scholarly journals Ictal Swearing as a Lateralizing Value for the Dominant Hemisphere in Temporal Lobe Epilepsy

2021 ◽  
Vol 11 (1) ◽  
pp. 110-111
Author(s):  
Woohee Ju ◽  
Jong-Su Kim ◽  
Yangmi Park ◽  
Dae Lim Koo ◽  
Hyunwoo Nam
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Dominant Hemisphere ◽  
Reasonable Suspicion ◽  
History Of

Ictal swearing, as an epileptic manifestation, has rarely been reported. Despite its poor localization value and unclear mechanism, several previous studies have reported that it frequently originates from the temporal lobe and more often from the non-dominant hemisphere. Herein, we report a case of a 41-year-old right-handed man with a history of stereotypical manifestation of ictal swearing with a left (dominant) hemisphere origin, confirmed by video electroencephalography monitoring. Reasonable suspicion that repetitive swearing could be a manifestation of seizures is important for clinicians not to misdiagnose the disease.

scholarly journals The “Natural” History of Medically Treated Temporal Lobe Epilepsy: What Can an Evidence-Based Approach Tell Us?

2012 ◽  
Vol 2012 ◽  
pp. 1-8
Author(s):  
Colin Bruce Josephson ◽  
Bernhard Pohlmann-Eden
Keyword(s):  
Natural History ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Population Based ◽  
Seizure Freedom ◽  
History Of ◽  
Prospective Cohorts ◽  
Eeg Recordings ◽  
Incident Cases ◽  
Treatment Prognosis

We systematically reviewed the literature to describe the “natural” history of medically treated temporal lobe epilepsy (TLE). No population-based studies recruiting incident cases of TLE irrespective of age exist. Prospective, population-based studies were limited to those recruiting only childhood-onset TLE or those reporting TLE as a subgroup of cohorts of focal epilepsies. Few studies have been performed in the “MRI era” limiting information on natural history secondary to specific pathologies. Available data suggests that TLE is highly variable, with unpredictable transient remissions and low rates of seizure freedom (30 to 50%). Etiology and failure of first and second drug seem to be the most important predictors for treatment prognosis. The role of initial precipitating injuries remains speculative, as imaging information of related events is either missing or conflicting. Prospective cohorts of new-onset TLE with long-term followup using advanced MRI techniques, timely EEG recordings, and assessments of psychiatric comorbidities are needed.

scholarly journals Imaging Depression in Epilepsy: Hints at the Biology of Despair

2007 ◽  
Vol 7 (5) ◽  
pp. 129-131
Author(s):  
Paul A. Garcia
Keyword(s):  
Major Depression ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Morphological Characteristics ◽  
Similar Degree ◽  
P Value ◽  
Depression Symptoms ◽  
History Of ◽  
Severity Of Depression

Major Depression in Temporal Lobe Epilepsy with Hippocampal Sclerosis: Clinical and Imaging Correlates. Briellmann RS, Hopwood MJ, Jackson GD. J Neurol Neurosurg Psychiatry 2007 Jan 26; [Epub ahead of print] PURPOSE: Refractory temporal lobe epilepsy (TLE) is often associated with hippocampal sclerosis (HS). Patients with Major Depression (MD) may also show structural abnormalities in the limbic system. Co-occurrence of TLE with HS and MD is not uncommon. We investigate clinical and morphological characteristics of TLE patients in relation to MD. METHODS: Thirty-four TLE patients with HS were assessed at a Comprehensive Epilepsy Program. All relevant clinical data were obtained, including the history of antecedent events to epilepsy. MD was diagnosed based on detailed psychiatric investigation. MRI was used to measure the volume and tissue signal (T2-relaxometry) of the hippocampus and amygdala. The imaging data were expressed as percentage of the values obtained in a series of 55 controls. RESULTS: A history of MD was present in 15 (44%) of the 34 patients. Patients with MD had a longer duration of their epilepsy ( p < 0.05), and a lower frequency of antecedent events (13% with MD, 58% without MD, p < 0.05). Both groups had a similar degree of ipsilateral HS (small hippocampal volume, increased hippocampal T2-relaxation time), and demonstrated bilateral amygdaloid atrophy. However, the contralateral amygdala showed lower signal in presence of MD (97 ± 9 msec; no MD: 103 ± 8 msec, ANCOVA, p < 0.05). CONCLUSION: The integrity of the amygdala may influence mood disturbances in TLE patients with HS, as depression was associated with a relative preservation of the contralateral amygdala. In contrast, hippocampal abnormalities were not related to the presence of depression. Hippocampal 1H-MRSI Correlates with Severity of Depression Symptoms in Temporal Lobe Epilepsy. Gilliam FG, Maton BM, Martin RC, Sawrie SM, Faught RE, Hugg JW, Viikinsalo M, Kuzniecky RI. Neurology 2007;68(5):364–368. OBJECTIVE: To investigate the association of an indicator of hippocampal function with severity of depression symptoms in temporal lobe epilepsy. METHODS: We evaluated 31 patients with video/EEG-confirmed temporal lobe epilepsy using creatine/ N-acetylaspartate ratio maps derived from a previously validated 1H magnetic resonance spectroscopic imaging (1H-MRSI) technique at 4.1 T. We also assessed depression symptoms, epilepsy-related factors, and self-perceived social and vocational disability. We used conservative nonparametric bivariate procedures to determine the correlation of severity of depression symptoms with imaging and clinical variables. RESULTS: The extent of hippocampal 1H-MRSI abnormalities correlated with severity of depression (Spearman rho = 0.65, p value < 0.001), but other clinical factors did not. CONCLUSION: The extent of hippocampal dysfunction is associated with depression symptoms in temporal lobe epilepsy and may be a more important factor than seizure frequency or degree of disability.

