Contradictory imaging and EEG results in resection surgery of bitemporal lobe epilepsy: A case report

Abstract

The present study describes the case of a 27-year-old, right-handed female with bilateral mesial temporal lobe epilepsy. Electroencephalogram (EEG) monitoring from implanted electrodes displayed two different and independent onsets on the two sides of the mesial temporal structures, which specifically included clinical generalized tonic clonic seizure (GTCS) discharges originating from the left mesial temporal lobe, as well as complex partial seizure (CPS) discharges arising from the right mesial region. However, fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) showed a unilateral abnormality, as in right mesial temporal lobe sclerosis. A decision was made to resect one side of the mesial temporal lobe, in order to avoid memory function impairment, and, relying on the MRI results, the right side was selected. However, surgery did not leave the patient seizure-free. The CPSs gradually eased, while the GTCSs originating from the left side became severely aggravated. In describing this case, the drawbacks of current epileptic diagnostic methods and surgical strategies for bitemporal lobe epilepsy are discussed, and the requirement for more treatment options is emphasized.

Bitemporal epilepsy: A specific anatomo-electro-clinical phenotype in the temporal lobe epilepsy spectrum

“…Except for points 1 and 2, which have never been reported before, these findings are in agreement with those of earlier studies [11,14,36]. Moreover, histopathology showed that only two of our four surgically treated BTLE patients had FCD, and other studies have found that the main histological finding in BTLE is HS [8,37], and have only infrequently described FCD or other focal lesions. All of these data indicate that the etiologies commonly observed in UTLE patients are less probable, or at least differently expressed, in patients with BTLE, thus leading to a distinct anatomo-electroclinical phenotype.…”

“…Some have indicated good surgical outcomes [8,10,12,40], but others have found unfavourable outcomes [9,11,14,41] and even a worsening after surgery [37]. On the basis of the data relating to our few patients who underwent surgery, patients with BTLE are not good candidates for resection, and probably account for a large proportion of poor TLE surgery outcomes.…”

Association of Electroencephalography (EEG) Power Spectra with Corneal Nerve Fiber Injury in Retinoblastoma Patients

“…The EEG method of prognosis used in this study agrees with previous reports on use of the corneal nerve for disease diagnosis and prognosis [ 13 – 15 ]. However, using EEG to diagnose corneal nerve injury in retinoblastoma patients has not been explored in previous studies.…”

Anticonvulsant effect of piperine ameliorates memory impairment, inflammation and oxidative stress in a rat model of pilocarpine-induced epilepsy

“…Epilepsy is a chronic neurological disorder caused by the repeated and excessive abnormal electrical impulses of brain neurons (1). The prevalence of epilepsy in the global population is ~5%, with up to 10 million patients with epilepsy in China alone (15).…”

“…Epilepsy is a neurological disease, and usually refers to a chronic disease with various recurrent clinical manifestations, resulting from the sudden abnormal electrical impulses of neurons in the brain (1). Refractory epilepsy, also known as intractable epilepsy, refers to epilepsy occurring multiple times each month and persists for >2 years, with no improvement observed with regular treatment (2).…”