scholarly journals Disconnective surgery in posterior quadrantic epilepsy: experience in a consecutive series of 10 patients

2013 ◽  
Vol 34 (6) ◽  
pp. E10 ◽  
Author(s):  
Christian Dorfer ◽  
Thomas Czech ◽  
Angelika Mühlebner-Fahrngruber ◽  
Aygül Mert ◽  
Gudrun Gröppel ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Lupus Erythematosus ◽  
Occipital Lobe ◽  
Pediatric Epilepsy ◽  
Consecutive Series ◽  
Cerebral Tumor ◽  
Invasive Approach ◽  
Cortical Involvement ◽  
The Right

Object Outcomes following functional hemispherotomy in patients with drug-resistant epilepsy have been well described. However, studies reporting long-term longitudinal outcomes after subhemispheric disconnective epilepsy surgery are still limited. Methods The authors conducted a retrospective review of prospectively collected data of 10 children who underwent temporoparietooccipital (TPO) disconnective surgery at the Vienna Pediatric Epilepsy Center. Results There were 3 males and 7 females (median age 8.7 years; range 4.2–22.1 years). The affected hemisphere was the left in 3 patients and the right in 7. The patients' median age at seizure onset was 3.0 years (range 0.2–8.3 years). The median duration of epilepsy before surgery was 5.2 years (range 1.3–17.2 years). The underlying pathology was TPO malformation of cortical development in 5 patients, and venous infarction, posterior hemispheric quadrant atrophy, Sturge-Weber syndrome, cortical involvement of a systemic lupus erythematosus, and gliosis after cerebral tumor treatment in 1 each. In 6 children, a pure TPO disconnection was performed; in 2 patients, the temporal lobe was resected and parietooccipital disconnection was performed. The 2 remaining patients had had previous epilepsy surgery that was extended to a TPO disconnection: disconnection of the occipital lobe (n = 1) and resection of the temporal lobe (n = 1). The authors encountered no complications while performing surgery. No patient needed blood replacement therapy. No patient developed CSF disturbances that warranted treatment. Nine of 10 patients are currently seizure free since surgery (Wieser Class 1a) at a median follow-up time of 2.1 years (range 4 months to 8.1 years). Conclusions Temporoparietooccipital disconnection is a safe and effective motor-sparing epilepsy surgery in selected cases. Technical adjuncts facilitate a better intraoperative visualization and orientation, thereby enabling a less invasive approach than previously suggested.

scholarly journals Multinodular and Vacuolating Neuronal Tumor

2018 ◽  
Vol 6 (9) ◽  
pp. 1697-1698 ◽  
Author(s):  
Charmaine Zahra ◽  
Reuben Grech
Keyword(s):  
Case Report ◽  
Brain Imaging ◽  
Temporal Lobe ◽  
Benign Lesion ◽  
Occipital Lobe ◽  
Imaging Findings ◽  
Cns Tumours ◽  
The Right ◽  
Rare Diagnosis ◽  
Neuronal Tumor

BACKGROUND: Multinodular and Vacuolating Neuronal Tumor (MVNT) of the cerebrum is a benign lesion described recently in the WHO CNS tumours in 2016. Although this tumour is uncommon, clinicians should be acquainted with the possible presentation and imaging findings. CASE REPORT: We present a case of a young gentleman whose only symptom was absence seizures. Brain imaging showed lesions, compatible with this rare diagnosis. CONCLUSION: Our description of imaging findings on MRI highlights the characteristic cystic appearances of note in the right occipital lobe, in contrast to the temporal lobe as the predominant location found in previous cases.

scholarly journals Thalamic Arousal Network Disturbances in Temporal Lobe Epilepsy and Improvement After Surgery

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Hernán F J González ◽  
Srijata Chakravorti ◽  
Sarah E Goodale ◽  
Kanupriya Gupta ◽  
Daniel O Claassen ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Occipital Lobe ◽  
Visuospatial Attention ◽  
Partial Recovery ◽  
Thalamic Nuclei ◽  
Spearman's Rho ◽  
Spearman’S Rho

