Mesial Extratemporal Lobe Epilepsy: Clinical Features and Surgical Strategies

AbstractBACKGROUND: Extratemporal lobe epilepsy surgery remains a diagnostic and therapeutic challenge. Scalp electroencephalography (EEG) correlates, clinical semiology, and imaging findings are often ambiguous or difficult to interpret, necessitating the need for invasive recordings. This is particularly true for those extratemporal lobe epilepsy cases in which seizures develop from the midline.OBJECTIVE: The aim of this study was to examine the clinical features and surgical strategies in mesial extratemporal lobe epilepsy.METHODS: A retrospective study reviewing clinical and surgical characteristics was conducted in 30 patients who underwent epilepsy surgery in mesial extratemporal areas at our institution between 1991 and 2011.RESULTS: Although the location of the epileptogenic zone was associated with specific seizure types, semiology proved to be heterogeneous. Although scalp EEG was of good lateralizing value, it was poor for localizing the epileptogenic zone, necessitating a frequent need for invasive electroencephalographic recordings.CONCLUSION: Surgical resections in mesial extratemporal regions were found to be safe and resulted in satisfactory seizure outcomes.

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Seizure Freedom After Epilepsy Surgery and Higher Baseline Cognition May Be Associated With a Negatively Correlated Epilepsy Network in Temporal Lobe Epilepsy

Frontiers in Neuroscience ◽

10.3389/fnins.2020.629667 ◽

2021 ◽

Vol 14 ◽

Author(s):

Elliot G. Neal ◽

Mike R. Schoenberg ◽

Stephanie Maciver ◽

Yarema B. Bezchlibnyk ◽

Fernando L. Vale

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Epilepsy Surgery ◽

Memory Function ◽

Brain Regions ◽

Seizure Freedom ◽

Epileptogenic Zone ◽

Temporal Lobes ◽

Scalp Eeg ◽

The Brain

Background: Brain regions positively correlated with the epileptogenic zone in patients with temporal lobe epilepsy vary in spread across the brain and in the degree of correlation to the temporal lobes, thalamus, and limbic structures, and these parameters have been associated with pre-operative cognitive impairment and seizure freedom after epilepsy surgery, but negatively correlated regions have not been as well studied. We hypothesize that connectivity within a negatively correlated epilepsy network may predict which patients with temporal lobe epilepsy will respond best to surgery.Methods: Scalp EEG and resting state functional MRI (rsfMRI) were collected from 19 patients with temporal lobe epilepsy and used to estimate the irritative zone. Using patients’ rsfMRI, the negatively correlated epilepsy network was mapped by determining all the brain voxels that were negatively correlated with the voxels in the epileptogenic zone and the spread and average connectivity within the network was determined.Results: Pre-operatively, connectivity within the negatively correlated network was inversely related to the spread (diffuseness) of that network and positively associated with higher baseline verbal and logical memory. Pre-operative connectivity within the negatively correlated network was also significantly higher in patients who would go on to be seizure free.Conclusion: Patients with higher connectivity within brain regions negatively correlated with the epilepsy network had higher baseline memory function, narrower network spread, and were more likely to be seizure free after surgery.

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Certain clinical features are associated with seizure frequency after epilepsy surgery

PsycEXTRA Dataset ◽

10.1037/e556132006-017 ◽

2006 ◽

Keyword(s):

Clinical Features ◽

Seizure Frequency ◽

Epilepsy Surgery

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Clinical features and prognosis of prosthetic joint infection caused by Staphylococcus lugdunensis - a multi-center retrospective study

10.26226/morressier.56d6be71d462b80296c970be ◽

2016 ◽

Author(s):

Piseth Seng

Keyword(s):

Retrospective Study ◽

Clinical Features ◽

Prosthetic Joint Infection ◽

Joint Infection ◽

Staphylococcus Lugdunensis ◽

Prosthetic Joint

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Ovarian teratomas: clinical features, imaging findings and management

Abdominal Radiology ◽

10.1007/s00261-020-02873-0 ◽

2021 ◽

Author(s):

Mohammed Saleh ◽

Priya Bhosale ◽

Christine O. Menias ◽

Preetha Ramalingam ◽

Corey Jensen ◽

...

Keyword(s):

Clinical Features ◽

Imaging Findings ◽

Ovarian Teratomas

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Clinical features of pharyngeal cancer: a retrospective study of 258 consecutive patients

The Journal of Laryngology & Otology ◽

10.1258/0022215011907703 ◽

2001 ◽

Vol 115 (2) ◽

pp. 112-118 ◽

Cited By ~ 18

Author(s):

A. Escribano Uzcudun ◽

P. Bravo Fernández ◽

J. J. Sánchez ◽

A. García Grande ◽

I. Rabanal Retolaza ◽

...

