How Different Are the Patients With Bilateral Hippocampal Sclerosis From the Unilateral Ones Clinically?

2016 ◽  
Vol 48 (3) ◽  
pp. 209-216 ◽  
Author(s):  
Ebru Nur Vanli-Yavuz ◽  
Betul Baykan ◽  
Serra Sencer ◽  
Altay Sencer ◽  
Isin Baral-Kulaksizoglu ◽  
...  
Keyword(s):  
Mental Retardation ◽  
Status Epilepticus ◽  
Epilepsy Surgery ◽  
Hippocampal Sclerosis ◽  
Control Group ◽  
High Signal ◽  
Binary Logistic Regression Analysis ◽  
Laboratory Findings ◽  
Patients With Epilepsy ◽  
Febrile Status Epilepticus

Purpose. There is a lack of knowledge on consecutive patients with epilepsy associated with bilateral hippocampal sclerosis (BHS). We aimed to investigate the differentiating features of BHS in comparison with unilateral HS (UHS). Method. We investigated our database for patients with epilepsy fulfilling the major magnetic resonance imaging criteria for BHS; namely, presence of bilateral atrophy and high signal changes on T2 and FLAIR series in the hippocampi. UHS patients seen in past 2 years were included as the control group. Clinical, EEG, and other laboratory findings, data on treatment response and epilepsy surgery were investigated from their files. Results. A total of 124 patients (31 with BHS and 93 with UHS; 49 right-sided and 44 left-sided) were included. We found that 16.1% of the BHS and 18.3% of the UHS groups were not drug-refractory. A binary logistic regression analysis performed with significant clinical features disclosed that history of febrile status epilepticus, mental retardation, and status epilepticus were statistically more common in BHS group. Moreover, diagnosis of psychosis established by an experienced psychiatrist and slowing of the EEG background activity were both found significantly more frequent in BHS. 66.67% of the operated BHS patients showed benefit from epilepsy surgery. Conclusions. BHS is a heterogeneous group, showing significant differences such as increased frequencies of mental retardation, status epilepticus, febrile status epilepticus and psychosis, in comparison to UHS. In all, 16.1% of the BHS cases showed a benign course similar to the UHS group and some patients with drug-resistant epilepsy may show benefit from epilepsy surgery.

scholarly journals Paradoxical GH response to TRH during status epilepticus in man

1999 ◽  
pp. 307-314 ◽  
Author(s):  
U Lindbom ◽  
AL Hulting ◽  
T Tomson
Keyword(s):  
Status Epilepticus ◽  
Epileptic Activity ◽  
Control Group ◽  
Fisher Exact Probability Test ◽  
Exact Probability ◽  
Paradoxical Response ◽  
Before And After ◽  
The Status ◽  
Altered Regulation ◽  
Patients With Epilepsy

Information on GH in relation to epilepsy is sparse, and to our knowledge there is no information on GH levels during status epilepticus in man. We studied GH in serum in six patients during status epilepticus, and in a control group of six seizure-free patients with epilepsy, before and after injection of TRH. The baseline GH values before TRH administration were within the normal range in all patients. After injection of TRH all patients with status epilepticus showed a paradoxical peak-shaped increase of GH to at least twice their baseline levels within 45 min after the injection (median basal GH value 1.5 mU/l and median peak GH value 6. 5 mU/l, mean increase 330%). No uniform reaction to TRH was observed in the control group (median basal GH value 2.7 U/l and median of the highest value within 45 min 5.2mU/l). A paradoxical peak reaction of GH to TRH was significantly more frequent in the status epilepticus group compared with the control group (P=0.008, Fisher exact probability test). TRH is not considered a GH-releasing hormone in humans during normal conditions, but a paradoxical response of GH to TRH, similar to that observed during status epilepticus, has been reported in various other pathological conditions, such as acromegaly, liver cirrhosis, mental depression and hypothyroidism. Our results of GH release after TRH administration in patients with status epilepticus suggest an altered regulation of GH as a result of the long-standing epileptic activity.

Investigation of Generalized EEG Paroxysms Accompanying Focal Epilepsies

2019 ◽  
Vol 50 (6) ◽  
pp. 413-422
Author(s):  
Arife Çimen Atalar ◽  
Ebru Nur Vanlı-Yavuz ◽  
Ebru Yılmaz ◽  
Nerses Bebek ◽  
Betül Baykan
Keyword(s):  
Focal Epilepsy ◽  
Hippocampal Sclerosis ◽  
Female Gender ◽  
Mesial Temporal Lobe Epilepsy ◽  
Control Group ◽  
Limited Information ◽  
Laboratory Findings ◽  
Parental Consanguinity ◽  
The Relationship ◽  
Eeg Features