Abstract INTRODUCTION The effects of temporal lobe epilepsy (TLE) on subcortical arousal structures remain incompletely understood. Here we evaluate thalamic arousal network functional connectivity in TLE and examine changes after epilepsy surgery. METHODS We examined 26 adult TLE patients and 26 matched control participants and used resting-state functional magnetic resonance imaging (fMRI) to measure functional connectivity between the thalamus (entire thalamus and 19 bilateral thalamic nuclei) and both neocortex and brainstem ascending reticular activating system (ARAS) nuclei. Postoperative imaging was completed for 19 patients > 1 yr after surgery and compared to preoperative baseline. RESULTS Before surgery, TLE patients demonstrated abnormal thalamo-occipital functional connectivity, losing the normal negative fMRI correlation between the intralaminar central lateral (CL) nucleus and medial occipital lobe seen in controls (P < .001, paired t-test). Patients also had abnormal connectivity between ARAS and CL, lower ipsilateral intrathalamic connectivity, and smaller ipsilateral thalamic volume compared to controls (P < .05 for each, paired t-tests). Abnormal brainstem-thalamic connectivity was associated with impaired visuospatial attention (? = −0.50, P = .02, Spearman's rho), while lower intrathalamic connectivity and volume were related to higher frequency of consciousness-sparing seizures (P < .02, Spearman's rho). After epilepsy surgery, patients with improved seizures showed partial recovery of thalamo-occipital and brainstem-thalamic connectivity, with values more closely resembling controls (P < .01 for each, ANOVA). CONCLUSION Overall, TLE patients demonstrate impaired connectivity in thalamic arousal networks that may be involved in visuospatial attention, but these disturbances may partially recover after successful epilepsy surgery. Thalamic arousal network dysfunction may contribute to morbidity in TLE.

Post-Stimulation Effect of Electroacupuncture at Yintang (EX-HN3) and GV20 on cerebral functional regions in healthy volunteers: A resting functional MRI study

2012 ◽  
Vol 30 (4) ◽  
pp. 307-315 ◽  
Author(s):  
Yu Zheng ◽  
Shanshan Qu ◽  
Na Wang ◽  
Limin Liu ◽  
Guanzhong Zhang ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Temporal Lobe ◽  
Parietal Lobe ◽  
Occipital Lobe ◽  
Cingulate Gyrus ◽  
Left Frontal Lobe ◽  
Posterior Cingulate Gyrus ◽  
Functional Regions ◽  
Limbic Lobe ◽  
The Right

Objective The aim of the present work was to observe the activation/deactivation of cerebral functional regions after electroacupuncture (EA) at Yintang (EX-HN3) and GV20 by functional MRI (fMRI). Design A total of 12 healthy volunteers were stimulated by EA at Yintang and GV20 for 30 min. Resting-state fMRI scans were performed before EA, and at 5 and 15 min after needle removal. Statistical parametric mapping was used to preprocess initial data, and regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) were analysed. Results ReHo at 5 min post stimulation showed increases in the left temporal lobe and cerebellum and decreases in the left parietal lobe, occipital lobe and right precuneus. At 15 min post stimulation, ReHo showed increases in the left fusiform gyrus; lingual gyrus; middle temporal gyrus; postcentral gyrus; limbic lobe; cingulate gyrus; paracentral lobule; cerebellum, posterior lobe, declive; right cuneus and cerebellum, anterior lobe, culmen. It also showed decreases in the left frontal lobe, parietal lobe, right temporal lobe, frontal lobe, parietal lobe and right cingulate gyrus. ALFF at 5 min post stimulation showed increases in the right temporal lobe, but decreases in the right limbic lobe and posterior cingulate gyrus. At 15 min post stimulation ALFF showed increases in the left frontal lobe, parietal lobe, occipital lobe, right temporal lobe, parietal lobe, occipital lobe and cerebellum, but decreases in the left frontal lobe, anterior cingulate gyrus, right frontal lobe and posterior cingulate gyrus. Conclusions After EA stimulation at Yintang and GV20, which are associated with psychiatric disorder treatments, changes were localised in the frontal lobe, cingulate gyrus and cerebellum. Changes were higher in number and intensity at 15 min than at 5 min after needle removal, demonstrating lasting and strong after-effects of EA on cerebral functional regions.

scholarly journals Thalamic arousal network disturbances in temporal lobe epilepsy and improvement after surgery

2019 ◽  
Vol 90 (10) ◽  
pp. 1109-1116 ◽  
Author(s):  
Hernán F J González ◽  
Srijata Chakravorti ◽  
Sarah E Goodale ◽  
Kanupriya Gupta ◽  
Daniel O Claassen ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Occipital Lobe ◽  
Visuospatial Attention ◽  
Partial Recovery ◽  
Thalamic Nuclei ◽  
Spearman's Rho ◽  
Spearman’S Rho

