scholarly journals Diagnostic efficiency of monitoring methods of brain bioelectric activity in temporal lobe pharmacoresistant epilepsy

2021 ◽  
Vol 8 (5) ◽  
pp. 21-28
Author(s):  
E. V. Marchenko ◽  
A. M. Aleksandrov ◽  
G. V. Odintsova ◽  
A. A. Chukhlovin
Keyword(s):  
Surgical Treatment ◽  
Temporal Lobe ◽  
Invasive Monitoring ◽  
Diagnostic Efficiency ◽  
Eeg Monitoring ◽  
Bioelectric Activity ◽  
Diagnostic Efficacy ◽  
Structural Epilepsy ◽  
The Brain ◽  
Video Eeg

Background. The basis of pre-surgical neurophysiological examinations of patients with pharmaco-resistant structural epilepsy is the method of monitoring bioelectrical activity of the brain, video-electroencephalographic monitoring and, if indicated, long-term invasive monitoring.Objective. The goal of the study is to estimate the diagnostic efficacy of the methods used for monitoring of the brain bioelectric activity on the basis of longterm results of surgical treatment of patients with temporal structural pharmaco-resistant epilepsy.Design and methods. The study included 61 patients with temporal lobe pharmaco-resistant epilepsy, who were divided into two groups: performance of video-EEG monitoring only (33 patients) and the additional use of invasive monitoring for the localization of the epileptogenic zone (28 patients). Each group was divided into subgroups depending on the outcome of surgical treatment: patients, in whom seizures ceased (Engel 1) and patients in whom seizures persisted to some degree (Engel 2-3-4). Invasive monitoring with ictal event recording was chosen as the reference method to calculate diagnostic efficacy.Results. Invasive monitoring was performed as part of the pre-surgical evaluation of patients with temporal lobe pharmaco-resistant epilepsy with a higher sensitivity (72.7 %) and accuracy (82.4 %) than video-EEG monitoring (sensitivity 50 %, accuracy 45.9 %).Conclusion. In simple monofocal variants of structural epilepsy, video-EEG monitoring has a sufficient level of diagnostic efficiency. The phenomenon of neurophysiological phenotypes convergence is responsible for the reduced diagnostic efficacy of noninvasive and invasive monitoring.

scholarly journals Temporal lobe epilepsy with unilateral hippocampal sclerosis and contralateral temporal scalp seizure onset: report of four patients with "burned-out hippocampus"

2005 ◽  
Vol 11 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Luís Otávio Sales Ferreira Caboclo ◽  
Eliana Garzon ◽  
Flávia Saori Miyashira ◽  
Henrique Carrete Jr ◽  
Ricardo da Silva Centeno ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Epileptogenic Zone ◽  
Invasive Monitoring ◽  
Eeg Monitoring ◽  
Ictal Eeg ◽  
High Resolution Mri ◽  
Surgical Evaluation ◽  
Video Eeg

ABSTRACT OBJECTIVES: Patients with temporal lobe epilepsy (TLE) and unilateral severe hippocampal sclerosis (HS) may have contralateral temporal scalp ictal onset. This has recently been called "burned-out hippocampus", which is believed to be a rare entity. In this study we report four patients with unilateral hippocampal sclerosis and contralateral ictal onset registered by scalp electrodes. We discuss the importance of such cases in presurgical evaluation of patients with TLE, as well as possible strategies used for evaluation of these particular cases. PATIENTS AND METHODS: We reviewed charts from all patients with TLE submitted to pre-surgical evaluation, which included high resolution MRI and prolonged video-electroencephalogram (video-EEG) monitoring with scalp and sphenoidal electrodes, during a three-year period (2002-2004). We looked for patients who only had seizures that were clearly contralateral in location to the atrophic hippocampus. RESULTS: Four patients fulfilled the criteria above. Two of these patients had semi-invasive video-EEG monitoring with foramen ovale (FO) electrodes, which revealed seizures originating from the temporal lobe with the atrophic hippocampus, hence confirming false lateralization in the scalp-sphenoidal EEG. These patients were submitted to surgical treatment and had favorable prognosis after surgery. CONCLUSIONS: Burned-out hippocampus syndrome may not be as rare as it was previously believed. Further studies will be necessary before one can affirm that patients with unilateral HS and scalp ictal EEG showing contralateral ictal onset may be operated without confirmation of the epileptogenic zone by invasive monitoring. In these patients, semi-invasive monitoring with FO electrodes might be an interesting alternative.

