Absence of Temporal Lobe Epilepsy Pathology in Dogs with Medically Intractable Epilepsy

Patient presenting as a case of Temporal Lobe Epilepsy (TLE) are usually resistant to antiepileptic drugs and surgery is the treatment of choice. This type of epilepsy may be due to Mesial Temporal Sclerosis (MTS), tumors [i.e. low grade glioma, Arterio-venous Malformation (AVM) etc], trauma, infection (Tuberculosis) etc. Here we report a case of surgically treated TLE that was due to a large tuberculoma in medial temporal lobe. Intractable epilepsy caused by tuberculoma is rare. The only presenting symptoms was Complex partial seizure (Psychomotor epilepsy) for which the patient underwent scalp EEG (Electro Encephalography) and MRI (Magnetic resonance imaging) of brain. The patient was managed by amygdalohippocampectomy with lesionectomy plus standard anterior lobectomy. Postoperatively she was on anti-tubercular therapy and on carbamazepine. The case was seizure and disease free till last follow up. Journal of Surgical Sciences (2012) Vol. 16 (2) : 106-109

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Interleukin-1β secretion in hippocampal sclerosis patients with mesial temporal lobe epilepsy

Neurology International ◽

10.4081/ni.2013.e17 ◽

2013 ◽

Vol 5 (3) ◽

pp. 17 ◽

Cited By ~ 4

Author(s):

Nihal Olgac Dundar ◽

Berrin Aktekin ◽

Nilufer Cicek Ekinci ◽

Duygu Sahinturk ◽

Ugur Yavuzer ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Promoter Region ◽

Mononuclear Cells ◽

Hippocampal Sclerosis ◽

Intractable Epilepsy ◽

Mesial Temporal Lobe Epilepsy ◽

Epilepsy Syndrome ◽

Significant Difference ◽

Mesial Temporal Lobe

Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is a common medically intractable epilepsy syndrome. Although pathogenesis of HS still remains highly controversial, genetics may play a role as a predisposing factor. Previous evidence in a Japanese population revealed that the homozygotes for allele T at position −511 of the interleukin (IL)-1β gene promoter region (IL-1β-511 T/T) confers susceptibility to the development of HS. However, whether this polymorphism has an effect on IL-1β levels in MTLE-HS patients was not demonstrated. This study aimed to analyze the distribution of this particular polymorphism in a group of Turkish HS patients and correlate the polymorphism with IL-1β secretion from the lymphocytes, thus revealing a functional role for IL-1β in the etiopathogenesis of HS. A single base pair polymorphism at position −511 in the promoter region of the IL-1β gene was analyzed. The spontaneous and 1 ng/mL lipopolysaccharide-stimulated production of IL-1β by peripheral blood mononuclear cells after 4 and 24 h of incubation were measured by ELISA method. The heterozygous type (−511 C/T) was the most common genotype. There was no difference in frequency of allele −511 T between patients and controls. Analysis of IL-1β levels, genotype and allele distributions showed no significant difference among the groups (P>0.05). Nevertheless, it was seen that patients who carry a T allele at position -511 of the IL-1β gene had increased IL-1β levels. T-allele carriage may be important. Only IL-1β secretion from the lymphocytes has been assessed in this study. Considering the importance of IL-1β in the etiopathogenesis of HS, further studies are needed to evaluate locally produced IL-1β levels.

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Temporal Lobe Epilepsy Semiology

Epilepsy Research and Treatment ◽

10.1155/2012/751510 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 19

Author(s):

Robert D. G. Blair

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Focal Epilepsy ◽

Intractable Epilepsy ◽

Febrile Seizures ◽

Mesial Temporal Sclerosis ◽

Careful Study ◽

Seizure Onset ◽

Seizure Semiology ◽

Seizure Onset Zone

Epilepsy represents a multifaceted group of disorders divided into two broad categories, partial and generalized, based on the seizure onset zone. The identification of the neuroanatomic site of seizure onset depends on delineation of seizure semiology by a careful history together with video-EEG, and a variety of neuroimaging technologies such as MRI, fMRI, FDG-PET, MEG, or invasive intracranial EEG recording. Temporal lobe epilepsy (TLE) is the commonest form of focal epilepsy and represents almost 2/3 of cases of intractable epilepsy managed surgically. A history of febrile seizures (especially complex febrile seizures) is common in TLE and is frequently associated with mesial temporal sclerosis (the commonest form of TLE). Seizure auras occur in many TLE patients and often exhibit features that are relatively specific for TLE but few are of lateralizing value. Automatisms, however, often have lateralizing significance. Careful study of seizure semiology remains invaluable in addressing the search for the seizure onset zone.

