scholarly journals P.012 Post-operative hippocampal volume changes on magnetic resonance volumetry in patients with mesial temporal lobe epilepsy

2018 ◽  
Vol 45 (s2) ◽  
pp. S18-S18
Author(s):  
K Iida ◽  
J Katayama ◽  
K Kagawa ◽  
M Katagiri ◽  
G Seyama ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Hippocampal Volume ◽  
Mesial Temporal Lobe Epilepsy ◽  
Seizure Freedom ◽  
Age At Surgery ◽  
Before And After ◽  
Mesial Temporal Lobe ◽  
Serial Mri

Background: We evaluate long-term post-operative hippocampal volume (HV) on non-epileptic hippocampus using MR volumetry as well as the neuropsychological outcome in patients with surgery for unilateral mesial temporal lobe epilepsy (MTLE) and achieved seizure-freedom. Methods: We studied 1.5-Tesla MRI before and after epilepsy surgery in 24 patients with MTLE. Serial MRI studies were scheduled at 4 post-operative consecutive periods; 6m-1y; 1-2y; 2-3y; 3-5y. We compared neuropsychological outcomes for memory and estimated IQ at the same periods with serial MRI up to 3 years. Results: The pre-operative non-epileptic HV was significantly smaller than HV in age-matched controls (n=14) (p<0.05). The HV became progressively atrophic after the surgery (p<0.05), correlating with the age at surgery (p<0.05) and pre-operative larger non-epileptic HV (p<0.05), but not with seizure duration. In 14 patients with non-dominant MTLE, the smaller dominant HV at 2-3y period correlated with decline of verbal memory (p<0.05). Conclusions: Post-operative progression of non-epileptic hippocampal atrophy was found with significantly more pronounce in patients with older age at surgery and larger pre-operative non-epileptic hippocampus. After the epileptogenic hippocampus is resected, the remaining hippocampus alone might exhaust to maintain the memory, especially in elders.

scholarly journals Surgical Outcomes and EEG Prognostic Factors After Stereotactic Laser Amygdalohippocampectomy for Mesial Temporal Lobe Epilepsy

2021 ◽  
Vol 12 ◽  
Author(s):  
Shasha Wu ◽  
Naoum P. Issa ◽  
Maureen Lacy ◽  
David Satzer ◽  
Sandra L. Rose ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Surgical Outcomes ◽  
Mesial Temporal Lobe Epilepsy ◽  
Seizure Freedom ◽  
Seizure Recurrence ◽  
Factors Associated ◽  
Scalp Eeg ◽  
Mesial Temporal Lobe

Objective: To assess the seizure outcomes of stereotactic laser amygdalohippocampectomy (SLAH) in consecutive patients with mesial temporal lobe epilepsy (mTLE) in a single center and identify scalp EEG and imaging factors in the presurgical evaluation that correlate with post-surgical seizure recurrence.Methods: We retrospectively reviewed the medical and EEG records of 30 patients with drug-resistant mTLE who underwent SLAH and had at least 1 year of follow-up. Surgical outcomes were classified using the Engel scale. Univariate hazard ratios were used to evaluate the risk factors associated with seizure recurrence after SLAH.Results: The overall Engel class I outcome after SLAH was 13/30 (43%), with a mean postoperative follow-up of 48.9 ± 17.6 months. Scalp EEG findings of interictal regional slow activity (IRSA) on the side of surgery (HR = 4.05, p = 0.005) and non-lateralizing or contra-lateralizing seizure onset (HR = 4.31, p = 0.006) were negatively correlated with postsurgical seizure freedom. Scalp EEG with either one of the above features strongly predicted seizure recurrence after surgery (HR = 7.13, p &lt; 0.001) with 100% sensitivity and 71% specificity.Significance: Understanding the factors associated with good or poor surgical outcomes can help choose the best candidates for SLAH. Of the variables assessed, scalp EEG findings were the most clearly associated with seizure outcomes after SLAH.

scholarly journals Multiple hippocampal transections for mesial temporal lobe epilepsy

2021 ◽  
Vol 12 ◽  
pp. 372
Author(s):  
David Pitskhelauri ◽  
Elina Kudieva ◽  
Maria Kamenetskaya ◽  
Antonina Kozlova ◽  
Pavel Vlasov ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Visual Memory ◽  
Focal Cortical Dysplasia ◽  
Mesial Temporal Lobe Epilepsy ◽  
Drug Resistant ◽  
Preoperative Level ◽  
Temporal Pole ◽  
Mesial Temporal Lobe

Background: The purpose of this study was to evaluate the effectiveness of multiple hippocampal transections (MHT) in the treatment of drug-resistant mesial temporal lobe epilepsy. Methods: Six patients underwent MHT at Burdenko Neurosurgery Center in 2018. The age of the patients varied from 18 to 43 years. All patients suffered from refractory epilepsy caused by focal lesions of the mesial temporal complex or temporal pole in dominant side. Postoperative pathology revealed neuronal-glial tumors in two patients, focal cortical dysplasia (FCD) of the temporal pole – in two patients, cavernous angioma – in one patient, and encephalocele of the preuncal area – in one patient. Results: All patients underwent surgery satisfactorily. There were no postoperative complications except for homonymous superior quadrantanopia. This kind of visual field loss was noted in four cases out of six. During the follow-up period five patients out of six had Engel Class I outcome (83.3%). In one case, seizures developed after 1 month in a patient with FCD in the uncus (Engel IVA). After surgery, three out of six patients developed significant nominative aphasia. Two patients relative to the preoperative level demonstrated improvement in delayed verbal memory after MHT. Two patients showed a decrease level in delayed verbal memory. In preoperative period, visual memory was below the normal in one patient. Delayed visual memory in two cases impaired compared to the preoperative level. Conclusion: MHT can be considered as an effective method of drug-resistant mesial temporal lobe epilepsy caused by tumors of the medial temporal complex. At the same time, MHT makes it possible to preserve memory in patients with structurally preserved hippocampus. However, MHT do not guarantee the preservation of memory after surgery.

