scholarly journals Prospective Quantitative Neuroimaging Analysis of Putative Temporal Lobe Epilepsy

2021 ◽  
Vol 12 ◽  
Author(s):  
Kost Elisevich ◽  
Esmaeil Davoodi-Bojd ◽  
John G. Heredia ◽  
Hamid Soltanian-Zadeh
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Prediction Models ◽  
Quantitative Imaging ◽  
Hippocampal Volume ◽  
Mesial Temporal Lobe Epilepsy ◽  
Nuclear Medicine Imaging ◽  
Class 1 ◽  
A Prospective Study ◽  
Quantitative Neuroimaging

Purpose: A prospective study of individual and combined quantitative imaging applications for lateralizing epileptogenicity was performed in a cohort of consecutive patients with a putative diagnosis of mesial temporal lobe epilepsy (mTLE).Methods: Quantitative metrics were applied to MRI and nuclear medicine imaging studies as part of a comprehensive presurgical investigation. The neuroimaging analytics were conducted remotely to remove bias. All quantitative lateralizing tools were trained using a separate dataset. Outcomes were determined after 2 years. Of those treated, some underwent resection, and others were implanted with a responsive neurostimulation (RNS) device.Results: Forty-eight consecutive cases underwent evaluation using nine attributes of individual or combinations of neuroimaging modalities: 1) hippocampal volume, 2) FLAIR signal, 3) PET profile, 4) multistructural analysis (MSA), 5) multimodal model analysis (MMM), 6) DTI uncertainty analysis, 7) DTI connectivity, and 9) fMRI connectivity. Of the 24 patients undergoing resection, MSA, MMM, and PET proved most effective in predicting an Engel class 1 outcome (>80% accuracy). Both hippocampal volume and FLAIR signal analysis showed 76% and 69% concordance with an Engel class 1 outcome, respectively.Conclusion: Quantitative multimodal neuroimaging in the context of a putative mTLE aids in declaring laterality. The degree to which there is disagreement among the various quantitative neuroimaging metrics will judge whether epileptogenicity can be confined sufficiently to a particular temporal lobe to warrant further study and choice of therapy. Prediction models will improve with continued exploration of combined optimal neuroimaging metrics.

Is inpatient ictal video-electroencephalographic monitoring mandatory in mesial temporal lobe epilepsy with unilateral hippocampal sclerosis? A prospective study

Epilepsia ◽  
2017 ◽  
Vol 59 (2) ◽  
pp. 410-419 ◽  
Author(s):  
Marina K. M. Alvim ◽  
Marcia E. Morita ◽  
Clarissa L. Yasuda ◽  
Benito P. Damasceno ◽  
Tátila M. Lopes ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Prospective Study ◽  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Mesial Temporal Lobe ◽  
A Prospective Study

scholarly journals Mesial temporal lobe epilepsy: long-term seizure outcome of patients primarily treated with transsylvian selective amygdalohippocampectomy

2018 ◽  
Vol 129 (1) ◽  
pp. 174-181 ◽  
Author(s):  
Christian Dorfer ◽  
Thomas Czech ◽  
Susanne Aull-Watschinger ◽  
Christoph Baumgartner ◽  
Rebekka Jung ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Class I ◽  
Seizure Outcome ◽  
Selective Amygdalohippocampectomy ◽  
Class 1 ◽  
Mesial Temporal Lobe

OBJECTIVEThe aim of this study was to present long-term seizure outcome data in a consecutive series of patients with refractory mesial temporal lobe epilepsy primarily treated with transsylvian selective amygdalohippocampectomy (SAHE).METHODSThe authors retrospectively analyzed prospectively collected data for all patients who had undergone resective surgery for medically refractory epilepsy at their institution between July 1994 and December 2014. Seizure outcome was assessed according to the International League Against Epilepsy (ILAE) and the Engel classifications.RESULTSThe authors performed an SAHE in 158 patients (78 males, 80 females; 73 right side, 85 left side) with a mean age of 37.1 ± 10.0 years at surgery. Four patients lost to follow-up and 1 patient who committed suicide were excluded from analysis. The mean follow-up period was 9.7 years. At the last available follow-up (or before reoperation), 68 patients (44.4%) had achieved an outcome classified as ILAE Class 1a, 46 patients (30.1%) Class 1, 6 patients (3.9%) Class 2, 16 patients (10.4%) Class 3, 15 patients (9.8%) Class 4, and 2 patients (1.3%) Class 5. These outcomes correspond to Engel Class I in 78.4% of the patients, Engel Class II in 10.5%, Engel Class III in 8.5%, and Engel Class IV in 2.0%. Eleven patients underwent a second surgery (anterior temporal lobectomy) after a mean of 4.4 years from the SAHE (left side in 6 patients, right side in 5). Eight (72.7%) of these 11 patients achieved seizure freedom.The overall ILEA seizure outcome since (re)operation after a mean follow-up of 10.0 years was Class 1a in 72 patients (47.0%), Class 1 in 50 patients (32.6%), Class 2 in 7 patients (4.6%), Class 3 in 15 patients (9.8%), Class 4 in 8 patients (5.2%), and Class 5 in 1 patient (0.6%). These outcomes correspond to an Engel Class I outcome in 84.3% of the patients.CONCLUSIONSA satisfactory long-term seizure outcome following transsylvian SAHE was demonstrated in a selected group of patients with refractory temporal lobe epilepsy.