ObjectiveThe effects of temporal lobe epilepsy (TLE) on subcortical arousal structures remain incompletely understood. Here, we evaluate thalamic arousal network functional connectivity in TLE and examine changes after epilepsy surgery.MethodsWe examined 26 adult patients with TLE and 26 matched control participants and used resting-state functional MRI (fMRI) to measure functional connectivity between the thalamus (entire thalamus and 19 bilateral thalamic nuclei) and both neocortex and brainstem ascending reticular activating system (ARAS) nuclei. Postoperative imaging was completed for 19 patients >1 year after surgery and compared with preoperative baseline.ResultsBefore surgery, patients with TLE demonstrated abnormal thalamo-occipital functional connectivity, losing the normal negative fMRI correlation between the intralaminar central lateral (CL) nucleus and medial occipital lobe seen in controls (p < 0.001, paired t-test). Patients also had abnormal connectivity between ARAS and CL, lower ipsilateral intrathalamic connectivity, and smaller ipsilateral thalamic volume compared with controls (p < 0.05 for each, paired t-tests). Abnormal brainstem–thalamic connectivity was associated with impaired visuospatial attention (ρ = −0.50, p = 0.02, Spearman’s rho) while lower intrathalamic connectivity and volume were related to higher frequency of consciousness-sparing seizures (p < 0.02, Spearman’s rho). After epilepsy surgery, patients with improved seizures showed partial recovery of thalamo-occipital and brainstem–thalamic connectivity, with values more closely resembling controls (p < 0.01 for each, analysis of variance).ConclusionsOverall, patients with TLE demonstrate impaired connectivity in thalamic arousal networks that may be involved in visuospatial attention, but these disturbances may partially recover after successful epilepsy surgery. Thalamic arousal network dysfunction may contribute to morbidity in TLE.

scholarly journals Prevalence of the Anterior Occipital Sulcus in the Human Brain: Anatomical Study

2016 ◽  
Vol 23 (1) ◽  
pp. 19-22
Author(s):  
Bassam MJ Addas
Keyword(s):  
Human Brain ◽  
Temporal Lobe ◽  
External Surface ◽  
Anatomical Study ◽  
Occipital Lobe ◽  
The Mean ◽  
The Right ◽  
Human Brains ◽  
Formalin Fixed

The objective of this article is to investigate the prevalence of the anterior occipital sulcus in the human brain. The external surface of 25 consecutive formalin fixed brains (50 hemispheres) were examined for the presence of the anterior occipital sulcus. The anterior occipital sulcus was identified in 11 (22%) hemispheres, seven on the right side and four on the left side. The sulcus length ranged from 1-5 cm with a mean length of 2.89 cm. The mean distance from the occipital lobe tip to the anterior occipital sulcus was 4.75 cm on the right side and 5 cm on the left side. The anterior occipital sulcus can be infrequently encountered in human brains (22%); when present it represents the posterior limit of the temporal lobe and the anterior limit of the occipital lobe.

Expanding the role of surgery in intractable extratemporal pediatric epilepsy

2008 ◽  
Vol 25 (3) ◽  
pp. E15 ◽  
Author(s):  
Monisha Goyal ◽  
Shenandoah Robinson
Keyword(s):  
Epilepsy Surgery ◽  
Palliative Therapy ◽  
Pediatric Epilepsy ◽  
Consecutive Series ◽  
Aggressive Approach ◽  
Neurological Sequelae ◽  
Intracranial Surgery ◽  
Multifocal Disease

The aim of epilepsy surgery in children is not only to control seizures but also to curtail future adverse neurological sequelae and improve quality of life. If presurgical evaluation demonstrates discordant or multifocal disease, intracranial surgery may be denied as a viable treatment option. When surgical therapy is offered not just as curative but also as palliative therapy, many children not considered optimal surgical candidates may benefit. From a consecutive series of 57 cases involving children who underwent intracranial epilepsy surgery at Rainbow Babies and Children's Hospital during 2001–2005, the authors present in detail 3 cases involving children who benefited significantly from such an aggressive approach. Marked improvement occurred not only in seizure control, but also in developmental and social functioning.

scholarly journals Intraoperative epileptogenic network visualization using gamma oscillation regularity correlation analysis in epilepsy surgery

2021 ◽  
Vol 12 ◽  
pp. 254
Author(s):  
Yuta Kobayashi ◽  
Yosuke Sato ◽  
Tatsuya Sugiyama ◽  
Tohru Mizutani
Keyword(s):  
Correlation Analysis ◽  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Structural Changes ◽  
Gamma Oscillation ◽  
Correlation Networks ◽  
Transsylvian Approach ◽  
Structural Abnormalities ◽  
Impaired Awareness ◽  
The Right

