scholarly journals Descending Cephalic to Epigastric Sensation in a Patient with Mesial Temporal Lobe Epilepsy: A Novel Observation

2022 ◽  
Author(s):  
Sachin Sureshbabu ◽  
Merisin Joseph ◽  
Sruthi K. G ◽  
Smilu Mohanlal ◽  
Sudhir Peter ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Insular Cortex ◽  
Mesial Temporal Lobe Epilepsy ◽  
Emission Tomography ◽  
Resonance Imaging ◽  
Clinical Expression ◽  
Selective Amygdalohippocampectomy ◽  
Positron Emission ◽  
Mesial Temporal Lobe

AbstractOne of the most frequent type of auras in mesial temporal lobe epilepsy (MTLE) is epigastric sensation. Until now the site of the symptomatogenic zone of the epigastric aura remains controversial. The temporal lobe as well as insular cortex has been implicated. Our case is that of a 29-year-old young woman who presented with an aura of descending cephalic to epigastric sensation as opposed to the prototypical ascending aura. Interictal and ictal recording favored a mesial temporal pattern. Magnetic resonance imaging brain showed left mesial temporal lobe sclerosis. Interictal positron emission tomography showed concordant findings. The patient underwent selective amygdalohippocampectomy following which she remains seizure-free. This previously unreported clinical expression of MTLE and its origins is discussed.

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.

Lateralising value of experiential hallucinations in temporal lobe epilepsy

2015 ◽  
Vol 86 (11) ◽  
pp. 1273-1276 ◽  
Author(s):  
Lukas Heydrich ◽  
Guillaume Marillier ◽  
Nathan Evans ◽  
Olaf Blanke ◽  
Margitta Seeck
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Single Photon ◽  
Focal Epilepsy ◽  
Photon Emission ◽  
Mesial Temporal Lobe Epilepsy ◽  
Positron Emission ◽  
Mesial Temporal Lobe ◽  
Deja Vu ◽  
Déjà Vu

ObjectivesEver since John Hughlings Jackson first described the so-called ‘dreamy state’ during temporal lobe epilepsy, that is, the sense of an abnormal familiarity (déjà vu) or vivid memory-like hallucinations from the past (experiential hallucinations), these phenomena have been studied and repeatedly linked to mesial temporal lobe structures. However, little is known about the lateralising value of either déjà vu or experiential hallucinations.MethodsWe analysed a sample of 28 patients with intractable focal epilepsy suffering from either déjà vu or experiential hallucinations. All the patients underwent thorough presurgical examination, including MRI, positron emission tomography, single-photon emission CT, EEG and neuropsychological examination.ResultsWhile déjà vu was due to right or left mesial temporal lobe epilepsy, experiential hallucinations were strongly lateralised to the left mesial temporal lobe. Moreover, there was a significant effect for interictal language deficits being more frequent in patients suffering from experiential hallucinations.ConclusionsThese results suggest a lateralising value for experiential hallucinations to the left temporal lobe.

scholarly journals Surgical Treatment of Mesial Temporal Lobe Epilepsy: Selective Amygdalohippocampectomy Using Niemeyer's Approach

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Santos Adriana Rodrigues Libório dos ◽  
Mufarrej Gabriel ◽  
Conceição Priscila Oliveira da ◽  
Cruz Paulo Luiz da Costa ◽  
Cavalcanti Daniel Dutra ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Selective Amygdalohippocampectomy ◽  
Mesial Temporal Lobe

scholarly journals Mesial temporal lobe epilepsy: long-term seizure outcome of patients primarily treated with transsylvian selective amygdalohippocampectomy

2018 ◽  
Vol 129 (1) ◽  
pp. 174-181 ◽  
Author(s):  
Christian Dorfer ◽  
Thomas Czech ◽  
Susanne Aull-Watschinger ◽  
Christoph Baumgartner ◽  
Rebekka Jung ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Class I ◽  
Seizure Outcome ◽  
Selective Amygdalohippocampectomy ◽  
Class 1 ◽  
Mesial Temporal Lobe

OBJECTIVEThe aim of this study was to present long-term seizure outcome data in a consecutive series of patients with refractory mesial temporal lobe epilepsy primarily treated with transsylvian selective amygdalohippocampectomy (SAHE).METHODSThe authors retrospectively analyzed prospectively collected data for all patients who had undergone resective surgery for medically refractory epilepsy at their institution between July 1994 and December 2014. Seizure outcome was assessed according to the International League Against Epilepsy (ILAE) and the Engel classifications.RESULTSThe authors performed an SAHE in 158 patients (78 males, 80 females; 73 right side, 85 left side) with a mean age of 37.1 ± 10.0 years at surgery. Four patients lost to follow-up and 1 patient who committed suicide were excluded from analysis. The mean follow-up period was 9.7 years. At the last available follow-up (or before reoperation), 68 patients (44.4%) had achieved an outcome classified as ILAE Class 1a, 46 patients (30.1%) Class 1, 6 patients (3.9%) Class 2, 16 patients (10.4%) Class 3, 15 patients (9.8%) Class 4, and 2 patients (1.3%) Class 5. These outcomes correspond to Engel Class I in 78.4% of the patients, Engel Class II in 10.5%, Engel Class III in 8.5%, and Engel Class IV in 2.0%. Eleven patients underwent a second surgery (anterior temporal lobectomy) after a mean of 4.4 years from the SAHE (left side in 6 patients, right side in 5). Eight (72.7%) of these 11 patients achieved seizure freedom.The overall ILEA seizure outcome since (re)operation after a mean follow-up of 10.0 years was Class 1a in 72 patients (47.0%), Class 1 in 50 patients (32.6%), Class 2 in 7 patients (4.6%), Class 3 in 15 patients (9.8%), Class 4 in 8 patients (5.2%), and Class 5 in 1 patient (0.6%). These outcomes correspond to an Engel Class I outcome in 84.3% of the patients.CONCLUSIONSA satisfactory long-term seizure outcome following transsylvian SAHE was demonstrated in a selected group of patients with refractory temporal lobe epilepsy.

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