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.

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.

scholarly journals Efficacy of limited hippocampal radiofrequency thermocoagulation for mesial temporal lobe epilepsy

2019 ◽  
Vol 131 (3) ◽  
pp. 781-789 ◽  
Author(s):  
Ching-Yi Lee ◽  
Han-Tao Li ◽  
Tony Wu ◽  
Mei-Yun Cheng ◽  
Siew-Na Lim ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporary Increase ◽  
Drug Resistant ◽  
Radiofrequency Thermocoagulation ◽  
Mesial Temporal Lobe

OBJECTIVERadiofrequency thermocoagulation (RFTC), which has been developed for drug-resistant epilepsy patients, involves less brain tissue loss due to surgery, fewer surgical adverse effects, and generally good seizure control. This study demonstrates the effectiveness of RFTC performed at limited hippocampal locations.METHODSDaily seizure diaries were prospectively maintained for at least 6 months by 9 patients (ages 30–59 years) with drug-resistant mesial temporal lobe epilepsy (MTLE) before treatment with RFTC. The limited target for stereotactic RFTC was chosen based on intraoperative electroencephalography (EEG) recording and was initially tested with a Radionics electrode at a low temperature, 45°C, for 60 seconds. The therapeutic RFTC heating parameters were 78°C–80°C for 90 seconds. All patients who received the RFTC treatment underwent both MRI and EEG recording immediately postoperatively and at the 3-month follow-up. Monthly outpatient clinic visits were arranged over 6 months to document seizure frequency and severity to clarify the changes noted in imaging studies and EEG patterns.RESULTSTwo patients were excluded from our analysis because one had undergone multiple seizure surgeries and the other had a poor recording of seizure frequency, before the RFTC surgery. Five and two patients underwent left-sided and right-sided RFTC, respectively. None of the patients had generalized tonic-clonic attacks postoperatively, and no adverse effects or complications occurred. According to MRI data, the effect of coagulation was limited to less than 1.0 cm in diameter and perifocal edema was also in limited range. The seizure frequency within 6 months decreased postoperatively with a mean reduction in seizures of 78% (range 36%–100%). Only two patients had a temporary increase in seizure frequency within 2 weeks of the surgery, and over 50% of all patients showed a decrease in average seizure frequency.CONCLUSIONSThe study results confirm that limited RFTC provides a more effective surgery with similar seizure control but fewer complications than resective surgery for drug-resistant MTLE patients.

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.

scholarly journals Memory impairment is not necessarily related to seizure frequency in mesial temporal lobe epilepsy with hippocampal sclerosis

Epilepsia ◽  
2014 ◽  
Vol 55 (8) ◽  
pp. 1197-1204 ◽  
Author(s):  
Denise Pacagnella ◽  
Tatila M. Lopes ◽  
Marcia E. Morita ◽  
Clarissa L. Yasuda ◽  
Fabio A. M. Cappabianco ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Seizure Frequency ◽  
Memory Impairment ◽  
Hippocampal Sclerosis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Lobe

scholarly journals The influence of seizure frequency on anterograde and remote memory in mesial temporal lobe epilepsy

Seizure ◽  
2014 ◽  
Vol 23 (9) ◽  
pp. 792-798 ◽  
Author(s):  
Virginie Voltzenlogel ◽  
Jean-Pierre Vignal ◽  
Edouard Hirsch ◽  
Liliann Manning
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Seizure Frequency ◽  
Mesial Temporal Lobe Epilepsy ◽  
Remote Memory ◽  
Mesial Temporal Lobe

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 Emotional declarative memory assessment of patients with mesial temporal lobe epilepsy and patients submitted to mesial temporal lobectomy

2010 ◽  
Vol 68 (5) ◽  
pp. 737-743 ◽  
Author(s):  
Lara De Vecchi Machado ◽  
Jean Edith Frank ◽  
Carlos Tomaz
Keyword(s):  
Working Memory ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Declarative Memory ◽  
Epileptic Seizures ◽  
Emotional Memory ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporal Lobectomy ◽  
Surgical Removal ◽  
Mesial Temporal Lobe

Epileptic seizures generate cognitive and behavioral impacts in individuals who suffer from epilepsy. Declarative memory is one of the cognitive functions that can be affected by epileptic seizures. The main objective of this work was to investigate neurocognitive function, especially the emotional working memory of patients with unilateral mesial temporal lobe epilepsy, and that of patients submitted to unilateral mesial temporal lobectomy. A face recognition test that can simultaneously recruit the frontal lobe (working memory) and mesial temporal lobe (emotional memory) was used to investigate emotional working memory. Our findings showed that the epilepsy factor significantly compromised the performance in the emotional memory test. On the other hand, surgical removal of the epileptic focus promoted an improvement in the emotional working memory of these patients, in addition to the significantly decrease in the number of seizures.

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