scholarly journals Preserved musical abilities following right temporal lobectomy

1996 ◽  
Vol 1 (4) ◽  
pp. E1
Author(s):  
Atsushi Koike ◽  
Hiroyuki Shimizu ◽  
Ichiro Suzuki ◽  
Buichi Ishijima ◽  
Morihiro Sugishita
Keyword(s):  
Standard Deviation ◽  
Temporal Lobe ◽  
Intractable Epilepsy ◽  
Sylvian Fissure ◽  
Temporal Lobectomy ◽  
Before And After ◽  
The Right ◽  
Lines Of Evidence

It has been widely accepted that the right temporal lobe plays a major role in the processing of music. One of the main lines of evidence was derived from Milner's study, published in 1962, which reported that right temporal lobectomy led to a decline in patient scores on four of the six subtests (Tonal Memory, Timbre, Loudness, and Time subtests) of the Seashore Measures of Musical Talents. That finding had led some surgeons and patients to hesitate in choosing right temporal lobectomy as a treatment for intractable epilepsy. The authors examined performance on the Seashore Measures before and after operations in 20 patients with right temporal lobectomy and nine patients with left temporal lobectomy. No disturbances in the Seashore Measures were detected after temporal lobectomy on either side. The extent of these temporal lobectomies was smaller than that of the temporal lobectomies in Milner's study, as measured along the sylvian fissure (1.5–4 cm; mean 2.7 cm, standard deviation (SD) 0.92 cm) and the base of the temporal lobe (3.5–5.5 cm; mean 4.7 cm, SD 0.63 cm). These findings indicate that the region resected on right temporal lobectomy in the present study is not essential for basic musical processing.

Preserved musical abilities following right temporal lobectomy

1996 ◽  
Vol 85 (6) ◽  
pp. 1000-1004 ◽  
Author(s):  
Atsushi Koike ◽  
Hiroyuki Shimizu ◽  
Ichiro Suzuki ◽  
Buichi Ishijima ◽  
Morihiro Sugishita
Keyword(s):  
Standard Deviation ◽  
Temporal Lobe ◽  
Intractable Epilepsy ◽  
Sylvian Fissure ◽  
Temporal Lobectomy ◽  
Content Type ◽  
Before And After ◽  
The Right ◽  
Lines Of Evidence ◽  
Fine Print

✓ It has been widely accepted that the right temporal lobe plays a major role in the processing of music. One of the main lines of evidence was derived from Milner's study, published in 1962, which reported that right temporal lobectomy led to a decline in patient scores on four of the six subtests (Tonal Memory, Timbre, Loudness, and Time subtests) of the Seashore Measures of Musical Talents. That finding had led some surgeons and patients to hesitate in choosing right temporal lobectomy as a treatment for intractable epilepsy. The authors examined performance on the Seashore Measures before and after operations in 20 patients with right temporal lobectomy and nine patients with left temporal lobectomy. No disturbances in the Seashore Measures were detected after temporal lobectomy on either side. The extent of these temporal lobectomies was smaller than that of the temporal lobectomies in Milner's study, as measured along the sylvian fissure (1.5–4 cm; mean 2.7 cm, standard deviation (SD) 0.92 cm) and the base of the temporal lobe (3.5–5.5 cm; mean 4.7 cm, SD 0.63 cm). These findings indicate that the region resected on right temporal lobectomy in the present study is not essential for basic musical processing.

scholarly journals Intractable Temporal Lobe Epilepsy (TLE) From Tuberculoma; Microneurosurgical Management of by Amygdalohippocampectomy with Lesionectomy Plus Standard Anterior Temporal lobectomy: A Case Report and Short Review of Literature

2019 ◽  
Vol 16 (2) ◽  
pp. 106-109
Author(s):  
Forhad Hossain Chowdhury ◽  
Mohammod Raziul Haque ◽  
AFM Momtazul Haque
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Venous Malformation ◽  
Intractable Epilepsy ◽  
Complex Partial Seizure ◽  
Temporal Lobectomy ◽  
Mesial Temporal Sclerosis ◽  
Low Grade ◽  
Presenting Symptoms

