scholarly journals Depression and temporal lobe epilepsy represent an epiphenomenon sharing similar neural networks: clinical and brain structural evidences

2013 ◽  
Vol 71 (3) ◽  
pp. 183-190 ◽  
Author(s):  
Kette D. R. Valente ◽  
Geraldo Busatto Filho
Keyword(s):  
Neural Networks ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Structural Basis ◽  
Mesial Temporal Sclerosis ◽  
Subcortical Structures ◽  
Temporal Lobes ◽  
Ancient Times ◽  
The Relationship

The relationship between depression and epilepsy has been known since ancient times, however, to date, it is not fully understood. The prevalence of psychiatric disorders in persons with epilepsy is high compared to general population. It is assumed that the rate of depression ranges from 20 to 55% in patients with refractory epilepsy, especially considering those with temporal lobe epilepsy caused by mesial temporal sclerosis. Temporal lobe epilepsy is a good biological model to understand the common structural basis between depression and epilepsy. Interestingly, mesial temporal lobe epilepsy and depression share a similar neurocircuitry involving: temporal lobes with hippocampus, amygdala and entorhinal and neocortical cortex; the frontal lobes with cingulate gyrus; subcortical structures, such as basal ganglia and thalamus; and the connecting pathways. We provide clinical and brain structural evidences that depression and epilepsy represent an epiphenomenon sharing similar neural networks.

scholarly journals Somatosensory aura in mesial temporal lobe epilepsy: semiologic characteristics, MRI findings and differential diagnosis with parietal lobe epilepsy

2006 ◽  
Vol 12 (3) ◽  
pp. 155-160 ◽  
Author(s):  
Márcio Andriani Rahal ◽  
Gerardo Maria de Araújo Filho ◽  
Luís Otávio Sales Ferreira Caboclo ◽  
Vivianne Pellegrino Rosa ◽  
Ricardo da Silva Centeno ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Parietal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Sclerosis ◽  
Presurgical Evaluation ◽  
Mri Findings ◽  
Tingling Sensation ◽  
Mesial Temporal Lobe ◽  
Prevalent Symptom

INTRODUCTION: Somatosensory auras (SSAs) are more usually described in patients with parietal lobe epilepsy (PLE), producing more commonly a localized cutaneous tingling sensation, involving hands and fingers followed by tonic or clonic focal seizures. These usually originate in the contralateral hemisphere. Etiology includes dysplasias, tumours, ischemic or postencephalitic gliosis. However, other focal epilepsies, such as frontal and temporal, may also originate SSAs. Although this type of aura is reported as rare in patients with mesial temporal lobe epilepsy (MTLE), this association has not been systematically studied. OBJECTIVES: The aim of this article was to describe the cases of four patients with refractory MTLE and SSAs, reporting their clinical characteristics and MRI findings. We discuss the localizing and lateralizing value of SSAs, particularly in the context of MTLE. METHODS AND RESULTS: Four patients with refractory MTLE and SSAs followed-up in the outpatient's clinic at the Epilepsy Section, Universidade Federal de São Paulo, were submitted to presurgical evaluation and corticoamygdalohippocampectomy. MRI in all cases showed unilateral mesial temporal sclerosis (MTS). Regarding seizure semiology, tingling sensation involving the upper extremity was the most prevalent symptom. Three of the four patients had SSAs contralateral to the MTS. Following the SSAs all patients most of the time presented other symptoms such as autonomic or psychic auras evolving to psychomotor seizures. After surgical treatment, two of the patients presented infrequent auras, and two were rendered seizure-free. CONCLUSION: Although rare, SSAs can be present in MTLE. The characteristics of autonomic or psychic auras, psychomotor seizures, neuropsychological deficits, and typical neurophysiologic and MRI findings may help differentiate patients with MTLE from those with PLE.

scholarly journals Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy

2015 ◽  
Vol 74 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Fábio A. Nascimento ◽  
Luana Antunes Maranha Gatto ◽  
Carlos Silvado ◽  
Maria Joana Mäder-Joaquim ◽  
Marlus Sidney Moro ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporal Lobectomy ◽  
Mesial Temporal Sclerosis ◽  
Anterior Temporal Lobectomy ◽  
Selective Amygdalohippocampectomy ◽  
Significant Difference ◽  
Mesial Temporal Lobe ◽  
Neuropsychological Outcomes

