scholarly journals Transient Hemifacial Sensory Loss with Xerophthalmia following Temporal Lobectomy

2000 ◽  
Vol 27 (3) ◽  
pp. 251-253 ◽  
Author(s):  
Ajith J. Thomas ◽  
Kost Elisevich ◽  
Brien Smith
Keyword(s):  
Temporal Lobe ◽  
Clinical Presentation ◽  
Nasal Congestion ◽  
Temporal Lobectomy ◽  
Sensory Loss ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Cavernous Malformations ◽  
Greater Superficial Petrosal Nerve ◽  
The Right

Objective and importance:The occurrence of a unilateral sensory loss in the second trigeminal distribution and the inability to tear following an ipsilateral temporal lobectomy has not been noted despite a number of reports of cranial nerve compromise under similar situations.Clinical presentation:A 48-year-old woman experienced complex partial seizures over three years attributable to the presence of cavernous malformations of the right temporal lobe.Intervention:An anterior temporal extrahippocampal resection was performed. The surgery was marked by the need for electrocoagulation of the dural base of the temporal lobe where numerous bleeding points were encountered. Postoperatively, the patient experienced an ipsilateral maxillary division sensory loss, absence of tearing, and diminished nasal congestion for an eight-month period until resolution.Conclusion:Injury of the fibers of the maxillary division of the trigeminal nerve and the adjacent greater superficial petrosal nerve appears to be the cause. No prior account of such an occurrence has been published.

Extent of Mesiobasal Resection Determines Outcome after Temporal Lobectomy for Intractable Complex Partial Seizures

Neurosurgery ◽  
1991 ◽  
Vol 29 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Mohamed H. Nayel ◽  
Issam A. Awad ◽  
Hans Luders
Keyword(s):  
Temporal Lobe ◽  
Seizure Frequency ◽  
Compartment Model ◽  
Extent Of Resection ◽  
Temporal Lobectomy ◽  
Seizure Outcome ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Lateral Structures

Abstract The extent of resection was assessed in 94 patients who underwent temporal lobectomy for medically intractable complex partial seizures originating from a unilateral seizure focus in the anteromesial temporal lobe. Postoperative magnetic resonance imaging in the coronal plane was used to quantify the extent of resection of lateral and mesiobasal structures according to a 20-compartment model of the temporal lobe. Successful seizure outcome (≥90% reduction in seizure frequency) was accomplished in 83% of the patients (all followed up for more than 1 year; mean duration of follow-up, 25.2 months) and correlated significantly (P<0.05) with the extent of mesiobasal resection, regardless of the extent of resection of lateral structures. Successful seizure outcome was accomplished in 81% of the patients with no structural lesions, and also correlated significantly (P<0.05) with the extent of mesiobasal resection regardless of the extent of lateral resection. A successful seizure outcome was accomplished in 90% of the 21 patients with structural lesions documented by neuroimaging studies. Two patients who underwent extensive lobectomy without resection of the structural lesion had no reduction in seizure frequency postoperatively. We conclude that the most important factor in determining the outcome of temporal lobectomy in patients with unilateral anteromesial temporal lobe epileptogenicity is the extent of resection of structures in the mesiobasal temporal lobe. In patients with structural lesions, lesion resection may be an added contributor to successful seizure outcome. (Neurosurgery 29:55-61, 1991)

Mood Disorder, ‘Pre-ictal’ Psychosis and Temporal Lobe Damage

1990 ◽  
Vol 157 (3) ◽  
pp. 441-444 ◽  
Author(s):  
Bankole A. Johnson ◽  
Lachlan B. Campbell
Keyword(s):  
Mood Disorder ◽  
Temporal Lobe ◽  
Clinical Manifestation ◽  
Partial Seizure ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Simple Partial Seizure ◽  
The Right

A patient with an abnormality in the right temporal lobe presented with episodes of mania many years before the clinical manifestation of both a simple partial seizure and complex partial seizures.