Patient presenting as a case of Temporal Lobe Epilepsy (TLE) are usually resistant to antiepileptic drugs and surgery is the treatment of choice. This type of epilepsy may be due to Mesial Temporal Sclerosis (MTS), tumors [i.e. low grade glioma, Arterio-venous Malformation (AVM) etc], trauma, infection (Tuberculosis) etc. Here we report a case of surgically treated TLE that was due to a large tuberculoma in medial temporal lobe. Intractable epilepsy caused by tuberculoma is rare. The only presenting symptoms was Complex partial seizure (Psychomotor epilepsy) for which the patient underwent scalp EEG (Electro Encephalography) and MRI (Magnetic resonance imaging) of brain. The patient was managed by amygdalohippocampectomy with lesionectomy plus standard anterior lobectomy. Postoperatively she was on anti-tubercular therapy and on carbamazepine. The case was seizure and disease free till last follow up. Journal of Surgical Sciences (2012) Vol. 16 (2) : 106-109

Seizure Types and Frequency in Patients Who “Fail” Temporal Lobectomy for Intractable Epilepsy

Neurosurgery ◽  
2013 ◽  
Vol 73 (5) ◽  
pp. 838-844 ◽  
Author(s):  
Dario J. Englot ◽  
Anthony T. Lee ◽  
Catherine Tsai ◽  
Cathra Halabi ◽  
Nicholas M. Barbaro ◽  
...  
Keyword(s):  
Intractable Epilepsy ◽  
Temporal Lobectomy ◽  
Seizure Type ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Generalized Seizures ◽  
Number Of Patients ◽  
Before And After

Abstract BACKGROUND: Temporal lobectomy can lead to favorable seizure outcomes in medically-refractory temporal lobe epilepsy (TLE). Although most studies focus on seizure freedom after temporal lobectomy, less is known about seizure semiology in patients who “fail” surgery. Morbidity differs between seizure types that impair or spare consciousness. Among TLE patients with seizures after surgery, how does temporal lobectomy influence seizure type and frequency? OBJECTIVE: To characterize seizure types and frequencies before and after temporal lobectomy for TLE, including consciousness-sparing or consciousness-impairing seizures. METHODS: We performed a retrospective longitudinal cohort study examining patients undergoing temporal lobectomy for epilepsy at our institution from January 1995 to August 2010. RESULTS: Among 241 TLE patients who received temporal lobectomy, 174 (72.2%) patients achieved Engel class I outcome (free of disabling seizures), including 141 (58.5%) with complete seizure freedom. Overall seizure frequency in patients with persistent postoperative seizures decreased by 70% (P < .01), with larger reductions in consciousness-impairing seizures. While the number of patients experiencing consciousness-sparing simple partial seizures decreased by only 19% after surgery, the number of individuals having consciousness-impairing complex partial seizures and generalized tonic-clonic seizures diminished by 70% and 68%, respectively (P < .001). Simple partial seizure was the predominant seizure type in 19.1% vs 37.0% of patients preoperatively and postoperatively, respectively (P < .001). Favorable seizure outcome was predicted by a lack of generalized seizures preoperatively (odds ratio 1.74, 95% confidence interval 1.06-2.86, P < .5). CONCLUSION: Given important clinical and mechanistic differences between seizures with or without impairment of consciousness, seizure type and frequency remain important considerations in epilepsy surgery.

A Double Dissociation in the Affective Modulation of Startle in Humans: Effects of Unilateral Temporal Lobectomy

2001 ◽  
Vol 13 (6) ◽  
pp. 721-729 ◽  
Author(s):  
E. Sumie Funayama ◽  
Christian Grillon ◽  
Michael Davis ◽  
Elizabeth A. Phelps
Keyword(s):  
Temporal Lobe ◽  
Visual Information ◽  
Medial Temporal Lobe ◽  
Emotional Processing ◽  
Right Hemisphere ◽  
Temporal Lobectomy ◽  
Opposite Pattern ◽  
Double Dissociation ◽  
Control Subjects ◽  
The Right

In the present study we report a double dissociation between right and left medial temporal lobe damage in the modulation of fear responses to different types of stimuli. We found that right unilateral temporal lobectomy (RTL) patients, in contrast to control subjects and left temporal lobectomy (LTL) patients, failed to show potentiated startle while viewing negative pictures. However, the opposite pattern of impairment was observed during a stimulus that patients had been told signaled the possibility of shock. Control subjects and RTL patients showed potentiated startle while LTL patients failed to show potentiated startle. We hypothesize that the right medial temporal lobe modulates fear responses while viewing emotional pictures, which involves exposure to (emotional) visual information and is consistent with the emotional processing traditionally ascribed to the right hemisphere. In contrast, the left medial temporal lobe modulates fear responses when those responses are the result of a linguistic/cognitive representation acquired through language, which, like other verbally mediated material, generally involves the left hemisphere. Additional evidence from case studies suggests that, within the medial temporal lobe, the amygdala is responsible for this modulation.