Neurophysiological phenotypes of pharmacoresistant temporal lobe epilepsy

2021 ◽  
pp. 9-12
Author(s):  
M. V. Aleksandrov ◽  
Y. V. Marchenko
Keyword(s):  
Surgical Treatment ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epileptic Focus ◽  
Bioelectrical Activity ◽  
Epileptogenic Zone ◽  
Invasive Monitoring ◽  
Ictal Activity ◽  
The Brain

Patients with a drug-resistant form of epilepsy can be treated by neurosurgery through the destruction or separation of the epileptic focus. If the results of clinical, neuro-imaging and neurophysiological methods are discordant, then the localization of the epileptogenic zone is performed based on the results of long-term invasive monitoring of the bioelectrical activity of the cortex and deep structures of the brain. The aim of this work was the retrospective analysis of the results of invasive monitoring of the bioelectrical activity of the brain to clarify the mechanisms of the formation of patterns of interictal and ictal activity in structural epilepsy. The study included 35 patients (18 men, 17 women) with drug-resistant temporal lobe epilepsy, who were treated at the Polenov Neurosurgical Institute. The examination included video-EEG monitoring, long-term invasive monitoring of bioelectrical activity of the cortex, and deep brain structures. The patients were divided into two groups according to the type of surgical treatment: 1) micro-surgical resection of the epileptic focus, including the zone of structural changes (24 patients); 2) stereotactic destruction of the amygdala-hippocampal complex (6 patients). The follow-up of the outcomes of the surgical treatment took place over 2-3 years. Depending on the results of the surgical treatment, the patients were divided into two groups: 1) patients with a favorable outcome (Engel 1–2) — 15 patients and 2) patients with no positive dynamics and a relatively poor outcome (Engel 3–4) — 15 patients. The results obtained showed that the patterns of interictal and ictal activity in their totality determine the neurophysiology, i.e the phenotype of temporal lobe epilepsy, reflecting the interference of pathogenetic and sanogenetic mechanisms. The localization of the epileptogenic zone should be based on the cumulative assessment of interictal and ictal activity. The presence of more than one focus of interictal activity, the secondary spread of epileptiform activity from the primary focus, are prognostically unfavorable factors.

scholarly journals Importance of Video-EEG Monitoring in the Diagnosis of Refractory Panic Attacks

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Batool F. Kirmani ◽  
Diana Mungall
Keyword(s):  
Temporal Lobe ◽  
Interesting Case ◽  
Panic Attacks ◽  
Eeg Monitoring ◽  
Partial Seizures ◽  
Delay In Diagnosis ◽  
Panic Disorders ◽  
Intense Fear ◽  
Temporal Lobe Seizures ◽  
Video Eeg

Partial seizures can be misdiagnosed as panic attacks. There is considerable overlap of symptoms between temporal lobe seizures and panic attacks making the diagnosis extremely challenging. Temporal lobe seizures can present with intense fear and autonomic symptoms which are also seen in panic disorders. This results in delay in diagnosis and management. We report an interesting case of a young woman who was diagnosed with right temporal lobe seizures with symptoms suggestive of a panic attack.

Usefulness of Unilateral Interictal Sharp Waves of Temporal Lobe Origin in Prolonged Video-EEG Monitoring Studies

Epilepsia ◽  
1993 ◽  
Vol 34 (5) ◽  
pp. 884-889 ◽  
Author(s):  
Andres M. Kanner ◽  
Harold H. Morris ◽  
Hans Luders ◽  
Dudley S. Dinner ◽  
Paul Ness ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Eeg Monitoring ◽  
Sharp Waves ◽  
Video Eeg

A Case of Musicogenic Epilepsy

2021 ◽  
Author(s):  
Ankkita Sharma Bhandari ◽  
Mandaville Gourie-Devi ◽  
Praveen Kumar ◽  
Laxmi Khanna
Keyword(s):  
Temporal Lobe ◽  
Lifestyle Modification ◽  
Abnormal Signal ◽  
Recent Onset ◽  
History Of ◽  
Abnormal Signal Intensity ◽  
Musicogenic Epilepsy ◽  
Electroencephalogram Eeg ◽  
The Brain ◽  
Video Eeg

AbstractMusicogenic epilepsy is a relatively rare form of epilepsy characterized by seizures triggered by specific music experiences, with an estimated prevalence of 1/10,000,000 population. We report a case of 12-year-old boy with a history of recent onset focal seizures associated with an aura of formed visual hallucinations, feeling of familiarity (déjà vu), and impending fear lasting for seconds to a minute followed by eye blinking, oral automatisms, and unresponsiveness for almost 15 minutes. These episodes, most often, were provoked by music. Video electroencephalogram (EEG) done in our institute was suggestive of reflex musicogenic epilepsy arising from the left anterior temporal lobe. Magnetic resonance imaging of the brain 3T with epilepsy protocol confirmed video EEG findings, with an abnormal signal intensity in the left hippocampal and mesial temporal lobe. Treatment included lifestyle modification and antiepileptic drugs.