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Normal cerebral cortical thickness in first-degree relatives of temporal lobe epilepsy patients

Neurology ◽

10.1212/wnl.0000000000006834 ◽

2018 ◽

Vol 92 (4) ◽

pp. e351-e358 ◽

Cited By ~ 5

Author(s):

Saud Alhusaini ◽

Magdalena A. Kowalczyk ◽

Clarissa L. Yasuda ◽

Mira K. Semmelroch ◽

Marilise Katsurayama ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Cortical Thickness ◽

Hippocampal Sclerosis ◽

Brain Mri ◽

Intractable Epilepsy ◽

Intracranial Volume ◽

Related Factors ◽

Cortical Thinning ◽

First Degree Relatives

ObjectiveTo examine cerebral cortex thickness in asymptomatic first-degree relatives of patients with mesial temporal lobe epilepsy (MTLE).MethodsWe investigated 127 asymptomatic first-degree relatives of patients with MTLE due to hippocampal sclerosis (HS) (mean age ± SD = 39.4 ± 13 years) and 203 healthy control individuals (mean age ± SD = 36.0 ± 11 years). Participants underwent a comprehensive clinical evaluation and structural brain MRI at 3 study sites. Images were processed simultaneously at each site using a surface-based morphometry method to quantify global brain measures, hippocampal volumes, and cerebral cortical thickness. Differences in brain measures between relatives of patients and controls were examined using generalized models, while controlling for relevant covariates, including age and sex.ResultsNone of the asymptomatic first-degree relatives of MTLE + HS patients showed evidence of HS on qualitative image assessments. Compared to the healthy controls, the asymptomatic relatives of patients displayed no significant differences in intracranial volume, average hemispheric surface area, or hippocampal volume. Similarly, no significant cerebral cortical thinning was identified in the relatives of patients. This was consistent across the 3 cohorts.ConclusionLack of cortical thickness changes in the asymptomatic relatives of patients indicates that the previously characterized MTLE + HS-related cortical thinning is not heritable, and is likely driven by disease-related factors. This finding therefore argues for early and aggressive intervention in patients with medically intractable epilepsy.

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TEMPORAL LOBE SURGERY FOR INTRACTABLE EPILEPSY IN CHILDREN

Neurosurgery ◽

10.1227/01.neu.0000245615.32226.83 ◽

2006 ◽

Vol 59 (6) ◽

pp. 1203-1214 ◽

Cited By ~ 77

Author(s):

Mony Benifla ◽

Hiroshi Otsubo ◽

Ayako Ochi ◽

Shelly K. Weiss ◽

Elizabeth J. Donner ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Intractable Epilepsy ◽

Temporal Lobectomy ◽

Seizure Outcome ◽

Mesial Temporal Sclerosis ◽

Low Grade ◽

Cavernous Malformations ◽

The Mean ◽

Secondary Generalization

Abstract OBJECTIVE Temporal lobectomy is a well-established neurosurgical procedure for temporal lobe epilepsy. In this study, we conducted a retrospective review of children with drug-resistant temporal lobe epilepsy to evaluate seizure outcome after temporal lobe surgery. METHODS We reviewed the medical records of 126 children who had surgery for temporal lobe epilepsy at The Hospital for Sick Children between 1983 and 2003. The records were examined for preoperative and intraoperative factors that could predict patient outcome after surgery. RESULTS The mean age at seizure onset was 5.9 years. The mean seizure duration before surgery was 5.6 years. All patients had preoperative computed tomographic scans, magnetic resonance imaging scans, or both. The mean age at the time of surgery was 13.5 years. Sixty-two patients underwent left temporal resections and 64 patients underwent right temporal resections. The histopathology of the temporal resections revealed low-grade brain tumors in 65 children (52%) and cavernous malformations in four children. Ganglioglioma and astrocytoma were the most common tumors encountered. Mesial temporal sclerosis was found in 16 patients (13%), astrogliosis in 15 patients (12%), and cortical dysplasia in eight patients (7%). Postoperative follow-up of at least 2 years was available for 106 patients and ranged up to 13.0 years. Seventy-four percent of patients had an Engel Class I or II outcome. Patients with temporal lobe lesions had better outcomes compared with those without lesions (P< 0.05). Patients without a history of secondary generalization of seizures also had a better outcome when compared with those with secondary generalization. Complications in the form of contralateral homonymous hemianopsia, dysphasia, and infection were found in 5% of patients. Twelve patients had a second temporal lobe procedure for intractable recurrent seizures. After a second procedure, seven patients returned to a seizure-free state. CONCLUSION Temporal lobe resections for epilepsy in children are effective and safe procedures, with a favorable impact on seizure control. Repeat temporal resections for recurrent seizures may also be effective in restoring a seizure-free outcome to children.

