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Thomas Sauvigny, Katja Brückner, Lasse Dührsen, Oliver Heese, Manfred Westphal, Stefan R G Stodieck, Tobias Martens
OBJECTIVE: Selective amygdalohippocampectomy (sAHE) is a well-established treatment for temporal lobe epilepsy, commonly with favorable neuropsychological outcome. Yet, it is still unknown if subsequent resection of the anteromesial temporal lobe (AMTLR), when necessary, deteriorates neuropsychological performance in this selected group of patients. Thus, we evaluated the clinical and neuropsychological data of patients who, due to insufficient seizure control after sAHE, received a subsequent ipsilateral AMTLR and compared these findings with patients who did not receive a second resection (control group)...
September 28, 2016: Epilepsia
F Irsel Tezer, Farid Xasiyev, Figen Soylemezoglu, Burcak Bilginer, Kader Karli Oguz, Serap Saygi
BACKGROUND: Hippocampal sclerosis (HS) is a common pathology in MTLE, patients may show different surgical outcomes and clinical features. The 2013 ILAE classification subdivides HS into 3 types (HS type 1: severe neuronal loss and gliosis predominantly in CA1 and CA4 regions; - HS type 2: CA1 predominant; HS type 3: CA4 predominant) and includes "gliosis only, as no-HS". The association of clinical and electrophysiological findings with different HS types has not been reported previously in detail...
August 16, 2016: Epilepsy Research
Takuma Higo, Hidenori Sugano, Madoka Nakajima, Kostadin Karagiozov, Yasushi Iimura, Masaru Suzuki, Kiyoshi Sato, Hajime Arai
PURPOSE: We retrospectively evaluated the diagnostic value of (18)F-2-fluorodeoxy-d-glucose positron emission tomography (FDG-PET) with statistical analysis for the foci detection and predictive utility for postsurgical seizure outcome of patients with mesial temporal lobe epilepsy (mTLE). METHOD: We evaluated 40 patients who were diagnosed mTLE and underwent selective amygdalohippocampectomy (SAH) or anterior temporal lobectomy (ATL) in our institute. Preoperative interictal FDG-PET with statistical analysis using three-dimensional stereotactic surface projection (3D-SSP) was detected with several clinical data including seizure semiology, MRI, scalp electroencephalography, surgical procedure with SAH or ATL and postsurgical outcome...
October 2016: Seizure: the Journal of the British Epilepsy Association
Baran Bozkurt, Ricardo da Silva Centeno, Feres Chaddad-Neto, Marcos Devanir Silva da Costa, Marcelo Augusto Acosta Goiri, Ali Karadag, Bekir Tugcu, Talat Cem Ovalioglu, Necmettin Tanriover, Serdar Kaya, Kaan Yagmurlu, Andrew Grande
The anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SelAH) have been used for surgical treatment of mesial temporal lobe epilepsy. We examined the comprehensive white matter tract anatomy of the temporal lobe to gain an insight into the trans-middle temporal gyrus, a lateral approach which has been commonly used. The transmiddle temporal gyrus approach was performed in a stepwise manner on cadaveric human heads to examine the traversing white matter pathways through it and the structures located in the temporal horn...
August 4, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Taylor J Abel, Royce Woodroffe, Toshio Moritani, Patricia Kirby, Matthew A Howard, Hiroto Kawasaki, Mary Ann Werz
INTRODUCTION: A convergence of clinical research suggests that the temporal pole (TP) plays an important, and potentially underappreciated, role in the genesis and propagation of seizures in temporal lobe epilepsy (TLE). Understanding the role of the TP in TLE is becoming increasingly important because selective surgical resections for medically intractable TLE spare TP cortex. The purpose of this study is to characterize the role of temporopolar cortex in TLE using dense electrocorticographic (ECoG) recordings of the TP in patients undergoing invasive monitoring for medically intractable TLE...
August 2016: Neurosurgery
Cameron A Elliott, Donald W Gross, B Matt Wheatley, Christian Beaulieu, Tejas Sankar
OBJECTIVE: Determine the extent and time course of volumetric changes in the contralateral hippocampus following surgery for medically refractory temporal lobe epilepsy (TLE). METHODS: Serial T1-weighted MRI brain scans were obtained in 26 TLE patients pre- and post-temporal lobe epilepsy surgery as well as in 12 control subjects of similar age. Patients underwent either anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SAH). Blinded, manual hippocampal volumetry (head, body, and tail) was performed in two groups: 1) two scan group [ATL (n=6); SAH (n=10)], imaged pre-surgery and on average at 5...
