Cerebellar atrophy and prognosis after temporal lobe resection.

Specht, Ulrich; May, Theodor W.; Schulz, Reinhard; Rohde, Mathias; Ebner, Alois; Schmidt, Robert; Schütz, Matthias; Wolf, Peter

doi:10.1136/jnnp.62.5.501

Cited by 60 publications

(65 citation statements)

References 33 publications

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“…25 Moreover, total cerebellectomy increased the seizure length in a study of kindled cats, and there was an association between the cerebellar volume reduction and poorer seizure control following anterior temporal lobectomy in patients with temporal lobe epilepsy. 26 Conversely, the decreased AEDs efficacy may have produced cerebellar dysfunction, resulting in cerebellar volume reduction and impaired pursuit eye movements. Prolonged seizures could evoke hypoxic-ischemic injury in the cerebellum.…”

Section: Discussionmentioning

confidence: 99%

Can pursuit eye movements reflect the efficacy of antiepileptic drugs?

Kim

Park

2017

Ann Clin Neurophysiol

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Background:We evaluated whether eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy. Methods: Thirty patients with epilepsy of unknown cause as well as age-and sex-matched normal controls were enrolled in this study. We divided the patients into drug-controlled epilepsy (n = 22) and drug-resistant epilepsy (n = 8) groups according to their seizure controls. We analyzed the differences in the parameters of the eye movements in these two groups compared with normal controls using video-based electro-oculography. In addition, we investigated the differences in the cerebellar volumes of these two groups using whole-brain T1-weighted images. Results: The latency and accuracy of saccade in patients with epilepsy were significantly different from normal controls, but they were not different between patients with drug-controlled epilepsy and drug-resistant epilepsy. However, the gain of pursuit was significantly decreased in patients with drug-resistant epilepsy compared with normal controls (p = 0.0010), whereas it was not different between patients with drug-controlled epilepsy and normal controls (p = 0.9646). In addition, the patients with drug-resistant epilepsy had lower cerebellar volumes than normal controls (p = 0.0052), whereas the cerebellar volumes in patients with drug-controlled epilepsy were not different from normal controls (p = 0.5050). Conclusions: We demonstrated that pursuit eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy, a finding that may be related to cerebellar dysfunction.

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Section: Discussionmentioning

confidence: 99%

Can pursuit eye movements reflect the efficacy of antiepileptic drugs?

Kim

Park

2017

Ann Clin Neurophysiol

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“…Cerebellar atrophy is a common finding in people suffering from epilepsy, including temporal lobe epilepsy [42][43][44] , the most common form of partial epilepsy 45 and the commonest form of drug-refractory epilepsy 42 . Although the precise mechanisms are still debated, cerebellar volume reduction in people with epilepsy is often attributed to age, presence of generalized tonic-clonic seizures, duration of epilepsy, antiepileptic medication, or the seizure activity itself [42][43][44]46,47 .…”

Section: Cerebellar and Autonomic Processmentioning

confidence: 99%

“…Although the precise mechanisms are still debated, cerebellar volume reduction in people with epilepsy is often attributed to age, presence of generalized tonic-clonic seizures, duration of epilepsy, antiepileptic medication, or the seizure activity itself [42][43][44]46,47 . Specht and colleagues demonstrated in 1997 that cerebellar atrophy diagnosed by MRI was a frequent finding in surgically treated patients with temporal lobe epilepsy 44 , and concluded that increased age, presence of generalized seizures, and intellectual disability were the principal factors associated with cerebellar volume losses in their patients 44 . Botez and co-workers studied 134 adult patients with epilepsy using high-resolution CT scans, and found a higher incidence of cerebellar atrophy with longer duration of epilepsy and treatment with phenytoin 48 .…”

Section: Cerebellar and Autonomic Processmentioning

confidence: 99%

“…Botez and co-workers studied 134 adult patients with epilepsy using high-resolution CT scans, and found a higher incidence of cerebellar atrophy with longer duration of epilepsy and treatment with phenytoin 48 . Convincing evidence exists that prolonged phenytoin use, or a single episode of phenytoin intoxication can elicit severe and irreversible cerebellar atrophy 42,44,49,50 . Although chronic cerebellar stimulation suggests an inhibitory role for the cerebellum as an intervention for intractable seizures, cerebellar volume reduction may reduce these effects in patients with chronic epilepsy 42,44,51 .…”

Section: Cerebellar and Autonomic Processmentioning

confidence: 99%

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Sudden death in a child with epilepsy: potential cerebellar mechanisms?

Arida

Sakamoto

Harper

2011

Arq. Neuro-Psiquiatr.

