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Temporal lobectomy

Shahram Saghafi, Lisa Ferguson, Olivia Hogue, Jordan M Gales, Richard Prayson, Robyn M Busch
OBJECTIVE: The International League Against Epilepsy (ILAE) proposed a classification system for hippocampal sclerosis (HS) based on location and extent of hippocampal neuron loss. The literature debates the usefulness of this classification system when studying memory in people with temporal lobe epilepsy (TLE) and determining memory outcome after temporal lobe resection (TLR). This study further explores the relationship between HS ILAE subtypes and episodic memory performance in patients with TLE and examines memory outcomes after TLR...
March 14, 2018: Epilepsia
Firas Bannout, Sheri Harder, Michael Lee, Alexander Zouros, Ravi Raghavan, Travis Fogel, Kenneth De Los Reyes, Travis Losey
The neurosurgical treatment of skull base temporal encephalocele for patients with epilepsy is variable. We describe two adult cases of temporal lobe epilepsy (TLE) with spheno-temporal encephalocele, currently seizure-free for more than two years after anterior temporal lobectomy (ATL) and lesionectomy sparing the hippocampus without long-term intracranial electroencephalogram (EEG) monitoring. Encephaloceles were detected by magnetic resonance imaging (MRI) and confirmed by maxillofacial head computed tomography (CT) scans...
March 12, 2018: Brain Sciences
Lisa Vaugier, Stanislas Lagarde, Aileen McGonigal, Agnès Trébuchon, Mathieu Milh, Anne Lépine, Didier Scavarda, Romain Carron, Fabrice Bartolomei
Management of patients after initial epilepsy surgical failure is challenging. In this study, we report our experience in using the stereoelectroencephalography (SEEG) method in the reevaluation of patients after initial epilepsy surgical failure. We selected 28 patients examined through SEEG in our department for drug-resistant focal epilepsy following initial epilepsy surgical failure. For each patient, the residual seizure onset zone (rSOZ) as defined by SEEG was classified as either contiguous if the seizure onset zone (SOZ) was focal and close to the surgical cavity (same lobe) or noncontiguous in cases where the SOZ included site(s) distant from the surgical cavity...
March 8, 2018: Epilepsy & Behavior: E&B
Noah Sideman, Ganne Chaitanya, Xiaosong He, Gaelle Doucet, Na Young Kim, Michael R Sperling, Ashwini D Sharan, Joseph I Tracy
OBJECTIVE: In epilepsy, asymmetries in the organization of mesial temporal lobe (MTL) functions help determine the cognitive risk associated with procedures such as anterior temporal lobectomy. Past studies have investigated the change/shift in a visual episodic memory laterality index (LI) in mesial temporal lobe structures through functional magnetic resonance imaging (fMRI) task activations. Here, we examine whether underlying task-related functional connectivity (FC) is concordant with such standard fMRI laterality measures...
February 27, 2018: Epilepsy & Behavior: E&B
Joey S J Smeets, Astrid M H Horstman, Olaf E M G Schijns, Jim T A Dings, Govert Hoogland, Annemie P Gijsen, Joy P B Goessens, Freek G Bouwman, Will K W H Wodzig, Edwin C Mariman, Luc J C van Loon
All tissues undergo continuous reconditioning via the complex orchestration of changes in tissue protein synthesis and breakdown rates. Skeletal muscle tissue has been well studied in this regard, and has been shown to turnover at a rate of 1-2% per day in vivo in humans. Few data are available on protein synthesis rates of other tissues. Because of obvious limitations with regard to brain tissue sampling no study has ever measured brain protein synthesis rates in vivo in humans. Here, we applied stable isotope methodology to directly assess protein synthesis rates in neocortex and hippocampus tissue of six patients undergoing temporal lobectomy for drug-resistant temporal lobe epilepsy (Clinical trial registration: NTR5147)...
February 8, 2018: Brain: a Journal of Neurology
Ang Song Yee, John Tharakan, Zamzuri Idris, Shalini Bhaskar, Sanihah Abdul Halim, Salmi Abd Razak, Zabidi Azhar Mohd Hussin, Regunath Kandasamy, Wan Mohd Nazaruddin Wan Hassan, Laila Mukmin, Mohamad Hasyizan Hassan, Tan Yew Chin, Badrisyah Idris, Abdul Rahman Izaini Ghani, Hillol Kanti Pal, Jain George, Sani Sayuthi, Mohamed Saufi Awang, Jafri Malin Abdullah
Epilepsy surgery has been performed by a few centres in Malaysia, including Hospital Universiti Sains Malaysia (HUSM). To date, a total of 15 patients have undergone epilepsy surgery in HUSM. The epilepsy surgery included anterior temporal lobectomy (ATL) with amygdalohippocampectomy (AH) and Vagal nerve stimulation (VNS). The surgical outcomes of the patients were assessed using the International League Against Epilepsy (ILAE) outcome scale. The ILAE scores for patients who underwent ATL with AH were comparatively better than those who underwent VNS...
