were etiology, an abnormal EEG, and prior febrile seizures in the overall group and an abnormal EEG in the cryptogenic group. These are similar to the risk factors for early recurrence. Conclusions. The majority of children with a first unprovoked seizure will not have recurrences. Children with cryptogenic first seizures and a normal EEG whose initial seizure occurs while awake have a particularly favorable prognosis, with a 5-year recurrence risk of only 21%. Late recurrences do occur but are uncommon.

Survival and risk factors for premature mortality in patients with parkinson’s disease

2021 ◽  
Vol LIII (3) ◽  
pp. 5-10
Author(s):  
Fatima N. Aliyeva
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Survival Rate ◽  
Confidence Interval ◽  
Causes Of Death ◽  
Age Of Onset ◽  
Premature Mortality ◽  
Parkinsons Disease ◽  
Cerebrovascular Accidents ◽  
Relationship Of

Aim. To assess the survival rate and risk factors for premature mortality in patients with Parkinsons disease in Baku. Material and research methods. The observation was carried out retrospectively, information was collected on all patients (110 patients) in whom the diagnosis of Parkinsons disease was first established in 20092010. These patients are provided with drugs free of charge, which made it possible to provide them with diagnostic monitoring in polyclinics. During 20102019, 94 patients with a diagnosis of Parkinsons disease died. All medical death certificates were selected for analysis. The diagnoses in column a of these documents were accepted as direct causes of death, regardless of the presence or absence of a causal relationship of these diagnoses with Parkinsons disease. Therefore, the reported cases were interpreted not as death due to Parkinsons disease, but as the death of a patient diagnosed with Parkinsons disease. Results. Noteworthy is the prevalence of men (72.7%) and people without dementia (70.9%) among patients. Within 10 years, 85.5% of patients died from various causes. The immediate causes of death were acute cerebrovascular accidents (36.2%) and acute myocardial infarction (24.5%). The annual survival rate of the observed patients was high (94%; 95% confidence interval 51100%). The five-year survival rate is 76% (95% confidence interval 42100%). Conclusions. (1) The survival rate of patients with Parkinsons disease within 10 years after the onset of signs ranges from 0.94 to 0.41 (five-year survival rate is 0.76). (2) The immediate causes of mortality in patients with Parkinsons disease were cerebrovascular accidents (36.2%), myocardial infarction (24.5%), pulmonary embolism (11.7%), pneumonia (10.6%) and others (17%). (3) The effect of age of onset and signs of Parkinsons disease, gender, comorbidity and dementia on survival is statistically significant (p 0.05).

scholarly journals Neurocysticercosis as a probable risk factor for hippocampal sclerosis

2018 ◽  
Vol 76 (11) ◽  
pp. 783-790 ◽  
Author(s):  
Gagandeep Singh ◽  
Josemir W. Sander
Keyword(s):  
Hippocampal Sclerosis ◽  
Taenia Solium ◽  
Population Based ◽  
Temporal Lobectomy ◽  
Epileptogenic Zone ◽  
Drug Resistant ◽  
Common Risk Factors ◽  
Longitudinal Imaging ◽  
Drug Resistant Epilepsy ◽  
Pathology Reports

ABSTRACT Neurocysticercosis is one of the most common risk factors for epilepsy but its association with drug-resistant epilepsy remains uncertain. Conjectures of an association with drug-resistant epilepsy have been fueled by reports of an association between calcific neurocysticercosis lesions (CNL) and hippocampal sclerosis (HS) from specialized epilepsy centers in Taenia solium-endemic regions. The debate arising from these reports is whether the association is causal. Evidence for the association is not high quality but sufficiently persuasive to merit further investigation with longitudinal imaging studies in population-based samples from geographically-diverse regions. The other controversial point is the choice of a surgical approach for drug-resistant epilepsy associated with CNL-HS. Three approaches have been described: standard anteromesial temporal lobectomy, lesionectomy involving a CNL alone and lesionectomy with anteromesial temporal lobectomy (for dual pathology); reports of the latter two approaches are limited. Presurgical evaluation should consider possibilities of delineating the epileptogenic zone/s in accordance with all three approaches.

scholarly journals The relationship of the age of onset of obesity to the success of its treatment in the adult

1975 ◽  
Vol 34 (2) ◽  
pp. 201-204 ◽  
Author(s):  
Margaret Ashwell
Keyword(s):  
Early Onset ◽  
Age Of Onset ◽  
Maximum Weight ◽  
Men And Women ◽  
Loss Of Weight ◽  
Relationship Of ◽  
The Relationship

1. A survey was done of 2333 men and women who claimed experience of slimming.2. Their loss of weight was determined from their maximum stated weight and their present weight. The loss of weight was calculated as the percentage of the maximum weight and was related to the stated age of onset of obesity.3. The results showed that those people in the survey who had been fat since childhood had lost just as much weight as those people who had become fat as adults.4. These results suggest that the treatment of early-onset obesity may not be an unrealistic objective.

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