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Uncinate Fasciculus in Temporal Lobe Epilepsy

Brain and Neurological Disorders ◽

10.31579/2642-973x/010 ◽

2019 ◽

Vol 2 (2) ◽

pp. 01-04

Author(s):

Simbrón Ribbeck Lourdes ◽

Sandoval Paredes Josefina ◽

Amador Sánchez Karen ◽

Taboada Barajas Jesús

Keyword(s):

Temporal Lobe Epilepsy ◽

Fractional Anisotropy ◽

Temporal Lobe ◽

Diffusion Tensor ◽

Intractable Epilepsy ◽

Uncinate Fasciculus ◽

Hemisphere Dominance ◽

Right Temporal Lobe Epilepsy ◽

White Fiber ◽

Diffusion Tensor Imaging Dti

Background and purpose: Temporal lobe epilepsy is the most common focal intractable epilepsy. Uncinate fasciculus is a white fiber bundle that connects the orbitofrontal cortex with the anterior temporal lobe, and is implicated in most of the superior mental functions. There is evidence of uncinate fasciculus as a propagation pathway of seizures from temporal lobe. The aim of the study is to determine uncinate fasciculus alterations in patients with temporal lobe epilepsy, through fractional anisotropy. Methods: Thirty-three patients with temporal lobe epilepsy (10 right and 23 left) were studied. All of them were right-handed and had left hemisphere dominance for language. A 1.5 T MR imaging scanner was used to obtain diffusion tensor imaging (DTI). Fractional anisotropy of uncinate fasciculus was calculated through TBSS (Tract Based Spatial Statistics). Statistical analysis was done using IBM SPSS (v. 25). Results: Fractional anisotropy was higher in right uncinate fasciculus, regardless of epilepsy side. Right uncinate fasciculus, at the insula level, showed lower fractional anisotropy in patients with right temporal lobe epilepsy. Conclusions: Results support the evidence of uncinate fasciculus as a pathway of propagation in temporal lobe epilepsy, specially at insular level.

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Microneurosurgical Management of Intractable Temporal Lobe Epilepsy (TLE) from Mesial Temporal Sclerosis (MTS) by Amygdalohippocampectomy plus Standard Anterior Temporal Lobectomy: A Report of Three Cases

Journal of Medicine ◽

10.3329/jom.v12i1.6934 ◽

1970 ◽

Vol 12 (1) ◽

pp. 61-65

Author(s):

Forhad Hossain Chowdhury ◽

Md Raziul Haque ◽

Md Shafiqul Islam ◽

Asit Chandra Sarker ◽

AFM Mofakkharul Islam

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Venous Malformation ◽

Intractable Epilepsy ◽

Complex Partial Seizure ◽

Temporal Lobectomy ◽

Mesial Temporal Sclerosis ◽

Low Grade ◽

College Hospital ◽

Presenting Symptoms

Intractable Temporal Lobe Epilepsy may be due to Mesial Temporal Sclerosis (MTS), tumors [i.e. low grade glioma, Arterio-venous Malformation (AVM) etc], trauma, infection (Tuberculosis) etc. Intractable Temporal Lobe Epilepsy (TLE) from Mesial Temporal Sclerosis (MTS) is usually resistant to antiepileptic drugs and surgery is the treatment of choice like other form of TLE . MTS is the most common cause of intractable epilepsy in adult. Here we report three cases of surgically treated TLE that were due to MTS in the department of neurosurgery, Dhaka Medical College Hospital and a private Hospital, Dhaka, Bangladesh from August 2009 to February 2010. In all cases the only presenting symptoms was complex partial seizure (Psychomotor epilepsy) for which all underwent scalp EEG (Electro Encephalogram) and MRI (Magnetic Resonance Imaging) of Brain. All patients were managed by amygdalohippocampectomy plus standard anterior lobectomy. All patients are seizure and disease free till last follow up. Keyword: Intractable temporal lobe epilepsy; Mesial temporal sclerosis; Microneurosurgical management; Amygdalohippocampectomy. DOI: 10.3329/jom.v12i1.6934J Medicine 2011; 12 : 61-65

