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

Preservation of Memory Despite Unresected Contralateral Hippocampal Volume Loss After Resection of Hippocampal Sclerosis in Seizure-Free Patients

2019 ◽  
Vol 132 ◽  
pp. e759-e765
Author(s):  
Koji Iida ◽  
Kota Kagawa ◽  
Masaya Katagiri ◽  
Go Seyama ◽  
Akira Hashizume ◽  
...  
Keyword(s):  
Hippocampal Sclerosis ◽  
Hippocampal Volume ◽  
Volume Loss

scholarly journals Contribution of TDP and hippocampal sclerosis to hippocampal volume loss in older-old persons

Neurology ◽  
2019 ◽  
Vol 94 (2) ◽  
pp. e142-e152 ◽  
Author(s):  
Lei Yu ◽  
Patricia A. Boyle ◽  
Robert J. Dawe ◽  
David A. Bennett ◽  
Konstantinos Arfanakis ◽  
...  
Keyword(s):  
Hippocampal Formation ◽  
Hippocampal Sclerosis ◽  
Statistical Significance ◽  
Lewy Bodies ◽  
Vascular Diseases ◽  
Region Of Interest ◽  
Hippocampal Volume ◽  
Volume Measurement ◽  
Volume Loss ◽  
Alzheimer Dementia

ObjectiveTo investigate the contribution of Alzheimer disease (AD) vs non-AD neuropathologies to hippocampal atrophy.MethodsThe Religious Orders Study and Rush Memory and Aging Project are clinicopathologic cohort studies of aging. The current study included 547 participants who had undergone brain autopsy and postmortem hippocampal volume measurement by November 1, 2018. Hippocampal volume was measured with postmortem MRI via a 3D region of interest applied to the hippocampal formation. Neuropathologies were measured via uniform structured evaluations. Linear regression analyses estimated the proportion of variance of hippocampal volume attributable to AD and non-AD neuropathologies.ResultsThe average age at death was 90 years, and the average hippocampal volume was 2.1 mL. AD, transactive response DNA-binding protein 43 (TDP), hippocampal sclerosis (HS), and atherosclerosis were associated with hippocampal volume. After demographics and total hemisphere volume were controlled for, 7.0% of the variance (95% bootstrapped confidence interval [CI] 4.3%–10.5%) of hippocampal volume was attributable to AD pathology. TDP/HS explained an additional 4.5% (95% CI 2.2%–7.6%). Among individuals with Alzheimer dementia (n = 232), 3.1% (95% CI 0.6%–7.7%) of the variance was attributable to AD pathology, and TDP/HS explained an additional 6.1% (95% CI 2.2%–11.6%). Among those without Alzheimer dementia (n = 307), 3.2% (95% CI 0.9%–7.3%) of the variance was attributable to AD pathology, and TDP/HS explained an additional 1.1%, which did not reach statistical significance. Lewy bodies and vascular diseases had modest contribution to the variance of hippocampal volume.ConclusionsBoth AD and TDP/HS contribute to hippocampal volume loss in older-old persons, with TDP/HS more strongly associated with hippocampal volume than AD in Alzheimer dementia.

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.

Untreated Depression and Hippocampal Volume Loss

2004 ◽  
Vol 161 (7) ◽  
pp. 1309-a-1310 ◽  
Author(s):  
BERNARD J. CARROLL
Keyword(s):  
Hippocampal Volume ◽  
Volume Loss

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.

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

Histopathologic subtype of hippocampal sclerosis and episodic memory performance before and after temporal lobectomy for epilepsy

Epilepsia ◽  
2018 ◽  
Vol 59 (4) ◽  
pp. 825-833 ◽  
Author(s):  
Shahram Saghafi ◽  
Lisa Ferguson ◽  
Olivia Hogue ◽  
Jordan M. Gales ◽  
Richard Prayson ◽  
...  
Keyword(s):  
Episodic Memory ◽  
Hippocampal Sclerosis ◽  
Memory Performance ◽  
Temporal Lobectomy ◽  
Before And After
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