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.

Familial mesial temporal lobe epilepsy and the borderland of déjà vu

2017 ◽  
Vol 82 (2) ◽  
pp. 166-176 ◽  
Author(s):  
Piero Perucca ◽  
Douglas E. Crompton ◽  
Susannah T. Bellows ◽  
Anne M. McIntosh ◽  
Tomas Kalincik ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Lobe ◽  
Deja Vu ◽  
Déjà Vu

Accuracy and Efficacy for Robotic Assistance in Implanting Responsive Neurostimulation Device Electrodes in Bilateral Mesial Temporal Lobe Epilepsy

2017 ◽  
Vol 14 (3) ◽  
pp. 267-272 ◽  
Author(s):  
Alvin Y Chan ◽  
Lilit Mnatsakanyan ◽  
Mona Sazgar ◽  
Indranil Sen-Gupta ◽  
Jack J Lin ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Focal Epilepsy ◽  
Mesial Temporal Lobe Epilepsy ◽  
Advanced Technology ◽  
Robotic Assistance ◽  
Mesial Temporal Lobe ◽  
Robotic Devices ◽  
New Treatment

Abstract BACKGROUND Responsive neurostimulation (RNS) is a relatively new treatment option that has been shown to be effective for patients with medically refractory focal epilepsy when resection is not possible, especially in bilateral mesial temporal onset. Robotic devices are becoming increasingly popular for use in stereotactic procedures such as stereoelectroencephalography, but have yet to be used when implanting RNS devices. OBJECTIVE To show that these 2 forms of advanced technology were compatible and could be used effectively in patient care. METHODS We implanted RNS devices in 3 patients with bilateral mesial temporal lobe epilepsy. Each patient was placed in the prone position, and electrode trajectories were planned via the robotic navigation system via a transoccipital approach. One lead was placed along each amygdalohippocampal complex. A small craniectomy was then created in the parietal region for RNS generator implantation. Actual and expected target locations and distance were calculated for each depth. There were no complications in this group. RESULTS RNS devices with bilateral leads were successfully implanted in all 3 patients, with bilateral mesial temporal lobe onset. Follow-up ranged from 3 to 6 mo, and there were no complications in this group. The median distance between the estimate and actual targets was 2.18 (range = 1.11-3.27) mm. CONCLUSION We show that implanting RNS devices with robotic assistance is feasible with excellent precision and accuracy. The advantages of using robotic assistance include higher flexibility, accuracy, precision, and consistency.

Neuroimaging in Temporal Lobe Epilepsy

CNS Spectrums ◽  
1997 ◽  
Vol 2 (7) ◽  
pp. 31-42 ◽  
Author(s):  
Gerard J. Muro ◽  
John P. Karis
Keyword(s):  
Magnetic Resonance ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Tomography ◽  
Resonance Spectroscopy ◽  
Mesial Temporal Sclerosis ◽  
Positron Emission

AbstractVarious neuroimaging modalities are available for evaluating patients with temporal lobe epilepsy (TLE). All patients considering surgery should undergo magnetic resonance imaging, which is valuable in the detection and characterization of lesions, particularly mesial temporal sclerosis, the most common abnormality in TLE. A localized seizure focus is predictive of successful surgical outcome. Complimentary neuroimaging studies include positron emission tomography, single-photon emission tomography, and proton magnetic resonance spectroscopy.

scholarly journals Menstrual cycle worsening of epileptic seizures in women with symptomatic focal epilepsy

2005 ◽  
Vol 63 (3b) ◽  
pp. 751-756 ◽  
Author(s):  
Ana Carolina Belini Bazán ◽  
Maria Augusta Montenegro ◽  
Fernando Cendes ◽  
Li Li Min ◽  
Carlos A.M. Guerreiro
Keyword(s):  
Menstrual Cycle ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Seizure Frequency ◽  
Focal Epilepsy ◽  
Epileptic Seizures ◽  
Mesial Temporal Lobe Epilepsy ◽  
Menstrual Cycles ◽  
Medical Appointment ◽  
Mesial Temporal Lobe

INTRODUCTION: Hormonal fluctuation is responsible for worsening of epileptic seizures during the menstrual cycle. OBJETIVE: To identify irregularities in the menstrual cycles of women with mesial temporal lobe epilepsy (MTLE) and extratemporal focal epilepsy (ETFE) and correlate the frequency of seizures during the menstrual cycles. METHOD: We evaluated prospectively women in the menacme with MTLE and ETFE. Calendars were provided for these patients, and they were asked to mark their seizure frequency according to the menses. Calendars were reviewed in each routine medical appointment. RESULTS: Thirty-nine patients with MTLE and 14 with ETFE were evaluated. We registered 211 cycles in the patients with MTLE and 49 in those with ETFE. Irregular menstrual cycles were found in 28 (28/39, 71.7%) patients with MTLE and 6 (6/14, 42.8%) with ETFE (p=0.052). Premenstrual seizure worsening was observed in 46 (21.8%) patients with MTLE and 9 (18.3%) with ETFE (p=0.596). Menstrual worsening was observed in 47 (22.2%) patients with MTLE and 15 (30.6%) with ETFE (p=0. 217). Ovulatory worsening was observed in 36 (17%) patients with MTLE and 13 (26.5%) with ETFE (p=0,126). Catamenial worsening was observed in 58 (27.4%) of the patients with MTLE and in 17 (34.7%) of the patients with ETFE (p=0.315). CONCLUSION: There was no difference between the group of patients with MTLE and ETFE regarding the frequency of irregular cycles and seizure worsening during the premenstrual, menstrual, catamenial or ovulatory periods.

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.