ABSTRACT Objective To contribute our experience with surgical treatment of patients with mesial temporal lobe epilepsy (mTLE) undergoing anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SelAH). Method This is a retrospective observational study. The sample included patients with medically refractory mTLE due to unilateral mesial temporal sclerosis who underwent either ATL or SelAH, at Hospital de Clinicas – UFPR, from 2005 to 2012. We report seizure outcomes, using Engel classification, cognitive outcomes, using measurements of verbal and visuospatial memories, as well as operative complications. Result Sixty-seven patients (33 ATL, 34 SelAH) were studied; median follow-up was 64 months. There was no statistically significant difference in seizure or neuropsychological outcomes, although verbal memory was more negatively affected in ATL operations on patients’ dominant hemispheres. Higher number of major complications was observed in the ATL group (p = 0.004). Conclusion Seizure and neuropsychological outcomes did not differ. ATL appeared to be associated with higher risk of complications.

The relationship between neuropsychological functioning and FDG-PET hypometabolism in intractable mesial temporal lobe epilepsy

2015 ◽  
Vol 44 ◽  
pp. 136-142 ◽  
Author(s):  
Alex A. Knopman ◽  
Chong H. Wong ◽  
Richard J. Stevenson ◽  
Judi Homewood ◽  
Armin Mohamed ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Fdg Pet ◽  
Neuropsychological Functioning ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Lobe ◽  
The Relationship

scholarly journals Radiological identification of temporal lobe epilepsy using artificial intelligence: a feasibility study

2021 ◽  
Author(s):  
Ezequiel Gleichgerrcht ◽  
Brent Munsell ◽  
Simon Keller ◽  
Daniel L Drane ◽  
Jens H Jensen ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Neural Networks ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Neurological Diseases ◽  
Visual Assessment ◽  
Structural Mri ◽  
Mesial Temporal Sclerosis ◽  
Mri Findings ◽  
Mri Features

Abstract Temporal lobe epilepsy is associated with magnetic resonance imaging (MRI) findings reflecting underlying mesial temporal sclerosis. Identifying these MRI features is critical for the diagnosis and management of temporal lobe epilepsy. To date, this process relies on visual assessment by highly trained human experts (e.g. neuroradiologists, epileptologists). Artificial intelligence is increasingly recognized as a promising aid in the radiological evaluation of neurological diseases, yet its applications in temporal lobe epilepsy have been limited. Here, we applied a convolutional neural networks to assess the classification accuracy of temporal lobe epilepsy based on structural MRI. We demonstrate that convoluted neural networks can achieve high accuracy in the identification of unilateral temporal lobe epilepsy cases even when the MRI had been originally interpreted as normal by experts. We show that accuracy can be potentiated by employing smoothed gray matter maps and a direct acyclic graphs approach. We further discuss the foundations for the development of computer-aided tools to assist with the diagnosis of epilepsy.

scholarly journals Structural Abnormalities are Similar in Familial and Nonfamilial Mesial Temporal Lobe Epilepsy

2004 ◽  
Vol 31 (3) ◽  
pp. 368-372 ◽  
Author(s):  
Fabio Thadeu Ferreira ◽  
Eliane Kobayashi ◽  
Iscia Lopes-Cendes ◽  
Fernando Cendes
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Visual Analysis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Control Group ◽  
Hippocampal Atrophy ◽  
Anterior Temporal Lobe ◽  
Temporal Lobes ◽  
Mesial Temporal Lobe ◽  
Lobe Atrophy

Background/Objective:Diffuse temporal lobe abnormalities can be observed on MRI of patients with mesial temporal lobe epilepsy (MTLE). Our objective was to perform qualitative and quantitative analyses of temporal lobe structures in patients with familial MTLE (FMTLE) and nonfamilial MTLE.Methods:Two groups of patients were ascertained: 67 FMTLE patients (14 with refractory seizures) and 30 patients with nonfamilial refractory MTLE. We performed qualitative analyses of MRI (with multiplanar reconstruction) and volumes of hippocampi and anterior temporal lobes in all patients, and in a normal control group of 23 individuals. We used the Chi-square test and ANOVA for statistical analyses.Results:We identified anterior temporal lobe abnormalities by visual analysis in only 4% of FMTLE patients and atrophy of the anterior temporal lobe by volumetric analysis in 19%. In the group of nonfamilial MTLE patients we found anterior temporal lobe abnormalities by visual analysis in 17% of patients and anterior temporal lobe atrophy in 13%. Hippocampal atrophy was present in 90% of FMTLE and in 83% of nonfamilial MTLE. No signs of cortical dysplasia were observed.Conclusion:Anterior temporal lobe atrophy and other abnormalities outside the mesial portion of temporal lobes were infrequent in both familial and nonfamilial MTLE patients. Despite the genetic basis, hippocampal atrophy in FMTLE is not associated with other abnormalities outside the mesial temporal regions.