Fentanyl-induced electrocorticographic seizures in patients with complex partial epilepsy

1992 ◽  
Vol 77 (2) ◽  
pp. 201-208 ◽  
Author(s):  
René Tempelhoff ◽  
Paul A. Modica ◽  
Kerry L. Bernardo ◽  
Isaac Edwards
Keyword(s):  
Temporal Lobe ◽  
Seizure Activity ◽  
Epileptiform Activity ◽  
Temporal Lobectomy ◽  
Electrode Arrays ◽  
Complex Partial Seizures ◽  
Content Type ◽  
Temporal Lobe Seizures ◽  
Eeg Recordings ◽  
The Right

✓ Although electrical seizure activity in response to opioids such as fentanyl has been well described in animals, scalp electroencephalographic (EEG) recordings have failed to demonstrate epileptiform activity following narcotic administration in humans. The purpose of this study was to determine whether fentanyl is capable of evoking electrical seizure activity in patients with complex partial (temporal lobe) seizures. Nine patients were studied in whom recording electrode arrays had been placed in the bitemporal epidural space several days earlier to determine which temporal lobe gave rise to their seizures. The symptomatic temporal lobe was localized by correlating clinical and electrical seizure activity obtained during continuous simultaneous videotape and epidural EEG monitoring. In each patient, clinical seizures and electrical seizure activity were consistently demonstrated to arise unilaterally from one temporal lobe (four on the right, five on the left). During fentanyl induction of anesthesia in preparation for secondary craniotomy for anterior temporal lobectomy, eight of the nine patients exhibited electrical seizure activity at fentanyl doses ranging from 17.7 to 35.71 µg · kg−1 (mean 25.75 µg · kg−1). More importantly, four of these eight seizures occurred initially in the “healthy” temporal lobe contralateral to the surgically resected lobe from which the clinical seizures had been shown to arise. These findings indicate that, in patients with complex partial seizures, moderate doses of fentanyl can evoke electrical seizure activity. The results of this study could have important implications for neurosurgical centers where electrocorticography is used during surgery for the purpose of determining the extent of the resection.

Epileptic Psychosis: An Evaluation of PSE Profiles

1985 ◽  
Vol 146 (2) ◽  
pp. 155-163 ◽  
Author(s):  
M. M. Perez ◽  
M. R. Trimble ◽  
N. M. F. Murray ◽  
I. Reider
Keyword(s):  
Temporal Lobe ◽  
Clinical Presentation ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
The Third ◽  
Clear Link ◽  
Epileptic Patients ◽  
Show Evidence ◽  
Patients With Epilepsy ◽  
State Examination

SummaryData are presented on 24 patients with epilepsy and psychosis whose clinical presentation was rated using the Present State Examination (PSE). Seventeen had complex partial seizures and a diagnosis of temporal lobe epilepsy, seven had generalised epilepsy. An association between a CATEGO category of nuclear schizophrenia (NS) and a lesion of the left side was noted. No clear link between depressive symptoms and a right-sided focus was discovered. Affective disorders were noted in both groups of epileptic patients, although paranoid psychoses were commoner in the temporal lobe group. There was also a tendency for the latter to have more delusions of persecution, ideas of reference, and special features of depression. The group rated as NS appear less likely to show evidence of intellectual deterioration than the other psychotic patients; in addition, the interval between the onset of their epilepsy and the onset of their psychosis is shorter. Radiological assessment by CAT reveals few differences between groups, but the psychotic samples do show higher than expected values on a number of variables, in particular the bilateral septum-caudate distance and the size of the third and fourth ventricle.

Lesionectomy versus electrophysiologically guided resection for temporal lobe tumors manifesting with complex partial seizures

1995 ◽  
Vol 83 (2) ◽  
pp. 231-236 ◽  
Author(s):  
Rashid Jooma ◽  
Hwa-shain Yeh ◽  
Michael D. Privitera ◽  
Maureen Gartner
Keyword(s):  
Surgical Treatment ◽  
Temporal Lobe ◽  
Analysis Of Covariance ◽  
Temporal Lobectomy ◽  
Epileptogenic Zone ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Group A ◽  
Group B

✓ Complex partial seizures associated with tumors and other mass lesions are readily diagnosed by modern imaging techniques but their optimum surgical treatment remains unresolved. Lesionectomy has been reported to produce seizure outcomes equal to outcomes after resection that ablates the epileptogenic cortex with the lesion. However, some evidence suggests that when the lesion is in the temporal lobe, simple excision of the tumor or lesion more often fails to control seizures. After retrospectively reviewing the records of 30 patients with complex partial seizures and temporal lobe tumors who underwent surgical treatment at the University of Cincinnati hospitals (1985–1992), the authors divided them into two groups: Group A (16 patients) underwent lesionectomy only and Group B (14 patients) received surgical treatment for seizures with electroencephalographic delineation of the epileptogenic zone and resection of the lesion. Seizure control was best achieved in Group B patients with 13 (92.8%) seizure free at follow up (mean 52 months). Only three (18.8%) of the Group A patients became seizure free after lesionectomy at follow up (mean 33 months). In eight Group A patients, who underwent temporal lobectomy as a second procedure after lesionectomy failed to control seizures, five (62.5%) became seizure free. Group B patients had a longer duration of seizures and were more likely to have lesions smaller than 2.5 cm compared with Group A. Analysis of covariance demonstrated that the differences in outcome between the groups remained significant even with adjustment for the variation in duration of seizures (p = 0.0006) and size of tumor (p = 0.0001). Based on this study, the authors found that the probable relief from seizures caused by a temporal lobe lesion is greater if the region of epileptogenicity, usually the amygdalohippocampal complex, is resected along with the tumor in a temporal lobectomy.