The Prognostic Significance of Interictal Epileptiform Activity in Postoperative EEGs of Patients with Mesial Temporal Lobe Epilepsy

2007 ◽  
Vol 38 (3) ◽  
pp. 137-142 ◽  
Author(s):  
Svetlana Kipervasser ◽  
Sari Nagar ◽  
Vladimir Chistik ◽  
Uri Kramer ◽  
Itzhak Fried ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epileptiform Activity ◽  
Prognostic Significance ◽  
Mesial Temporal Lobe Epilepsy ◽  
Seizure Recurrence ◽  
Group 3 ◽  
Mesial Temporal Lobe ◽  
Eeg Recordings ◽  
A Prospective Study

It has not been established whether electroencephalography (EEG) is a contributing factor in predicting the outcome of surgery for epilepsy. We conducted a prospective study on 26 patients (M/F 14/12, age: 33 ± 7.5 years, range 19–48) with mesial temporal lobe epilepsy (MTLE) who were followed for 2 years after surgery and who underwent routine EEG recordings 5.6 ± 3 months (range 3–12) postoperatively. Interictal epileptiform activity (IEA) on the EEG was compared in 17 seizure-free patients to 9 patients with recurrent seizures. The two groups were similar in gender, age, febrile convulsions, trauma, family history, seizure frequency prior to surgery, epilepsy duration and number of antiepileptic drugs. Following surgery, 17 study patients (65%) became seizure free; 9 (35%) had seizure recurrence. Postoperative EEG recordings showed IEA in 8/26 study patients (31%), 3 of whom were from the seizure-free group (3/17, 18%); 5 had seizure recurrence (5/9, 56%) (p=0.078). IEAs in postoperative EEGs were less frequently demonstrated in patients who were seizure free, but the presence of postoperative IEAs does not preclude successful surgical outcome.

scholarly journals P.012 Post-operative hippocampal volume changes on magnetic resonance volumetry in patients with mesial temporal lobe epilepsy

2018 ◽  
Vol 45 (s2) ◽  
pp. S18-S18
Author(s):  
K Iida ◽  
J Katayama ◽  
K Kagawa ◽  
M Katagiri ◽  
G Seyama ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Hippocampal Volume ◽  
Mesial Temporal Lobe Epilepsy ◽  
Seizure Freedom ◽  
Age At Surgery ◽  
Before And After ◽  
Mesial Temporal Lobe ◽  
Serial Mri

Background: We evaluate long-term post-operative hippocampal volume (HV) on non-epileptic hippocampus using MR volumetry as well as the neuropsychological outcome in patients with surgery for unilateral mesial temporal lobe epilepsy (MTLE) and achieved seizure-freedom. Methods: We studied 1.5-Tesla MRI before and after epilepsy surgery in 24 patients with MTLE. Serial MRI studies were scheduled at 4 post-operative consecutive periods; 6m-1y; 1-2y; 2-3y; 3-5y. We compared neuropsychological outcomes for memory and estimated IQ at the same periods with serial MRI up to 3 years. Results: The pre-operative non-epileptic HV was significantly smaller than HV in age-matched controls (n=14) (p<0.05). The HV became progressively atrophic after the surgery (p<0.05), correlating with the age at surgery (p<0.05) and pre-operative larger non-epileptic HV (p<0.05), but not with seizure duration. In 14 patients with non-dominant MTLE, the smaller dominant HV at 2-3y period correlated with decline of verbal memory (p<0.05). Conclusions: Post-operative progression of non-epileptic hippocampal atrophy was found with significantly more pronounce in patients with older age at surgery and larger pre-operative non-epileptic hippocampus. After the epileptogenic hippocampus is resected, the remaining hippocampus alone might exhaust to maintain the memory, especially in elders.

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