scholarly journals Changes in resting-state connectivity in pediatric temporal lobe epilepsy

2018 ◽  
Vol 22 (3) ◽  
pp. 270-275 ◽  
Author(s):  
Fabio Grassia ◽  
Andrew V. Poliakov ◽  
Sandra L. Poliachik ◽  
Kaitlyn Casimo ◽  
Seth D. Friedman ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Network Connectivity ◽  
Blood Oxygen Level Dependent ◽  
Mesial Temporal Sclerosis ◽  
Blood Oxygen Level ◽  
Temporal Lobes ◽  
Significant Difference ◽  
Dependent Signal ◽  
Healthy Side

OBJECTIVEFunctional connectivity magnetic resonance imaging (fcMRI) is a form of fMRI that allows for analysis of blood oxygen level–dependent signal changes within a task-free, resting paradigm. This technique has been shown to have efficacy in evaluating network connectivity changes with epilepsy. Presurgical data from patients with unilateral temporal lobe epilepsy were evaluated using the fcMRI technique to define connectivity changes within and between the diseased and healthy temporal lobes using a within-subjects design.METHODSUsing presurgical fcMRI data from pediatric patients with unilateral temporal lobe epilepsy, the authors performed seed-based analyses within the diseased and healthy temporal lobes. Connectivity within and between temporal lobe seeds was measured and compared.RESULTSIn the cohort studied, local ipsilateral temporal lobe connectivity was significantly increased on the diseased side compared to the healthy temporal lobe. Connectivity of the diseased side to the healthy side, on the other hand, was significantly reduced when compared to connectivity of the healthy side to the diseased temporal lobe. A statistically significant regression was observed when comparing the changes in local ipsilateral temporal lobe connectivity to the changes in inter–temporal lobe connectivity. A statistically significant difference was also noted in ipsilateral connectivity changes between patients with and those without mesial temporal sclerosis.CONCLUSIONSUsing fcMRI, significant changes in ipsilateral temporal lobe and inter–temporal lobe connectivity can be appreciated in unilateral temporal lobe epilepsy. Furthermore, fcMRI may have a role in the presurgical evaluation of patients with intractable temporal lobe epilepsy.

scholarly journals Neuropsychology Outcomes Following Trephine Epilepsy Surgery: The Inferior Temporal Gyrus Approach for Amygdalohippocampectomy in Medically Refractory Mesial Temporal Lobe Epilepsy

Neurosurgery ◽  
2017 ◽  
Vol 82 (6) ◽  
pp. 833-841 ◽  
Author(s):  
Mike R Schoenberg ◽  
William E Clifton ◽  
Ryan W Sever ◽  
Fernando L Vale
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Visual Memory ◽  
Mesial Temporal Lobe Epilepsy ◽  
Significant Decline ◽  
Mesial Temporal Sclerosis ◽  
Wada Test ◽  
Inferior Temporal Gyrus ◽  
Mesial Temporal Lobe

Abstract BACKGROUND Surgery is indicated in cases of mesial temporal lobe epilepsy(MTLE) that are refractory to medical management. The inferior temporal gyrus (ITG) approach provides access to the mesial temporal lobe (MTL) structures with minimal tissue disruption. Reported neuropsychology outcomes following this approach are limited. OBJECTIVE To report neuropsychological outcomes using an ITG approach to amygdalohippocampectomy (AH) in patients with medically refractory MTLE based on a prospective design. METHODS Fifty-four participants had Engel class I/II outcome following resection of MTL using the ITG approach. All participants had localization-related epilepsy confirmed by long-term surface video-electroencephalography and completed pre/postsurgical evaluations that included magnetic resonance imaging (MRI), Wada test or functional MRI, and neuropsychology assessment. RESULTS Clinical semiology/video-electroencephalography indicated that of the 54 patients, 28 (52%) had left MTLE and 26 (48%) had right MTLE. Dominant hemisphere resections were performed on 23 patients (43%), nondominant on 31(57%). Twenty-nine (29) had pathology-confirmed mesial temporal sclerosis (MTS). Group level analyses found declines in verbal memory for patients with language-dominant resections (P < .05). No significant decline in neuropsychological measures occurred for patients with MTS. Participants without MTS who underwent a language-dominant lobe resection exhibited a significant decline in verbal and visual memory (P < .05). Nondominant resection participants did not exhibit significant change in neuropsychology scores (P > .05). CONCLUSION Neuropsychology outcomes of an ITG approach for selective mesial temporal resection are comparable to other selective AH techniques showing minimal adverse cognitive effects. These data lend support to the ITG approach for selective AH as an option for MTLE.