September 2016: Epilepsy Research
Shantala Hegde, Rose Dawn Bharath, Malla Bhaskara Rao, Karthik Shiva, Arivazhagan Arimappamagan, Sanjib Sinha, Jamuna Rajeswaran, Parthasarathy Satishchandra
Mesial temporal lobe epilepsy (TLE) affects a range of cognitive functions and musical abilities. We report a 16-year-old boy diagnosed with drug-resistant right-medial TLE. He is a professional musician, trained in Carnatic classical music. Clinical, electrophysiological, magnetic resonance imaging (MRI) and positron emission tomography evaluation localized the seizure focus to the right medial temporal lobe. Patient underwent detailed neuropsychological evaluation and functional MRI (fMRI) for musical abilities prior to surgery...
July 1, 2016: Neurocase
Abigail P McCallum, Matthew J Gallek, Wyatt Ramey, Ann Manziello, Marlys H Witte, Michael J Bernas, David M Labiner, Martin E Weinand
INTRODUCTION: Despite being one of the most common neurological diseases, it is unknown whether there may be a genetic basis to temporal lobe epilepsy (TLE). Whole genome analyses were performed to test the hypothesis that temporal cortical gene expression differs between TLE patients with high vs. low baseline seizure frequency. METHODS: Baseline seizure frequency was used as a clinical measure of epileptogenicity. Twenty-four patients in high or low seizure frequency groups (median seizures/month) underwent anterior temporal lobectomy with amygdalohippocampectomy for intractable TLE...
September 2016: Pathophysiology: the Official Journal of the International Society for Pathophysiology
Aparna Banerjee Dixit, Jyotirmoy Banerjee, Abuzar Ansari, Manjari Tripathi, Sarat P Chandra
AIM: This study is focused on GABRG2 gene sequence variations in patients with mesial temporal lobe epilepsy (mTLE). The GABAAreceptor is a heteropentameric receptor and alpha-1 beta-2 gamma-2 subunits combination is most abundant and present in almost all regions of the brain. The gamma-2 subunit (GABRG2) gene mutations have been reported in different epilepsy pathologies. In the present study we have looked for GABRG2 gene sequence variations in patients with mTLE. MATERIALS AND METHODS: Twenty patients (12 females and eight males, age 4...
April 2016: Annals of Indian Academy of Neurology
Daniel Delev, Bettina Wabbels, Johannes Schramm, Michael Nelles, Christian E Elger, Marec von Lehe, Hans Clusmann, Alexander Grote
BACKGROUND: Selective amygdalohippocampectomy (SAH) is an accepted surgical procedure for treatment of pharmacoresistant mesial temporal lobe epilepsy, but it may lead to postoperative visual field deficits (VFDs). Here we present a prospective randomised trial comparing the postoperative VFDs after either a trans-sylvian or temporobasal approach for SAH. METHOD: Forty-eight patients were randomly assigned to trans-sylvian (n = 24) or temporobasal (n = 24) SAH...
September 2016: Acta Neurochirurgica
Aditya Vedantam, Daniel Hansen, Bradley Daniels, Sandi Lam
The authors report an unusual case of acute, rapidly progressive, unilateral neck swelling following extubation after elective left anterior temporal lobectomy with amygdalohippocampectomy. Due to severe neck swelling, the patient developed critical airway compromise, brachial plexopathy, and Horner's syndrome. After critical airway management and appropriate rehabilitation, the patient recovered completely and remains seizure free at 1.5 years of follow-up. This case highlights the importance of early recognition of acute postoperative sialadenitis and the steps needed to prevent serious morbidity and possible mortality from this rare complication...
October 2016: Journal of Neurosurgery. Pediatrics
Matthew J Gallek, Jesse Skoch, Tracy Ansay, Mandana Behbahani, David Mount, Ann Manziello, Marlys Witte, Michael Bernas, David M Labiner, Martin E Weinand
Whole genome analyses were performed to test the hypothesis that temporal cortical gene expression differs between epilepsy patients rendered seizure-free versus non-seizure-free following anterior temporal lobectomy with amygdalohippocampectomy (ATL/AH). Twenty four patients underwent ATL/AH to treat medically intractable seizures of temporal lobe origin (mean age 35.5 years, mean follow-up 42.2 months); they were then dichotomized into seizure-free and non-seizure-free groups. Tissue RNA was isolated from the lateral temporal cortex and gene expression analysis was performed...
June 2, 2016: Neurogenetics
Kristin S Golombeck, Kathrin Bönte, Constanze Mönig, Karen M van Loo, Marvin Hartwig, Wolfram Schwindt, Guido Widman, Matthias Lindenau, Albert J Becker, Markus Glatzel, Christian E Elger, Heinz Wiendl, Sven G Meuth, Hubertus Lohmann, Catharina C Gross, Nico Melzer
OBJECTIVES: To characterize the cellular autoimmune response in patients with γ-aminobutyric acid (GABA)B receptor antibody-associated limbic encephalitis (GABAB-R LE). METHODS: Patients underwent MRI, extensive neuropsychological assessment, and multiparameter flow cytometry of peripheral blood and CSF. RESULTS: We identified a series of 3 cases of nonparaneoplastic GABAB-R LE and one case of paraneoplastic GABAB-R LE associated with small cell lung cancer...