FLUORODEOXYGLUCOSE–POSITRON EMISSION TOMOGRAPHIC IMAGING FOR THE DIAGNOSIS OF MESIAL TEMPORAL LOBE EPILEPSY

Neurosurgery ◽  
2008 ◽  
Vol 63 (6) ◽  
pp. 1130-1138 ◽  
Author(s):  
Warren W. Boling ◽  
Melissa Lancaster ◽  
Michal Kraszpulski ◽  
Adriana Palade ◽  
Gary Marano ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Visual Inspection ◽  
Mesial Temporal Lobe Epilepsy ◽  
Positron Emission Tomographic ◽  
Positron Emission ◽  
Mri Volumetry ◽  
Mesial Temporal Lobe

Abstract OBJECTIVE Fluorodeoxyglucose (FDG)-positron emission tomographic (PET) imaging plays an important role in the evaluation of intractable epilepsy. The metabolic defect has proven utility in the lateralization of temporal lobe epilepsy. However, the role of FDG–PET imaging in the localization of a seizure focus within the temporal lobe is uncertain. We evaluated FDG–PET imaging for the capability to localize a temporal seizure focus within the mesial structures. METHODS Twenty-eight patients who underwent selective amygdalohippocampectomy for intractable temporal lobe epilepsy were studied. Patients were divided into 2 groups: those who were free of seizures (FS) and those with persisting seizures postoperatively. FS patients were defined by having mesial temporal lobe epilepsy (MTLE). Preoperative FDG–PET activity was evaluated in temporal lobe structures and contrasted with magnetic resonance imaging (MRI) for usefulness in identifying MTLE in an individual. RESULTS Pathology of the hippocampus revealed mesial temporal sclerosis in all but 1 patient. Qualitative visual inspection of the MRI scan was not reliable in the identification of MTLE (P = 0.15). MRI volumetry found smaller mesial temporal structures (P = 0.04) in FS patients. Mesial temporal metabolic activity was reduced in the FS group (hippocampus, P = 0.001). However, a combination of imaging modalities was found to be the best predictor of MTLE. PET imaging plus MRI qualitative inspection identified all patients with and without MTLE correctly and was superior to MRI alone (P = 0.01 and P = 0.02, respectively). CONCLUSION MRI volumetry and PET imaging were comparable (P = 0.73) and able to identify MTLE in most patients, but a combination of PET imaging and MRI visual inspection was superior in the recognition of MTLE.

scholarly journals MRI network progression in mesial temporal lobe epilepsy related to healthy brain architecture

2021 ◽  
pp. 1-17
Author(s):  
Victoria L. Morgan ◽  
Graham W. Johnson ◽  
Leon Y. Cai ◽  
Bennett A. Landman ◽  
Kurt G. Schilling ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Focal Epilepsy ◽  
Structural Connectivity ◽  
Mesial Temporal Lobe Epilepsy ◽  
Seizure Focus ◽  
Functional Gradient ◽  
Mesial Temporal Lobe ◽  
Brain Architecture ◽  
The Brain

We measured MRI network progression in mesial temporal lobe epilepsy (mTLE) patients as a function of healthy brain architecture. Resting-state functional MRI and diffusion-weighted MRI were acquired in 40 unilateral mTLE patients and 70 healthy controls. Data were used to construct region-to-region functional connectivity, structural connectivity, and streamline length connectomes per subject. Three models of distance from the presumed seizure focus in the anterior hippocampus in the healthy brain were computed using the average connectome across controls. A fourth model was defined using regions of transmodal (higher cognitive function) to unimodal (perceptual) networks across a published functional gradient in the healthy brain. These models were used to test whether network progression in patients increased when distance from the anterior hippocampus or along a functional gradient in the healthy brain decreases. Results showed that alterations of structural and functional networks in mTLE occur in greater magnitude in regions of the brain closer to the seizure focus based on healthy brain topology, and decrease as distance from the focus increases over duration of disease. Overall, this work provides evidence that changes across the brain in focal epilepsy occur along healthy brain architecture.

scholarly journals Expression and Potential Function of Plasma Exosomal microRNAs (miR-483-5p, miR-671-5p, and miR-150-3p) in a Mouse Mode and in Mesial Temporal Lobe Epilepsy Patients

2016 ◽  
Author(s):  
Shaofeng Yan ◽  
Guiyang Liu ◽  
Wenyan Xie ◽  
Dawei Meng ◽  
Hua Zhang ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Signaling Pathway ◽  
Potential Function ◽  
Temporal Lobe ◽  
Molecular Mechanisms ◽  
Focal Epilepsy ◽  
Mesial Temporal Lobe Epilepsy ◽  
Nervous System Development ◽  
Exosomal Mirnas ◽  
Mesial Temporal Lobe

Mesial temporal lobe epilepsy (mTLE) is one of the most common and refractory focal epilepsy syndromes. The molecular mechanisms of TLE are not completely understood. The aim of this study was to investigate the expression and potential function of plasma exosomal miRNAs (miR-483-5p, miR-671-5p, and miR-150-3p) in a mouse mode and in temporal lobe epilepsy patients. It was found that exosomal miRNAs were differentially expressed in three phases of the mouse mode, and exosomal miRNAs were down-regulated in mTLE patients compared with healthy controls. A bioinformatics analysis showed that target genes of exosomal miRNAs were significantly involved in the apoptotic process, cell adhesion, nervous system development, neurotrophin signaling pathway, PI3K-Akt signaling pathway, and metabolic pathways. The areas under the curve of miR-483-5p and miR-150-3p were 0.8714 (sensitivity = 75.00%, specificity = 91.65%) and 0.8213 (sensitivity = 67.50%, specificity = 90.00%), respectively. More importantly, the exosomal miRNAs were significantly associated with clinical parameters. Exosomal miRNAs may have the potential to become diagnostic and therapeutic biomarkers.

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