Intraoperative hippocampal electrocorticography to predict the extent of hippocampal resection in temporal lobe epilepsy surgery

2000 ◽  
Vol 93 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Guy M. McKhann ◽  
Julie Schoenfeld-McNeill ◽  
Donald E. Born ◽  
Michael M. Haglund ◽  
George A. Ojemann
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Seizure Control ◽  
Epileptiform Activity ◽  
Neuronal Loss ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Sclerosis ◽  
Content Type ◽  
Pathological Subtype ◽  
Fine Print

Object. Among the variety of surgical procedures that are performed for the treatment of medically refractory mesial temporal lobe epilepsy (TLE), no consensus exists as to how much of the hippocampus should be removed. Whether all patients require a maximal hippocampal resection has not yet been determined.Methods. At the University of Washington, all TLE operations are performed in a tailored fashion, guided by electrocorticography (ECoG). The amount of hippocampal resection is determined intraoperatively by the extent of interictal epileptiform abnormalities on ECoG recorded from that structure, resulting in a hippocampal resection that is individualized for each patient. Using this approach, the authors prospectively observed 140 consecutive patients who underwent surgery for mesial TLE with pathological diagnoses of either mesial temporal sclerosis with neuronal loss (MTS group) or mild gliosis without neuronal loss (non-MTS group) to determine whether the extent of hippocampal resection correlates with outcome when a tailored approach is used. Additionally, the authors analyzed whether the presence of residual interictal epileptiform activity on ECoG following mesial temporal resection predicts poorer seizure control.With at least 18 months of clinical follow up, 67% of the 140 patients were seizure free or had only a single postoperative seizure. There was no correlation between the size of the hippocampal resection and seizure control in the group as a whole or when stratified by pathological subtype. Using an intraoperatively tailored strategy, individuals with a larger hippocampal resection (> 2.5 cm) were not more likely to have seizure-free outcomes than patients with smaller resections (p = 0.9). Additionally, both MTS and non-MTS patients, in whom postoperative ECoG detected residual epileptiform hippocampal (but not cortical or parahippocampal) interictal activity following surgical resection, had significantly worse seizure outcomes (p = 0.01 in the MTS group; p = 0.002 in the non-MTS group).Conclusions. Intraoperative hippocampal ECoG can predict how much hippocampus should be removed to maximize seizure-free outcome, allowing for sparing of possibly functionally important hippocampus.

scholarly journals Electrophysiological and auditory behavioral evaluation of individuals with left temporal lobe epilepsy

2010 ◽  
Vol 68 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Caroline Nunes Rocha ◽  
Carmen Silvia Molleis Galego Miziara ◽  
Maria Luiza Giraldes de Manreza ◽  
Eliane Schochat
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Event Related Potential ◽  
P300 Amplitude ◽  
P300 Latency ◽  
Mesial Temporal Sclerosis ◽  
Left Temporal Lobe ◽  
Behavioral Test ◽  
Temporal Lobes ◽  
Laterality Effect

The purpose of this study was to determine the repercussions of left temporal lobe epilepsy (TLE) for subjects with left mesial temporal sclerosis (LMTS) in relation to the behavioral test-Dichotic Digits Test (DDT), event-related potential (P300), and to compare the two temporal lobes in terms of P300 latency and amplitude. We studied 12 subjects with LMTS and 12 control subjects without LMTS. Relationships between P300 latency and P300 amplitude at sites C3A1,C3A2,C4A1, and C4A2, together with DDT results, were studied in inter-and intra-group analyses. On the DDT, subjects with LMTS performed poorly in comparison to controls. This difference was statistically significant for both ears. The P300 was absent in 6 individuals with LMTS. Regarding P300 latency and amplitude, as a group, LMTS subjects presented trend toward greater P300 latency and lower P300 amplitude at all positions in relation to controls, difference being statistically significant for C3A1 and C4A2. However, it was not possible to determine laterality effect of P300 between affected and unaffected hemispheres.

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