June 2016: Neurology® Neuroimmunology & Neuroinflammation
Su Hyun Han, Eun Mi Lee, Eun Ju Choi, Han Uk Ryu, Joong Koo Kang, Jong Woo Chung
BACKGROUND AND PURPOSE: This study aimed to determine the effects of anterior temporal lobectomy with amygdalohippocampectomy (ATL-AH) on central auditory processing (CAP) in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE-HS), and to identify factors that may contribute to the postoperative worsening of CAP. METHODS: Frequency-pattern, duration-pattern, and dichotic tests were performed before and after epilepsy surgery in 22 patients with normal hearing according to pure-tone audiometry...
April 2016: Journal of Clinical Neurology
D N Okishev, O B Belousova, O D Shekhtman, Sh Sh Eliava, O B Sazonova, D N Kopachev
BACKGROUND: In some cases, single-stage or delayed amygdalohippocampectomy (AHE) can be used for effective treatment of epileptic syndrome upon resection of temporal lobe cavernomas. The efficacy of AHE in treatment of temporal epilepsies is proved in general; however, the indications for surgery in patients with cavernomas are not developed. OBJECTIVE: The study objective was to evaluate the efficacy and safety AHE in the treatment of epilepsy in patients with temporal lobe cavernomas and to define the indications for surgery...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Naotaka Usui
This article reviews the current topics in the field of epilepsy surgery. Each type of epilepsy is associated with a different set of questions and goals. In mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS), postoperative seizure outcome is satisfactory. A recent meta-analysis revealed superior seizure outcome after anterior temporal lobectomy compared with selective amygdalohippocampectomy; in terms of cognitive outcome; however, amygdalohippocampectomy may be beneficial. In temporal lobe epilepsy with normal magnetic resonance imaging (MRI), postoperative seizure outcome is not as favorable as it is in MTLE with HS; further improvement of seizure outcome in these cases is necessary...
May 15, 2016: Neurologia Medico-chirurgica
Bawarjan Schatlo, Max Jägersberg, Gerhard Paass, Rupert Faltermeier, Jörg Streich, Bernhard Meyer, Karl Schaller
OBJECTIVE: The aim of this study was to assess (1) whether vasoreactivity is altered in patients with epilepsy and (2) whether the two most commonly used approaches, the trans-Sylvian (TS) and the trans-cortical (TC) route, differ in their impact on cortical blood flow. METHODS: Patients were randomized to undergo selective amygdalohippocampectomy (selAH) through a TC or TS route. Before and after selAH, we recorded microcirculation parameters on the superficial cortex surrounding the surgical corridor...
2015: Neurological Research
Bertrand Mathon, Stéphane Clemenceau
BACKGROUND: Hippocampal sclerosis is the most common cause of drug-resistant epilepsy amenable for surgical treatment and seizure control. The rationale of the selective amygdalohippocampectomy is to spare cerebral tissue not included in the seizure generator. METHOD: Describe the selective amygdalohippocampectomy through the trans-superior temporal gyrus keyhole approach. CONCLUSION: Selective amygdalohippocampectomy for temporal lobe epilepsy is performed when the data (semiology, neuroimaging, electroencephalography) point to the mesial temporal structures...
April 2016: Acta Neurochirurgica
Brynn K Dredla, John A Lucas, Rober E Wharen, William O Tatum
The most effective treatment for drug-resistant seizures associated with mesial temporal lobe epilepsy (mTLE) is surgical resection. Neurocognitive sequelae may occur and are especially likely to occur after left temporal lobectomy. Smaller resections observed with selective amygdalohippocampectomy have resulted in a more favorable neurocognitive outcome in some cases when compared to standard anterior temporal lobectomy. Specifically, MRI-guided interstitial laser thermal ablation (MRgLITT) uses a superselective stereotactic amygdalohippocampotomy that has been reported to preserve object recognition and naming abilities compared with standard temporal lobe resection...
March 2016: Epilepsy & Behavior: E&B
Samia Elkommos, Bernd Weber, Pitt Niehusmann, Elisa Volmering, Mark P Richardson, Yen Y Goh, Anthony G Marson, Christian Elger, Simon S Keller
PURPOSE: Semi-quantitative analysis of hippocampal internal architecture (HIA) on MRI has been shown to be a reliable predictor of the side of seizure onset in patients with temporal lobe epilepsy (TLE). In the present study, we investigated the relationship between postoperative seizure outcome and preoperative semi-quantitative measures of HIA. METHODS: We determined HIA on high in-plane resolution preoperative T2 short tau inversion recovery MR images in 79 patients with presumed unilateral mesial TLE (mTLE) due to hippocampal sclerosis (HS) who underwent amygdalohippocampectomy and postoperative follow up...
February 2016: Seizure: the Journal of the British Epilepsy Association
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