The value of interictal diffusion-weighted imaging in lateralizing temporal lobe epilepsy

Neurology ◽  
2007 ◽  
Vol 68 (2) ◽  
pp. 122-127 ◽  
Author(s):  
T. Wehner ◽  
E. LaPresto ◽  
J. Tkach ◽  
P. Liu ◽  
W. Bingaman ◽  
...  
Epilepsia ◽  
2008 ◽  
Vol 42 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Beate Diehl ◽  
Imad Najm ◽  
Paul Ruggieri ◽  
Jean Tkach ◽  
Armin Mohamed ◽  
...  

Author(s):  
A Budhram ◽  
JW Britton ◽  
GB Liebo ◽  
A McKeon ◽  
SJ Pittock ◽  
...  

Background: Limbic encephalitis (LE) classically causes medial temporal lobe T2-hyperintensity on magnetic resonance imaging (MRI), but this can also occur with seizure activity. Identifying neuroimaging patterns that can distinguish between LE and seizure activity may help avoid diagnostic confusion in such challenging cases. Methods: Through retrospective review of Mayo Clinic patients who had medial temporal lobe T2-hyperintensity on MRI, we identified non-LE patients with seizure-related medial temporal lobe T2-hyperintensity. Their diffusion-weighted imaging (DWI) was reviewed to look for diffusion restriction patterns potentially unique to seizure activity. Next, a control cohort of LE patients with medial temporal lobe T2-hyperintensity was identified, and their DWI was reviewed to see if these diffusion restriction patterns could help distinguish seizure activity from LE. Results: We identified 10 non-LE patients who had medial temporal lobe T2-hyperintensity due to seizure activity; 9/10 had one of two medial temporal lobe diffusion restriction patterns we uncovered as being potentially unique to seizure activity. In contrast, only 5/57 LE patients had one of these diffusion restriction patterns identified, all of whom had seizures reported. Conclusions: We report two diffusion restriction patterns that may help distinguish seizure activity from LE. Recognition of these diffusion restriction patterns should prompt evaluation for possible seizure activity.


2012 ◽  
Vol 24 (10) ◽  
pp. 1998-2014 ◽  
Author(s):  
Richard J. Binney ◽  
Geoffrey J. M. Parker ◽  
Matthew A. Lambon Ralph

In recent years, multiple independent neuroscience investigations have implicated critical roles for the rostral temporal lobe in auditory and visual perception, language, and semantic memory. Although arising in the context of different cognitive functions, most of these suggest that there is a gradual convergence of sensory information in the temporal lobe that culminates in modality- and perceptually invariant representations at the most rostral aspect. Currently, however, too little is known regarding connectivity within the human temporal lobe to be sure of exactly how and where convergence occurs; existing hypotheses are primarily derived on the basis of cross-species generalizations from invasive nonhuman primate studies, the validity of which is unclear, especially where language function is concerned. In this study, we map the connectivity of the human rostral temporal lobe in vivo for the first time using diffusion-weighted imaging probabilistic tractography. The results indicate that convergence of sensory information in the temporal lobe is in fact a graded process that occurs along both its longitudinal and lateral axes and culminates in the most rostral limits. We highlight the consistency of our results with those of prior functional neuroimaging, computational modeling, and patient studies. By going beyond simple fasciculus reconstruction, we systematically explored the connectivity of specific temporal lobe areas to frontal and parietal language regions. In contrast to the graded within-temporal lobe connectivity, this intertemporal connectivity was found to dissociate across caudal, mid, and rostral subregions. Furthermore, we identified a basal rostral temporal region with very limited connectivity to areas outside the temporal lobe, which aligns with recent evidence that this subregion underpins the extraction of modality- and context-invariant semantic representations.


2019 ◽  
Vol 33 (7) ◽  
pp. 986-995 ◽  
Author(s):  
Elizabeth Stewart ◽  
Cathy Catroppa ◽  
Linda Gonzalez ◽  
Deepak Gill ◽  
Richard Webster ◽  
...  

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