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Natural History of Temporal Lobe Epilepsy: Antecedents and Progression

Epilepsy Research and Treatment ◽

10.1155/2012/195073 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Garima Shukla ◽

Asuri N. Prasad

Keyword(s):

Natural History ◽

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Viral Infections ◽

Age Of Onset ◽

Intractable Epilepsy ◽

Latency Period ◽

Published Data ◽

Treatment Resistant ◽

History Of

Temporal lobe epilepsy represents the largest group of patients with treatment resistant/medically intractable epilepsy undergoing epilepsy surgery. The underpinnings of common forms of TLE in many instances begin in early life with the occurrence of an initial precipitating event. The first epileptic seizure often occurs after a variable latency period following this event. The precise natural history and progression following the first seizure to the development of TLE, its subsequent resolution through spontaneous remission or the development of treatment resistant epilepsy remain poorly understood. Our present understanding of the role played by these initial events, the subsequent latency to development of temporal lobe epilepsy, and the emergence of treatment resistance remains incomplete. A critical analysis of published data suggest that TLE is a heterogeneous condition, where the age of onset, presence or absence of a lesion on neuroimaging, the initial precipitating event, association with febrile seizures, febrile status epilepticus, and neurotropic viral infections influence the natural history and outcome. The pathways and processes through which these variables coalesce into a framework will provide the basis for an understanding of the natural history of TLE. The questions raised need to be addressed in future prospective and longitudinal observational studies.

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2. Surgery for medically intractable temporal lobe epilepsy (M3-C Treatment strategy for intractable epilepsy)

Japanese Journal of Neurosurgery ◽

10.7887/jcns.13.328_2 ◽

2004 ◽

Vol 13 (4) ◽

pp. 328

Author(s):

Tomakatsu Hori

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Treatment Strategy ◽

Intractable Epilepsy

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In vivo Characterization of MRI-based T1w/T2w Ratios and Covariance Network in Temporal Lobe Epilepsy

10.1101/2020.12.03.20243238 ◽

2020 ◽

Author(s):

Yuchao Jiang ◽

Wei Li ◽

Yingjie Qin ◽

Le Zhang ◽

Xin Tong ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Intractable Epilepsy ◽

Epileptic Seizures ◽

Magnetic Resonance Images ◽

Damage Spreading ◽

Transfer Station ◽

Patient Groups ◽

System Disorder

AbstractTemporal lobe epilepsy (TLE) is the most common type of intractable epilepsy in adults. A novel method based on the ratio of T1-weighted (T1w) and T2-weighted (T2w) magnetic resonance images can investigate brain microstructural changes and how these regional changes interact with each other. This study estimated T1w/T2w ratios in 42 left TLE (LTLE) and 42 right TLE (RTLE) patients and 41 healthy controls (HC). A T1w/T2w structural covariance network (SCN) was built by calculating correlations between any two regions across subjects and analysed by graph theory. Voxel-wise comparisons of T1w/T2w laterality were performed among the three groups. Compared to HC, both patient groups showed decreased T1w/T2w in frontotemporal regions, amygdala and thalamus; however, the LTLE showed lower T1w/T2w in left medial temporal regions than RTLE. Moreover, the LTLE exhibited decreased global efficiency compared with HC and more increased connections than RTLE. The laterality in putamen was differently altered between the two patient groups: higher laterality at posterior putamen in LTLE and higher laterality at anterior putamen in RTLE. This study demonstrated T1w/T2w reductions in frontotemporal and subcortical regions and extensive disconnections of SCN, providing evidence that TLE is a system disorder with widespread disruptions at regional and network levels. The putamen may play a transfer station role in damage spreading induced by epileptic seizures from the hippocampus.

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