scholarly journals A Case of Cognitive Decline Resulting from Aging, Temporal Lobe Epilepsy, and Environmental Factors

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Nikhila Veluri
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Cognitive Decline ◽  
Cognitive Functioning ◽  
Temporal Lobe ◽  
Panic Attacks ◽  
Caucasian Woman ◽  
Age Related ◽  
Imaging Results ◽  
Patient Reported ◽  
History Of

Cognitive functioning is imperative in our daily lives. It allows us to understand, process, and react appropriately to different situations. Aging has been linked to cognitive decline. The degree and rate of cognitive decline are crucial as they differentiate normal aging from dementia or memory loss secondary to medical conditions. A 63-year-old Caucasian woman with a 50-year history of temporal lobe epilepsy experienced memory difficulties in recent years. She was admitted voluntarily to the neuropsychiatry ward for a 3-day ambulatory electroencephalogram (EEG), which reported mild bitemporal structural or functional abnormality. The patient reported subjective seizure experiences that were not reflective of seizure activity on the EEG. Possible causes included panic attacks or other anxiety experiences. Routine laboratory test and magnetic resonance imaging results were unremarkable. During her hospital stay she showed improvement in cognitive functioning. However, anxiety continued to negatively impact her memory. We hypothesized that the memory impairments could have resulted from age, psychological factors, the patient’s own expectations, pressure from the environment and history of TLE. We diagnosed the patient with mild cognitive impairment and adjustment disorder with anxiety. She was discharged with seizure and anxiety medication. This report highlights the importance of both age-related and disease-related variables when diagnosing patients with cognitive decline.

scholarly journals Stereotactic laser ablation of amygdala and hippocampus using a Leksell stereotactic frame

2018 ◽  
Vol 44 (videosuppl2) ◽  
pp. V1 ◽  
Author(s):  
Ahmed J. Awad ◽  
Ha S. Nguyen ◽  
Elsa Arocho-Quinones ◽  
Ninh Doan ◽  
Wade Mueller ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Perioperative Complications ◽  
Mesial Temporal Lobe Epilepsy ◽  
Stereotactic Frame ◽  
History Of ◽  
Mesial Temporal Lobe ◽  
Invasive Techniques ◽  
Patients With Epilepsy

Approximately one-third of patients with epilepsy are resistant to medical therapy, particularly in those with mesial temporal lobe epilepsy. While there are several surgical modalities, efforts have been focused on developing safer and minimally invasive techniques. In this video, the authors present the case of a 45-year-old woman with a 2-year history of refractory left mesial temporal lobe epilepsy who underwent MRI-guided laser ablation of amygdala and hippocampus. There were no perioperative complications.The video can be found here: https://youtu.be/XFHt2jTdE_4.

scholarly journals MRI-negative Temporal Lobe Epilepsy: Is there a Role for PET?

2005 ◽  
Vol 5 (3) ◽  
pp. 118-119 ◽  
Author(s):  
Theodore H. Schwartz
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Fdg Pet ◽  
Visual Analysis ◽  
Hippocampal Sclerosis ◽  
Significant Difference ◽  
Hippocampal Sparing ◽  
Temporal Lobe Seizures ◽  
Temporal Structures ◽  
History Of