December 2017: Malaysian Journal of Medical Sciences: MJMS
Gonzalo Alarcón, Diego Jiménez-Jiménez, Antonio Valentín, David Martín-López
OBJECTIVES: To model cortical connections in order to characterize their oscillatory behavior and role in the generation of spontaneous electroencephalogram (EEG). METHODS: We studied averaged responses to single pulse electrical stimulation (SPES) from the non-epileptogenic hemisphere of five patients assessed with intracranial EEG who became seizure free after contralateral temporal lobectomy. Second-order control system equations were modified to characterize the systems generating a given response...
November 23, 2017: International Journal of Neural Systems
Yan-En Lyu, Xiao-Fei Xu, Shuang Dai, Xiao-Bo Dong, Shao-Ping Shen, Yao Wang, Chong Liu
BACKGROUND: Anterior temporal lobectomy (ATL) is the standard surgical treatment for temporal lobe epilepsy (TLE), but patients may suffer from recurrent seizures post-surgery. Invasive electrical monitoring plays a critical role in precisely identifying the epileptic foci. This study aimed to evaluate and compare the benefits of long-term invasive electroencephalography (EEG) monitoring and two-stage surgery with the classical approach to examine their effect on post-surgical brain function and complications...
January 19, 2018: International Journal of Surgery
Grace E Rice, Helen Caswell, Perry Moore, Paul Hoffman, Matthew A Lambon Ralph
The presence and degree of specialization between the anterior temporal lobes (ATLs) is a key issue in debates about the neural architecture of semantic memory. Here, we comprehensively assessed multiple aspects of semantic cognition in a large group of postsurgical temporal lobe epilepsy (TLE) patients with left versus right anterior temporal lobectomy (n = 40). Both subgroups showed deficits in expressive and receptive verbal semantic tasks, word and object recognition, naming and recognition of famous faces and perception of faces and emotions...
January 17, 2018: Cerebral Cortex
Julien Detour, Caroline Bund, Charles Behr, Hélène Cebula, Ercument A Cicek, Maria-Paola Valenti-Hirsch, Béatrice Lannes, Benoît Lhermitte, Astrid Nehlig, Pierre Kehrli, François Proust, Edouard Hirsch, Izzie-Jacques Namer
OBJECTIVE: Within a complex systems biology perspective, we wished to assess whether hippocampi with established neuropathological features have distinct metabolome. Apparently normal hippocampi with no signs of sclerosis (noHS), were compared to hippocampal sclerosis (HS) type 1 (HS1) and/or type 2 (HS2). Hippocampus metabolome from patients with epilepsy-associated neuroepithelial tumors (EANTs), namely, gangliogliomas (GGs) and dysembryoplastic neuroepithelial tumors (DNTs), was also compared to noHS epileptiform tissue...
January 17, 2018: Epilepsia
Aashish Jain, Dheeraj Arora, Yatin Mehta
The prevalence of epilepsy worldwide is around 0.5%-2% of the population. Antiepileptic medications are the first line of treatment in most of the cases but approximately 25%-30% epilepsy patients are refractory to the single or combination therapy. The surgical option for temporal lobe epilepsy is temporal lobectomy, which has its inherent risk of neurological deficits after the surgery. Patients who are either refractory to combination therapy or do not want surgical temporal lobectomy are the candidates for electrical stimulation therapy...
January 2018: Annals of Cardiac Anaesthesia
Cameron A Elliott, Donald W Gross, B Matt Wheatley, Christian Beaulieu, Tejas Sankar
OBJECTIVES: 1) Characterize the evolution of microstructural changes in the contralateral, non-operated hippocampus-using longitudinal diffusion tensor imaging (DTI)-following surgery for temporal lobe epilepsy (TLE). 2) Characterize the downstream extra-hippocampal volumetric changes of the fornix and mammillary bodies after TLE surgery. 3) Examine the relationship between these measures and seizure/cognitive outcome. METHODS: Serial structural and DTI brain MRI scans were collected in 25 TLE patients pre- and post-surgery (anterior temporal lobectomy, ATL - 13; selective amygdalohippocampectomy, SelAH - 12) and in 12 healthy controls...