Asymmetry of Neuronal Activity During Extracellular Microelectrode Recording from Left and Right Human Temporal Lobe Neocortex During Rhyming and Line-Matching

2000 ◽  
Vol 12 (5) ◽  
pp. 803-812 ◽  
Author(s):  
Theodore H. Schwartz ◽  
Michael M. Haglund ◽  
Ettore Lettich ◽  
George A. Ojemann
Keyword(s):  
Temporal Lobe ◽  
Neuronal Activity ◽  
Right Hemisphere ◽  
Cerebral Dominance ◽  
Firing Frequency ◽  
Hemispheric Lateralization ◽  
Temporal Lobectomy ◽  
Complex Partial Seizures ◽  
Match To Sample ◽  
The Right

Recordings of neuronal activity in humans have identified few correlates of the known hemispheric asymmetries of functional lateralization. Here, we examine single-unit activity recorded from both hemispheres during two delayed match-to-sample tasks that show strong hemispheric lateralization based on lesion effects; a line-matching (LM) task related to the right hemisphere, and a rhyming (RHY) task related to the left. Nineteen neuronal populations were recorded with extracellular microelectrodes from the left temporal neocortex of 11 awake patients, and 18 from the right in 9 patients during anterior temporal lobectomy for complex partial seizures under local anesthesia. All subjects were left hemisphere dominant for language. Twelve (32%) populations exhibited statistically significant changes in activity at p < .05. Although changes in firing frequency were recorded from both hemispheres during both tasks, the RHY task elicited changes in activity several hundred milliseconds earlier on the left side than on the right. The LM task, on the other hand, induced changes earlier on the right side than on the left. Both hemispheres contained units active during verbal responses regardless of which behavior elicited the response. Our results indicate that cerebral dominance is reflected in earlier neuronal activity in the anterior temporal lobe during tasks lateralized to that hemisphere.

scholarly journals Memory, Emotional and Vocational Impairments before and after Anterior Temporal Lobectomy for Complex Partial Seizures

Epilepsia ◽  
2006 ◽  
Vol 47 (11) ◽  
pp. 1922-1930 ◽  
Author(s):  
Mario F. Dulay ◽  
Michele K. York ◽  
Elizabeth M. Soety ◽  
Winifred J. Hamilton ◽  
Eli M. Mizrahi ◽  
...  
Keyword(s):  
Temporal Lobectomy ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Anterior Temporal Lobectomy ◽  
Before And After

scholarly journals Chronic (Rasmussen’s) Encephalitis in an Adult

2003 ◽  
Vol 30 (3) ◽  
pp. 263-265 ◽  
Author(s):  
Richard Wennberg ◽  
Sukriti Nag ◽  
Mary-Pat McAndrews ◽  
Andres M. Lozano ◽  
Richard Farb ◽  
...  
Keyword(s):  
Visual Field ◽  
Right Visual Field ◽  
Loss Of Consciousness ◽  
Mild Head Injury ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
The Past ◽  
Rasmussen’S Encephalitis ◽  
The Face ◽  
The Right

A 24-year-old woman was referred because of incompletely-controlled complex partial seizures. Her seizures had started at age 21, after a mild head injury with brief loss of consciousness incurred in a biking accident, and were characterized by a sensation of bright flashing lights in the right visual field, followed by numbness and tingling in the right foot, spreading up the leg and to the arm, ultimately involving the entire right side, including the face. Occasionally they spread further to involve right facial twitching with jerking of the right arm and leg, loss of awareness and, at the onset of her epilepsy, rare secondarily generalized convulsions. Seizure frequency averaged three to four per month. She was initially treated with phenytoin and clobazam and subsequently changed to carbamazepine 800 milligrams per day. She also complained that her right side was no longer as strong as her left and that it was also numb, especially the leg, but felt that this weakness had stabilized or improved slightly over the past two years.

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