Tailored Temporal Lobectomy for Medically Intractable Epilepsy

Neurosurgery ◽  
2012 ◽  
Vol 71 (3) ◽  
pp. 703-709 ◽  
Author(s):  
Steven M. Falowski ◽  
David Wallace ◽  
Andres Kanner ◽  
Michael Smith ◽  
Michael Rossi ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Intractable Epilepsy ◽  
Temporal Lobectomy ◽  
Class I ◽  
Visual Field Defects ◽  
Seizure Outcome ◽  
Temporal Lobe Resection ◽  
Generalized Epilepsy

Abstract BACKGROUND: There have been only a few large series that have used a tailored temporal lobectomy. OBJECTIVE: To clarify whether tailoring a temporal lobe resection will lead to equivalent epilepsy outcomes or have the same predictive factors for success when compared with standard resections. METHODS: Retrospective analysis of 222 patients undergoing a tailored temporal lobe resection. Demographic measures and typical factors influencing outcome were evaluated. RESULTS: Pathology included 222 cases. With a mean follow-up of 5.4 years, 70% of patients achieved Engel class I outcome. A significant factor predicting Engel class I outcome on multivariate analysis was lesional pathology (P = .04). Among patients with hippocampal sclerosis, extent of lateral neocortical resection and hippocampal resection were not statistically associated with Engel class I outcome (P = .93 and P = .24). However, an analysis of Engel class subgroups a to d showed that patients who had a complete hippocampectomy in the total series were more likely to achieve an Engel class Ia outcome (P = .04). This was also true among patients with hippocampal sclerosis (P = .03). Secondarily, generalized seizure (P = .01) predicted outcome less than Engel class I. Predictive of poor outcome was the need for preoperative electrodes (P = .02). Complications included superior quadrant visual field defects, 2 cases of permanent dysphasia, and 3 wound infections. CONCLUSION: Predictors of successful seizure outcome for a tailored temporal lobectomy are similar to standard lobectomy. Patients with secondarily generalized epilepsy and cases in which preoperative subdural electrodes were thought necessary were less likely to achieve class I outcome. Among Engel class I cases, those who had a complete hippocampectomy were more likely to achieve Engel class Ia outcome.

scholarly journals Transient Hemifacial Sensory Loss with Xerophthalmia following Temporal Lobectomy

2000 ◽  
Vol 27 (3) ◽  
pp. 251-253 ◽  
Author(s):  
Ajith J. Thomas ◽  
Kost Elisevich ◽  
Brien Smith
Keyword(s):  
Temporal Lobe ◽  
Clinical Presentation ◽  
Nasal Congestion ◽  
Temporal Lobectomy ◽  
Sensory Loss ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Cavernous Malformations ◽  
Greater Superficial Petrosal Nerve ◽  
The Right

Objective and importance:The occurrence of a unilateral sensory loss in the second trigeminal distribution and the inability to tear following an ipsilateral temporal lobectomy has not been noted despite a number of reports of cranial nerve compromise under similar situations.Clinical presentation:A 48-year-old woman experienced complex partial seizures over three years attributable to the presence of cavernous malformations of the right temporal lobe.Intervention:An anterior temporal extrahippocampal resection was performed. The surgery was marked by the need for electrocoagulation of the dural base of the temporal lobe where numerous bleeding points were encountered. Postoperatively, the patient experienced an ipsilateral maxillary division sensory loss, absence of tearing, and diminished nasal congestion for an eight-month period until resolution.Conclusion:Injury of the fibers of the maxillary division of the trigeminal nerve and the adjacent greater superficial petrosal nerve appears to be the cause. No prior account of such an occurrence has been published.