February 2018: Epilepsy Research
Ashalatha Radhakrishnan, Ramshekhar Menon, Mathew Abraham, George Vilanilam, Suvasini Sharma, Bejoy Thomas, Chandrashekharan Kesavadas, Ajith Cherian, Raviprasad Varma, Sanjeev V Thomas
PURPOSE: To determine the factors predicting seizure outcome in children who underwent anterior temporal lobectomy (ATL) for drug-resistant temporal lobe epilepsy (TLE). METHODS: Among the 664 patients who underwent ATL for TLE from 1995 to 2008, there were 134 children. "Excellent" outcome in them was defined as seizure freedom during the entire follow-up (Engel class I a); "good outcome", if in remission last 2 years, and the rest as "unfavorable outcome". To identify the potential predictors of seizure recurrence, the attributes of recurred and non-recurred groups was compared by univariate and multivariate analysis...
January 2, 2018: Epilepsy Research
Young Min Park, Kyung Ho Oh, Jae-Gu Cho, Seung-Kuk Baek, Soon-Young Kwon, Kwang-Yoon Jung, Jeong-Soo Woo
OBJECTIVE: We analyzed the changes in voice- and swallowing-related symptoms that occurred over time in patients who underwent thyroidectomy and identified any associated risk factors. METHODS: One hundred and three patients who underwent thyroidectomy were enrolled. RESULTS: The mean thyroidectomy voice-related questionnaire (TVQ) score before surgery was 12.41 ± 12.19; it significantly increased to 28.24 ± 18.01 ( P < .001) 1 month postoperatively, decreased to 24...
January 1, 2018: Annals of Otology, Rhinology, and Laryngology
X Y Tai, B Bernhardt, M Thom, P Thompson, S Baxendale, M Koepp, N Bernasconi
Cognitive decline is increasingly described as a co-morbidity of temporal lobe epilepsy (TLE). Mechanisms underlying cognitive impairment are not fully understood despite examining clinical factors, such as seizure frequency, and cellular mechanisms of excitotoxicity. We review the neuropsychometry evidence for progressive cognitive decline and examine the pathology and neuroimaging evidence supporting a neurodegenerative process in hippocampal sclerosis (HS)-related TLE. Accelerated cognitive decline is described in groups of adult HS-related TLE patients...
December 30, 2017: Neuropathology and Applied Neurobiology
Mary K Morris, Dawn Bowers, John Williamson, Kenneth M Heilman
To learn if a right temporal lobectomy altered a patient's autonomic and cognitive responses to aversive and appetitive pictures, we investigated a man whose right anterior temporal lobe and amygdala had been resected to remove an arteriovenous malformation. This patient revealed unusually low self-reports of arousal with a lack of heightened skin conductance responses to aversive pictures. For pleasant pictures, his self-reports of arousal and his physiological responses were similar to healthy men. This patient's responses are consistent with a bivalent model of emotional processing, with a right temporal lobectomy compromising the activation of his defensive action response system...
December 20, 2017: Neurocase
Mario Arturo Alonso-Vanegas, Iván D Freire Carlier, Daniel San-Juan, Alma Rosa Martínez, Carlos Trenado
BACKGROUND AND OBJECTIVE: The parahippocampal gyrus plays an important role in the epileptogenic pathways of mesial temporal lobe epilepsy caused by hippocampal sclerosis (mTLE-HS); its resection could prevent epileptic seizures with fewer complications. This study evaluates the initial efficacy and safety of anterior temporal lobectomy (ATL), selective amygdalohipppocampectomy (SAH), and parahippocampectomy (PHC) surgical approaches in mTLE-HS. METHODS: A randomized comparative pilot clinical trial (2008-2011) was performed that included patients with mTLE-HS who underwent ATL, trans-T3 SAH, and trans-T3 PHC...
February 2018: World Neurosurgery
Jerzy P Szaflarski
No abstract text is available yet for this article.
September 2017: Epilepsy Currents
Fady Girgis, Madeline E Greil, Philip S Fastenau, Jennifer Sweet, Hans Lüders, Jonathan P Miller
BACKGROUND: Multiple hippocampal transection (MHT) is a surgical treatment for mesial temporal lobe epilepsy associated with improved postoperative neuropsychological outcomes compared with lobectomy. OBJECTIVE: To determine whether resection of the amygdala and anterior temporal neocortex during MHT affects postoperative seizure/memory outcome. METHODS: Seventeen patients with normal magnetic resonance imaging and stereo-electroencephalogram-proven drug-resistant dominant mesial temporal lobe epilepsy were treated with MHT...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
José D Carrillo-Ruiz, Pablo Andrade, Mary Fonseca, Fiacro Jiménez, María L Montes-Castillo, Francisco Velasco
Background: Neurotomies were one of the first procedures performed in the field of functional neurosurgery. Microstimulators and microscopes facilitate the performance of neurotomies to treat focal spasticity. This report shows how three different consecutive neurotomies were performed in one patient with chronic left upper/lower extremity spasticity. Case Description: A 65-year-old male with intractable epilepsy underwent a right temporal lobectomy for seizure control...
2017: Surgical Neurology International
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