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Epilepsy is the most common neurological disorder in humans. People with epilepsy are more likely to die prematurely than those without epilepsy, with the most common epilepsy-related category of death being sudden unexpected death in epilepsy (SUDEP). The central mechanisms underlying the fatal process remain unclear, but cardiac and respiratory mechanisms appear to be involved. Recently, cerebellar, thalamic, basal ganglia and limbic brain structures have been shown to be implicated in respiratory and cardiac rate regulation. We discuss here the potential mechanisms underlying the fatal process, with a description of cerebellar actions likely failing in that SUDEP process. Key words: SUDEP, epilepsy, cerebellum, respiratory mechanisms, seizures.Morte súbita em uma criança com epilepsia: potenciais mecanismos cerebelares? RESUMO Epilepsia é uma das doenças neurológicas mais comuns em seres humanos. Pessoas com epilepsia têm maior chance de morrer prematuramente do que pessoas sem epilepsia, sendo a principal causa de óbito a morte súbita em epilepsia (SUDEP). Os mecanismos centrais envolvidos neste processo fatal não são claros, mas mecanismos cardíacos e respiratórios parecem estar envolvidos. Recentemente, regiões cerebrais como o cerebelo, núcleos talâmicos, gânglios basais e estruturas límbicas foram relacionadas com a variação das frequências cardíaca e respiratória. Aqui, discutiremos potenciais mecanismos envolvidos na SUDEP, com uma descrição do possível papel do cerebelo na sua ocorrência. Palavras-chave: SUDEP, epilepsia, cerebelo, mecanismos respiratórios e crises.

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“…[19][20][21][22][23][24][25][26][27][28][29][30][31] The cerebellar dimensions obtained in the study will be useful in clinical practice by making it possible to assess a decrease in cerebellum dimensions on radiological images between the ages of 0 and 4 years, when the cerebellum is still growing, and will also be applicable for the standardization of measurement values. The purpose of this study was therefore to obtain a database suitable for clinical use by performing cerebellar development dimension measurements in normal individuals aged 0-4 years.…”

Section: Assessment Of Cerebellar Dimensions Usingmentioning

confidence: 99%

Assessment of Cerebellar Dimensions Using Magnetic Resonance Imaging in Children Aged 0-4 Years

Ayhan¹,

Yeğinoğlu²,

Kul³

2015

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Several diseases progress with cerebellar atrophy and hypoplasia. Cerebellum dimension measurements facilitating the assessment of decreases in cerebellum size on radiological images between the ages of 0 and 4 years in particular, when the cerebellum is still growing, will be of considerable use in clinical practice and appropriate for measurement value standardization. This will allow easier interpretetation of findings, together with more accurate diagnosis or a decrease in delays caused by false diagnosis. This study, the purpose of which was to obtain a database suitable for clinical use by performing cerebellar development dimension measurements in normal individuals aged 0-4 years, investigated the effect on cerebellar dimensions of parameters such as height, weight, head circumference and birth week. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : One hundred fourty children aged 0-4 years, 56 girls and 84 boys, undergoing magnetic resonance imaging of the brain at the Karadeniz Technical University Farabi Hospital Radiology Department with no structural cerebral or cerebellar abnormalities were included in the study. R Re es su ul lt ts s: : In this study of cerebellar dimensions in healthy children, these were positively correlated with weight, head circumference and height in both genders. Preterm birth had a significant effect on cerebellar dimensions. C Co on nc cl lu us si io on n: : In conclusion, this scale developed by measuring the cerebellar dimensions of healthy children aged 0-4 years will be of considerable practical assistance in terms of assessing measurements performed in a clinical environment. K Ke ey y W Wo or rd ds s: : Magnetic resonance imaging; child Ö ÖZ ZE ET T A Am ma aç ç: : Serebellumun atrofisi ve hipoplazisi ile giden birçok hastalık mevcuttur. Özellikle serebellumun büyümeye devam ettiği 0-4 yaş arasında radyolojik görüntülerde serebellum boyutlarındaki azalmanın değerlendirilebilmesi için serebellum boyutlarının ölçümleri, klinikte pratik olarak yararlı olacak ve ölçüm değerlerinin standardizasyonu için uygun olacaktır. Böylece bulguların daha kolay tanımlanabileceği ve doğru tanı konulamaması ya da tanı konulmasındaki gecikmelerin azalacağı öngörülmektedir. Bu nedenle 0-4 yaş arası normal bireylerde serebellum gelişimi boyut ölçümleri ile yaparak klinik kullanıma uygun bir veri dökümü elde etmeyi amaçladığımız bu çalışmada boy, kilo, baş çevresi, doğum haftası gibi parametrelerin serebellum boyutları üzerine etkilerini de değerlendirdik. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Araştırmaya Karadeniz Teknik Üniversitesi Radyoloji Bölümünde beyin manyetik rezonans görüntülemesi yapılan ve serebral ve serebellum anomalisi olmayan 0-4 yaş arasındaki 56 kız, 84 erkek çocuk dahil edilmiştir. B Bu ul lg gu ul la ar r: : Sağlıklı ço-cuklarda serebellum boyutlarını saptadığımız bu çalışmada, serebellum boyutlarının her iki cinsiyette boy, kilo ve baş çevresi ile pozitif korelasyon olduğu ve erken do...

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Cerebellar atrophy and prognosis after temporal lobe resection.

Cited by 60 publications

References 33 publications

Can pursuit eye movements reflect the efficacy of antiepileptic drugs?

Can pursuit eye movements reflect the efficacy of antiepileptic drugs?

Sudden death in a child with epilepsy: potential cerebellar mechanisms?

Assessment of Cerebellar Dimensions Using Magnetic Resonance Imaging in Children Aged 0-4 Years

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