Medial Temporal Encephalocele and Medically Intractable Epilepsy: A Tailored Inferior Temporal Lobectomy and Case Report

2019 ◽  
Vol 18 (1) ◽  
pp. E19-E22 ◽  
Author(s):  
Anthony L Mikula ◽  
Karim ReFaey ◽  
Sanjeet S Grewal ◽  
Jeffrey W Britton ◽  
Jamie J Van Gompel
Keyword(s):  
Case Report ◽  
Temporal Lobe ◽  
Refractory Epilepsy ◽  
Statistical Parametric Mapping ◽  
Intractable Epilepsy ◽  
Middle Cranial Fossa ◽  
Temporal Lobectomy ◽  
Seizure Freedom ◽  
Temporal Region ◽  
Medically Refractory Epilepsy

AbstractBACKGROUND AND IMPORTANCETemporal lobe encephaloceles are increasingly recognized as a potential cause of medically refractory epilepsy and surgical treatment has proven effective. Resection of the encephalocele and associated cortex is often sufficient to provide seizure control. However, it is difficult to determine the extent of adjacent temporal lobe that should be resected. We present a case report and our technique of a tailored inferior temporal pole resection.CLINICAL PRESENTATIONA 32-yr-old man with an 11-yr history of medically refractory epilepsy. Prolonged electroencephalography (EEG) revealed frequent left and rare right frontotemporal sharp waves. Numerous seizures were captured with EEG, all of which originated from the left temporal region. Statistical parametric mapping (SPM) subtraction ictal–interictal SPECT coregistered with magnetic resonance imaging (MRI) (SISCOM) demonstrated ictal hyperperfusion in the anterior left temporal lobe. MRI showed 2 encephaloceles in the left anterior temporal lobe with the accompanying bony defects in the floor of the middle cranial fossa apparent on the computed tomography scan. The patient underwent left temporal craniotomy with intraoperative electrocorticography, resection of the encephaloceles, and a tailored inferior temporal lobectomy (IFTL) and repair of the middle fossa defects. At 7 mo follow up he reported seizure-freedom since surgery.CONCLUSIONResection of temporal encephalocele and adjacent cortex is safe and effective procedure for select patients with medically refractory epilepsy. This video demonstrates our technique which provides a more standardized approach to the resection.

Fentanyl-induced electrocorticographic seizures in patients with complex partial epilepsy

1992 ◽  
Vol 77 (2) ◽  
pp. 201-208 ◽  
Author(s):  
René Tempelhoff ◽  
Paul A. Modica ◽  
Kerry L. Bernardo ◽  
Isaac Edwards
Keyword(s):  
Temporal Lobe ◽  
Seizure Activity ◽  
Epileptiform Activity ◽  
Temporal Lobectomy ◽  
Electrode Arrays ◽  
Complex Partial Seizures ◽  
Content Type ◽  
Temporal Lobe Seizures ◽  
Eeg Recordings ◽  
The Right

✓ Although electrical seizure activity in response to opioids such as fentanyl has been well described in animals, scalp electroencephalographic (EEG) recordings have failed to demonstrate epileptiform activity following narcotic administration in humans. The purpose of this study was to determine whether fentanyl is capable of evoking electrical seizure activity in patients with complex partial (temporal lobe) seizures. Nine patients were studied in whom recording electrode arrays had been placed in the bitemporal epidural space several days earlier to determine which temporal lobe gave rise to their seizures. The symptomatic temporal lobe was localized by correlating clinical and electrical seizure activity obtained during continuous simultaneous videotape and epidural EEG monitoring. In each patient, clinical seizures and electrical seizure activity were consistently demonstrated to arise unilaterally from one temporal lobe (four on the right, five on the left). During fentanyl induction of anesthesia in preparation for secondary craniotomy for anterior temporal lobectomy, eight of the nine patients exhibited electrical seizure activity at fentanyl doses ranging from 17.7 to 35.71 µg · kg−1 (mean 25.75 µg · kg−1). More importantly, four of these eight seizures occurred initially in the “healthy” temporal lobe contralateral to the surgically resected lobe from which the clinical seizures had been shown to arise. These findings indicate that, in patients with complex partial seizures, moderate doses of fentanyl can evoke electrical seizure activity. The results of this study could have important implications for neurosurgical centers where electrocorticography is used during surgery for the purpose of determining the extent of the resection.

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