Keyword(s):

Retrospective Study ◽

Head And Neck ◽

Clinical Features ◽

Medical Records ◽

Performance Status ◽

Nasopharyngeal Cancer ◽

University Hospital ◽

Premalignant Lesions ◽

Pharyngeal Cancer ◽

Presenting Symptoms

Pharyngeal cancer still presents an unsatisfactory mortality (30-40 per cent in most series, with a slightly better prognosis for nasopharyngeal cancer relative to both oropharyngeal and hypophyarngeal cancers) despite advances in treatment. Therefore, it is critical to know the clinical features of pharyngeal cancer. The purpose of this study was to investigate the most relevant clinical features of pharyngeal cancer (oropharyngeal, hypopharyngeal, and nasopharyngeal) in order to improve knowledge of this malignancy with the aim of ameliorating diagnosis and treatment.The retrospective study was based on a review of medical records from 258 consecutive patients with pharyngeal cancer (oropharyngeal, hypopharyngeal and nasopharyngeal) diagnosed at La Paz University Hospital, Madrid, Spain, between January 1 1991 and and December 31 1995. Medical records were provided by the Departments of Otorhinolaryngology, Head and Neck Surgery, Radiation Oncology, and Medical Oncology.All medical records were analysed for the following clinical variables: 1) incidence, 2) sociodemographics, 3) sites (oropharynx, hypopharynx, nasopharynx) and subsites, 4) clinical and histological staging, 5) pathlogy, 6) presenting symptoms, 7) time to diagnosis, 8) patients’ general performance status at diagnosis, 9) personal cancer history and synchronous head and neck tumours, 10) premalignant lesions, and 11) paediatric cases.Our most outstanding finding was the excessively long time that elapsed between first clinical manifestation appearance and conclusive diagnosis of pharyngeal cancer (4.7 months for pharynx, 4.5 for oropharynx, 4.4 for hypopharynx and 6.5 for nasopharynx cancers). It was found that nasopharyngeal cancer was quite different from both oropharyngeal and hypopharyngeal cancers with respect to its potential aetiology, risk factors and clinical presentation. In addition it has a better prognosis.

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Clinical features and management of multifocal hepatic hemangiomas in children: a retrospective study

Scientific Reports ◽

10.1038/srep31744 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 11

Author(s):

Yi Ji ◽

Siyuan Chen ◽

Bo Xiang ◽

Zhicheng Xu ◽

Xiaoping Jiang ◽

...

Keyword(s):

Retrospective Study ◽

Clinical Features ◽

Hepatic Hemangiomas

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Clinical features, imaging findings and outcomes of headache associated with sexual activity

Cephalalgia ◽

10.1177/0333102410364675 ◽

2010 ◽

Vol 30 (11) ◽

pp. 1329-1335 ◽

Cited By ~ 41

Author(s):

Yen-Chi Yeh ◽

Jong-Ling Fuh ◽

Shih-Pin Chen ◽

Shuu-Jiun Wang

Keyword(s):

Sexual Activity ◽

Clinical Features ◽

Age At Onset ◽

Neurological Deficits ◽

Artery Dissection ◽

Imaging Findings ◽

Cerebral Vasoconstriction ◽

The Central Nervous System ◽

Headache Clinic ◽

Neurovascular Imaging

Objectives: To study the clinical profiles, imaging findings and outcomes and field test the diagnostic criteria proposed by the International Classification of Headache Disorders, 2nd edition (ICHD-II) in patients with headache associated with sexual activity (HSA). Methods: We recruited 30 patients (16 men, 14 women, mean age at onset 40.2 ± 10.0 years) with headache associated with sexual activity at a headache clinic from 2004 to 2009. None of the patients had neurological deficits at onset. Results: Twenty patients (67%) had secondary causes, including one subarachnoid hemorrhage, one basilar artery dissection, and 18 cases reversible cerebral vasoconstriction syndrome (RCVS). Ten patients (33%) had primary HSA. The demographics, headache profiles, drug response and clinical course were similar between primary and secondary HSA. Compared to prior studies done in Western societies, our patients had similar clinical features but with a higher ratio of females (50%) and a higher frequency of chronic course (39%). Discussion: Sixty-seven percent of patients with RCVS could not fulfill the criteria of reversible angiopathy of the central nervous system (Code 6.7.3) proposed by the ICHD-II. The most common reason was headache resolution in more than two months. In addition, 40% of patients with primary HSA could not fulfill the ICHD-II criteria for primary HSA (Code 4.4). Conclusions: Our study found that intracranial vascular disorders were very common in patients with HSA. Thorough neurovascular imaging is required for all patients with HSA.

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