Transsylvian hippocampal transection for mesial temporal lobe epilepsy: surgical indications, procedure, and postoperative seizure and memory outcomes

2013 ◽  
Vol 119 (5) ◽  
pp. 1098-1104 ◽  
Author(s):  
Takehiro Uda ◽  
Michiharu Morino ◽  
Hirotaka Ito ◽  
Noriaki Minami ◽  
Atsushi Hosono ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Memory Function ◽  
Mesial Temporal Lobe Epilepsy ◽  
Hippocampal Atrophy ◽  
Delayed Recall ◽  
Nonverbal Memory ◽  
Mesial Temporal Lobe ◽  
The Right

Object Amygdalohippocampectomy is a well-established, standard surgery for medically intractable mesial temporal lobe epilepsy (MTLE). However, in the case of MTLE without hippocampal atrophy or sclerosis, amygdalohippocampectomy is associated with decreased postoperative memory function. Hippocampal transection (HT) has been developed to overcome this problem. In HT the hippocampus is not removed; rather, the longitudinal hippocampal circuits of epileptic activities are disrupted by transection of the pyramidal layer of the hippocampus. The present study describes a less invasive modification of HT (transsylvian HT) and presents the seizure and memory outcomes for this procedure. Methods Thirty-seven patients with MTLE (18 men and 19 women; age range 9–63 years; 19 with surgery on the right side and 18 with surgery on the left side; seizure onset from 3 to 34 years) who were treated with transsylvian HT were retrospectively analyzed. All patients had left-side language dominance, and follow-up periods ranged from 12 to 94 months (median 49 months). Seizure outcomes were evaluated for all patients by using the Engel classification. Memory function was evaluated for 22 patients based on 3 indices (verbal memory, nonverbal memory, and delayed recall), with those scores obtained using the Wechsler Memory Scale–Revised. Patients underwent evaluation of the memory function before and after surgery (6 months–1 year). Results Engel Class I (completely seizure free) was achieved in 25 patients (67.6%). Class II and Class III designation was achieved in 10 (27%) and 2 patients (5.4%), respectively. There were differences in memory outcome between the sides of operation. On the right side, verbal memory significantly increased postoperatively (p = 0.003) but nonverbal memory and delayed recall showed no significant change after the operation (p = 0.718 and p = 0.210, respectively). On the left side, all 3 indices (verbal memory, nonverbal memory, and delayed recall) showed no significant change (p = 0.331, p = 0.458, and p = 0.366, respectively). Conclusions Favorable seizure outcome and preservation of verbal memory were achieved with transsylvian HT for the treatment of MTLE without hippocampal atrophy or sclerosis.

scholarly journals Patterns of seizure control in patients with mesial temporal lobe epilepsy with and without hippocampus sclerosis

2015 ◽  
Vol 73 (2) ◽  
pp. 79-82 ◽  
Author(s):  
Ana Carolina Coan ◽  
Brunno M. Campos ◽  
Felipe P.G Bergo ◽  
Bruno Y. Kubota ◽  
Clarissa L. Yasuda ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Seizure Control ◽  
Hippocampal Sclerosis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Similar Proportion ◽  
Seizure Freedom ◽  
Seizure Recurrence ◽  
Prolonged Seizure ◽  
Mesial Temporal Lobe

Objective Patients with mesial temporal lobe epilepsy (MTLE) may present unstable pattern of seizures. We aimed to evaluate the occurrence of relapse-remitting seizures in MTLE with (MTLE-HS) and without (MTLE-NL) hippocampal sclerosis. Method We evaluated 172 patients with MTLE-HS (122) or MTLE-NL (50). Relapse-remitting pattern was defined as periods longer than two years of seizure-freedom intercalated with seizure recurrence. “Infrequent seizures” was considered as up to three seizures per year and “frequent seizures” as any period of seizures higher than that. Results Thirty-seven (30%) MTLE-HS and 18 (36%) MTLE-NL patients had relapse-remitting pattern (X2, p = 0.470). This was more common in those with infrequent seizures (X2, p < 0.001). Twelve MTLE-HS and one MTLE-NL patients had prolonged seizure remission between the first and second decade of life (X2, p = 0.06). Conclusion Similar proportion of MTLE-HS or MTLE-NL patients present relapse-remitting seizures and this occurs more often in those with infrequent seizures.

Biomagnetic profiles of verbal memory success in patients with mesial temporal lobe epilepsy

2009 ◽  
Vol 16 (3) ◽  
pp. 527-533 ◽  
Author(s):  
F. Maestú ◽  
P. Campo ◽  
I. García-Morales ◽  
A. del Barrio ◽  
N. Paul ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Lobe
Sign in / Sign up

Export Citation Format

Share Document