Background: We have recently demonstrated that gamma oscillation (30–70 Hz) regularity (GOR) analysis accurately localized epileptogenic focus using intraoperative electrocorticographic data. In this report, we assessed whether GOR correlation analysis could depict epileptogenic networks intraoperatively. Dual foci in temporal lobe epilepsy without hippocampal structural abnormalities are difficult to diagnose. Using our GOR correlation analysis, we aimed to intraoperatively visualize such dual foci and epileptogenic networks. Case Description: A 56-year-old man suffered from pharmacoresistant focal impaired awareness seizures. Magnetic resonance imaging demonstrated an 8 × 12-mm cavernoma in the right inferior temporal gyrus without any structural changes in the hippocampus. Since ictal semiology indicated a high probability of epileptogenicity in the right hippocampus, we reached the hippocampus using a transsylvian approach and assessed intraoperative GOR correlation analysis in the lateral temporal lobe where the cavernoma was located and the hippocampus, simultaneously. High GORs suggestive of epileptogenicity were identified in both the lateral temporal lobe and the hippocampus. Furthermore, they were connected using GOR correlation networks. When the high GOR locations in the lateral temporal lobe and the cavernoma were removed, high GORs and those networks were found within the hippocampus only. After additional hippocampal transection, high GORs and these networks were absent. The patient became seizure-free after the surgery. Conclusion: Our GOR correlation analysis may be a powerful tool for intraoperative evaluation of epileptogenic networks in epilepsy surgery.

scholarly journals THE CONTRIBUTION OF EEG RECORDINGS TO THE AUDIOVISUAL RECOGNITION OF WORDS IN UNIVERSITY STUDENTS WITH DYSLEXIA

2021 ◽  
Author(s):  
Pavlos Christodoulides ◽  
◽  
Victoria Zakopoulou ◽  
Katerina D. Tzimourta ◽  
Alexandros T. Tzallas ◽  
...  
Keyword(s):  
University Students ◽  
Temporal Lobe ◽  
Adult Population ◽  
Brain Activation ◽  
Occipital Lobe ◽  
Auditory Task ◽  
Left Temporal Lobe ◽  
Prefrontal Area ◽  
Eeg Recordings ◽  
The Right

"Dyslexia is one of the most frequent specific learning disorders which has often been associated with deficits in phonological awareness mainly caused by auditory and visual inabilities to recognize and discriminate phonemes and graphemes within words. Neuroimaging techniques like EEG recordings have been widely used to assess hemispheric differences in brain activation between students with dyslexia and their typical counterparts. Although dyslexia is a lifelong disorder which persists into adulthood, very few studies have been carried out targeting in adult population. In this study, we examined the brain activation differences between 14 typical (control group) and 12 university students with dyslexia (experimental group). The participants underwent two tasks consisting of 50 3-word groups characterized by different degrees of auditory and visual distinctiveness. The whole procedure was recorded with a 14-sensor sophisticated wearable EEG recording device (Emotiv EPOC+). The findings from the auditory task revealed statistically significant differences among the two sets of groups in the left temporal lobe in ?, ? and ? rhythms, in the left occipital lobe in ? rhythm, and in the right prefrontal area in ?, ? and ? rhythms, respectively. The students with dyslexia reported higher mean scores only in ? rhythm in the left temporal lobe, and in ?, ? and ? rhythms in the right prefrontal area. Concerning the visual task, statistically significant differences were evident in the left temporal lobe in ?, ? rhythms, in the occipital lobe in ?, ? and ? rhythms, in the parietal lobe in ? rhythm, and in the right occipital lobe in ?, ? and ? rhythms. The students with dyslexia reported higher mean scores only in the ? rhythm of both the left and right occipital lobe. The results indicate that there are differences in the hemispheric brain activation of students with or without dyslexia in various rhythms in both experimental conditions, thus, shedding light in the neurophysiological discrepancies between the two groups. It also lays great emphasis on the necessity of carrying out more studies in adult population with dyslexia."

What face familiarity feelings say about the lateralization of specific entities within the core system

2019 ◽  
Vol 42 ◽  
Author(s):  
Guido Gainotti
Keyword(s):  
Temporal Lobe ◽  
Memory System ◽  
Core System ◽  
The Core ◽  
Memory Traces ◽  
Specific Memory ◽  
Target Article ◽  
Temporal Structures ◽  
The Right

Abstract The target article carefully describes the memory system, centered on the temporal lobe that builds specific memory traces. It does not, however, mention the laterality effects that exist within this system. This commentary briefly surveys evidence showing that clear asymmetries exist within the temporal lobe structures subserving the core system and that the right temporal structures mainly underpin face familiarity feelings.

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