Interictal focal EEG features were frequently observed in generalized, epilepsies, but there is limited information about interictal, epileptiform/nonepileptiform generalized paroxysms in focal epilepsies. We aimed to report the frequency and associated factors of generalized EEG discharges in focal epilepsy with unknown cause (FEUC) and mesial, temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). A total of 200 patients (FEUC in 90 patients; MTLE-HS in 110 patients) were included. Generalized epileptiform (spike/sharp waves simultaneously in all regions) and nonspecific generalized discharges (paroxysmal slow waves) were investigated. All clinical and laboratory findings of 2 groups were compared with each other and with remaining control group, without generalized paroxysms, statistically. Generalized EEG features were present in 22 (11%; 4 males) patients; 9 in the FEUC group (10%; 2) and 13 in the MTLE-HS group (11.8%). Female gender ( P < .021), febrile seizure ( P < .034), precipitant factors ( P < .025), and parental consanguinity ( P < .033) were significantly higher in the group with generalized EEG findings. Monotherapy rates were lower in the MTLE-HS group ( P < .05). The relationship of generalized EEG features with female gender and parental consanguinity may point out to a genetic property among focal epilepsies, while the relationship with febrile seizures and precipitant factors may be a clue about mechanisms with more extensive involvement of the neuronal networks.

Epilepsy surgery in a liver-transplanted girl with temporal lobe epilepsy and hippocampal sclerosis following PRES with status epilepticus

2016 ◽  
Vol 20 (4) ◽  
pp. 652-656 ◽  
Author(s):  
Robertino Dilena ◽  
Gabriella Nebbia ◽  
Lorenzo Fiorica ◽  
Marcello Farallo ◽  
Irene Degrassi ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Hippocampal Sclerosis

Febrile Status Epilepticus

2019 ◽  
Vol 08 (03) ◽  
pp. 079-082
Author(s):  
Isaac Molinero ◽  
Shlomo Shinnar
Keyword(s):  
Risk Factors ◽  
Status Epilepticus ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Early Treatment ◽  
Febrile Seizure ◽  
Hippocampal Sclerosis ◽  
Febrile Seizures ◽  
Medical Emergency ◽  
Febrile Status Epilepticus

AbstractFebrile status epilepticus (FSE) is defined as a febrile seizure lasting 30 minutes or more and is considered the extreme end of the complex febrile seizure spectrum. It remains unclear why some children are predisposed to the development of FSE compared with others. FSE is considered as medical emergency and as such, early treatment is crucial. The consequences of FSE have been a topic of interest for many years, specially its association with temporal lobe epilepsy and hippocampal sclerosis. In this article, we review the epidemiology, risk factors, pathophysiology, treatment, and prognosis including findings from the “Consequences of Prolonged Febrile Seizures in Childhood” (FEBSTAT) study.

scholarly journals Hippocampal sclerosis after febrile status epilepticus: The FEBSTAT study

2014 ◽  
Vol 75 (2) ◽  
pp. 178-185 ◽  
Author(s):  
Darrell V. Lewis ◽  
Shlomo Shinnar ◽  
Dale C. Hesdorffer ◽  
Emilia Bagiella ◽  
Jacqueline A. Bello ◽  
...  
Keyword(s):  
Status Epilepticus ◽  
Hippocampal Sclerosis ◽  
Febrile Status Epilepticus

scholarly journals Synaptic Reshaping and Neuronal Outcomes in the Temporal Lobe Epilepsy

2021 ◽  
Vol 22 (8) ◽  
pp. 3860
Author(s):  
Elisa Ren ◽  
Giulia Curia
Keyword(s):  
Animal Models ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Current Knowledge ◽  
Focal Epilepsy ◽  
Ex Vivo ◽  
Hippocampal Sclerosis ◽  
Control Group ◽  
Epileptogenic Zone ◽  
Epileptiform Discharges

Temporal lobe epilepsy (TLE) is one of the most common types of focal epilepsy, characterized by recurrent spontaneous seizures originating in the temporal lobe(s), with mesial TLE (mTLE) as the worst form of TLE, often associated with hippocampal sclerosis. Abnormal epileptiform discharges are the result, among others, of altered cell-to-cell communication in both chemical and electrical transmissions. Current knowledge about the neurobiology of TLE in human patients emerges from pathological studies of biopsy specimens isolated from the epileptogenic zone or, in a few more recent investigations, from living subjects using positron emission tomography (PET). To overcome limitations related to the use of human tissue, animal models are of great help as they allow the selection of homogeneous samples still presenting a more various scenario of the epileptic syndrome, the presence of a comparable control group, and the availability of a greater amount of tissue for in vitro/ex vivo investigations. This review provides an overview of the structural and functional alterations of synaptic connections in the brain of TLE/mTLE patients and animal models.

Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

2020 ◽  
pp. 1-8
Author(s):  
S. Patel ◽  
M. Clancy ◽  
H. Barry ◽  
N. Quigley ◽  
M. Clarke ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Epilepsy Surgery ◽  
Refractory Epilepsy ◽  
Post Surgery ◽  
Axis I ◽  
Patients With Epilepsy ◽  
The Impact

Abstract Objectives: There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication. Methods: This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery. Results: There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001). Conclusions: This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

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