MRI-negative PET-positive Temporal Lobe Epilepsy: A Distinct Surgically Remediable Syndrome Carne RP, O'Brien TJ, Kilpatrick CJ, MacGregor LR, Hicks RJ, Murphy MA, Bowden SC, Kaye AH, Cook MJ Brain 2004;127:2276–2285 Most patients with nonlesional temporal lobe epilepsy (NLTLE) will have the findings of hippocampal sclerosis (HS) on a high-resolution MRI. However, a significant minority of patients with NLTLE and electroclinically well-lateralized temporal lobe seizures have no evidence of HS on MRI. Many of these patients have concordant hypometabolism on fluorodeoxyglucose-PET ([18F]FDG-PET). The pathophysiologic basis of this latter group remains uncertain. We aimed to determine whether NLTLE without HS on MRI represents a variant of or a different clinicopathologic syndrome from that of NLTLE with HS on MRI. The clinical, EEG, [18F]FDG-PET, histopathologic, and surgical outcomes of 30 consecutive NLTLE patients with well-lateralized EEG but without HS on MRI (HS–ve TLE) were compared with 30 consecutive age- and sex-matched NLTLE patients with well-lateralized EEG with HS on MRI (HS+ve TLE). Both the HS+ve TLE group and the HS–ve TLE patients had a high degree of [18F]FDG-PET concordant lateralization (26 of 30 HS–ve TLE vs. 27 of 27 HS+ve TLE). HS–ve TLE patients had more widespread hypometabolism on [18F]FDG-PET by blinded visual analysis [odds ratio (OR,+∞(2.51,–); P = 0.001]. The HS–ve TLE group less frequently had a history of febrile convulsions [OR,0.077 (0.002 to 0.512), P = 0.002], more commonly had a delta rhythm at ictal onset [OR,3.67 (0.97 to 20.47); P = 0.057], and less frequently had histopathologic evidence of HS [OR,0 (0 to 0.85); P = 0.031]. No significant difference in surgical outcome despite half of those without HS having a hippocampal-sparing procedure. Based on the findings outlined, HS–ve PET-positive TLE may be a surgically remediable syndrome distinct from HS+ve TLE, with a pathophysiologic basis that primarily involves lateral temporal neocortical rather than mesial temporal structures.

scholarly journals Mild Non-lesional Temporal Lobe Epilepsy: A Common, Unrecognized Disorder with Onset in Adulthood

1998 ◽  
Vol 25 (4) ◽  
pp. 282-286 ◽  
Author(s):  
Umberto Aguglia ◽  
Antonio Gambardella ◽  
Emilio Le Plane ◽  
Demetrio Messina ◽  
Rosario L. Oliveri ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Age At Onset ◽  
Positive Family History ◽  
High Rate ◽  
Occurrence Rate ◽  
Mesial Temporal Sclerosis ◽  
Cross Sectional ◽  
History Of ◽  
History Of Epilepsy

ABSTRACT:Objective:To compare mild vs. severe non-lesional temporal lobe epilepsy (TLE).Methods:Data from 104 consecutive patients with non-lesional TLE were reviewed. Seventy-three of the 104 fulfilled the criteria for inclusion in this study of a follow-up period longer than three years at our Institute. Patients were considered to have a mild TLE if they were seizure free for at least three years after appropriate antiepileptic medication, or had rare (≤ 2/year) complex partial or secondarily generalized seizures for at least three years with or without appropriate antiepileptic therapy. Clinical, EEG and MRI data of mild vs. severe non-lesional TLE patients were compared on the basis of a cross-sectional study design.Results:Of the 73 patients with non-lesional TLE included in the study, 43 (59%) had mild TLE, and 30 (41%) had severe TLE. Duration of epilepsy was significantly shorter (mean 15.2 ± 10.5 years vs. 26.4 ± 13.2 years) and age at onset was significantly higher (mean 34.3 ± 15.3 years vs. 7.8 ± 6.8 years) in mild than in severe TLE group. Patients with mild TLE had also a significantly higher prevalence of positive family history of epilepsy (37.2% vs. 10%), and a significantly lower occurrence rate of febrile convulsions (FC) (4.7% vs. 33.3%), mesial temporal sclerosis (MTS) (6.9% vs. 36.7%), and intelligence deficiency (0% vs. 20%). In mild TLE there was also a significantly high rate (58.1% vs. 0%) of delayed diagnosis (from 1 to 28 years), because of misdiagnosis (39.5%) or no medical counseling (18.6%).Conclusions:Mild non-lesional TLE is a common, unrecognized disorder mainly characterized by both onset in adulthood and high prevalence of familial history of epilepsy. The present findings suggest that mild non-lesional TLE may represent a clinical entity different from severe non-lesional TLE.

History of surgery for temporal lobe epilepsy

2017 ◽  
Vol 70 ◽  
pp. 57-60 ◽  
Author(s):  
Ali A. Asadi-Pooya ◽  
Cyrus Rostami
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
History Of Surgery ◽  
History Of

The Aetiology of Aggression in Temporal-Lobe Epilepsy

1988 ◽  
Vol 153 (1) ◽  
pp. 50-55 ◽  
Author(s):  
J. L Herzberg ◽  
P. B. C. Fenwick
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Aggressive Behaviour ◽  
Social Variables ◽  
Complex Interplay ◽  
Retrospective Case ◽  
Cat Scan ◽  
History Of ◽  
Male Sex ◽  
Iq Scores

A retrospective case-note survey was carried out on 31 subjects admitted with temporal-lobe epilepsy to the Maudsley hospital from 1974–1983 inclusive. Fourteen aggressive subjects were compared with the non-aggressive patients on 95 organic, developmental, and social variables. Aggressive behaviour was associated with male sex, early onset of seizures, and a history of long-standing behavioural problems. Aggressive subjects had lower mean IQ scores and poorer occupational records than controls. No relationship was found between aggression and the presence of specific EEG or CAT scan findings, or a history of psychosis. The results demonstrate the complex interplay between organic and socially mediated factors underlying aggressive behaviour in temporal-lobe epilepsy.

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