scholarly journals Antiepileptic Drug Withdrawal in Patients with Temporal Lobe Epilepsy Undergoing Presurgical Video-EEG Monitoring

Epilepsia ◽  
2008 ◽  
Vol 42 (2) ◽  
pp. 251-255 ◽  
Author(s):  
Der-Jen Yen ◽  
Chien Chen ◽  
Yang-Hsin Shih ◽  
Yuh-Cherng Guo ◽  
Li-Ting Liu ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Antiepileptic Drug ◽  
Temporal Lobe ◽  
Drug Withdrawal ◽  
Eeg Monitoring ◽  
Antiepileptic Drug Withdrawal ◽  
Video Eeg

scholarly journals Heart rate analysis differentiates dialeptic complex partial temporal lobe seizures from auras and non-epileptic seizures

2007 ◽  
Vol 65 (3a) ◽  
pp. 565-568 ◽  
Author(s):  
Gisele R. de Oliveira ◽  
Francisco de A.A. Gondim ◽  
R. Edward Hogan ◽  
Francisco H. Rola
Keyword(s):  
Heart Rate ◽  
Temporal Lobe ◽  
Epileptic Seizures ◽  
Eeg Monitoring ◽  
Rate Analysis ◽  
Temporal Lobe Seizures ◽  
Heart Rate Analysis ◽  
Video Eeg

The distinction of non-epileptic from epileptic events is difficult even for experienced neurologists. We retrospectively evaluated 59 dialeptic events from 27 patients admitted for video EEG monitoring to check whether heart rate (HR) analysis could help in differentiating dialeptic complex partial temporal lobe seizures (TLS) from dialeptic simple partial TLS, and non-epileptic dialeptic events. Baseline HR was increased in the simple partial TLS in comparison to complex partial TLS and non-epileptic groups (p<0.05). HR increase accompanied each individual dialeptic complex partial TLS (100% of the events, p<0.05) bur HR returned to baseline in the post-ictal phase. Ictal HR was not altered in the non-epileptic or simple partial TLS groups. Our findings suggest that ictal centrally mediated tachycardia is characteristic of dialeptic TLS (both tachycardia and bradycardia have been reported during TLS). This finding may be used as a criterion to distinguish dialeptic complex partial TLS from simple partial and non-epileptic dialeptic events.

scholarly journals Hyperventilation, More than Just Hot Air

2006 ◽  
Vol 6 (3) ◽  
pp. 76-77 ◽  
Author(s):  
Warren T. Blume
Keyword(s):  
Temporal Lobe ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Eeg Monitoring ◽  
Hot Air ◽  
Interictal Discharges ◽  
Idiopathic Epilepsies ◽  
Photon Emission Computed Tomography ◽  
Video Eeg

Hyperventilation Revisited: Physiological Effects and Efficacy on Focal Seizure Activation in the Era of Video-EEG Monitoring Guaranha MS, Garzon E, Buchpiguel CA, Tazima S, Yacubian EM, Sakamoto AC Epilepsia 2005;46(1):69–75 Purpose Hyperventilation is an activation method that provokes physiological slowing of brain rhythms, interictal discharges, and seizures, especially in generalized idiopathic epilepsies. In this study, we assessed its effectiveness in inducing focal seizures during video-EEG monitoring. Methods We analyzed the effects of hyperventilation (HV) during video-EEG monitoring of patients with medically intractable focal epilepsies. We excluded children younger than 10 years, mentally retarded patients, and individuals with frequent seizures. Results We analyzed 97 patients; 24 had positive seizure activation (PSA), and 73 had negative seizure activation (NSA). No differences were found between groups regarding sex, age, age at epilepsy onset, duration of epilepsy, frequency of seizures, and etiology. Temporal lobe epilepsies were significantly more activated than frontal lobe epilepsies. Spontaneous and activated seizures did not differ in terms of their clinical characteristics, and the activation did not affect the performance of ictal single-photon emission computed tomography (SPECT). Conclusions HV is a safe and effective method of seizure activation during monitoring. It does not modify any of the characteristics of the seizures and allows the obtaining of valuable ictal SPECTs. This observation is clinically relevant and suggests the effectiveness and the potential of HV in shortening the presurgical evaluation, especially of temporal lobe epilepsy patients, consequently reducing its costs and increasing the number of candidates for epilepsy surgery.

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