Do auras predict seizure outcome after temporal lobe epilepsy surgery?

Radhakrishnan, Ashalatha; Menon, Ramshekhar; Chandran, Anuvitha; Thomas, Sanjeev V; Vilanilam, George C; Abraham, Mathew; Menon, Deepak; Soumya, V; Kesavadas, C.; Cherian, Ajith; Sarma, Sankara P.

doi:10.1016/j.eplepsyres.2018.08.006

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…Our study did not find prognostic value for auras in predicting postsurgical outcome. The result corroborates many previous studies, 28–31 except for those of Sperling et al 32 . and Arifin et al 33 .…”

Section: Discussionsupporting

confidence: 93%

“…Our study did not find prognostic value for auras in predicting postsurgical outcome. The result corroborates many previous studies, [28][29][30][31] except for those of Sperling et al 32 and Arifin et al 33 The former argued for favorable prognostic significance of auras for patients undergoing temporal lobectomy; however, strictly speaking, their finding did not reach statistical significance (p = 0.06), although the trend was toward a greater likelihood of being free of seizure in patients with auras than in those without auras. Similarly, the latter demonstrated occurrence of auras conveyed a favorable prognosis in TLE patients, but a baseline assessment among the two groups was not attempted, which may introduce potential confounding factors.…”

Section: Prognostic Value Of Auras and Fear Aura In Epilepsy Surgerysupporting

confidence: 91%

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The localization and lateralization of fear aura and its surgical prognostic value in patients with focal epilepsy

Cao

Tao

Wang

et al. 2022

Ann Clin Transl Neurol

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Objective Fear aura has traditionally been considered relevant to epileptic discharges from mesial temporal areas, and few studies have investigated its effect on surgical outcome in drug‐resistant epilepsy. We aim to assess the localizing and lateralizing value as well as prognostic significance of fear aura in patients with focal epilepsy. Methods The occurrence of fear aura in relation to epileptogenic origin and its association with postoperative outcome were analyzed in 146 consecutive patients undergoing resective surgery for intractable epilepsy. Results Ninety‐four (64.4%) patients reported auras, and 31 (21.2%) reported fear aura in their seizures. One hundred ten (75.3%) patients had an Engel class I outcome until last follow‐up, of whom 24 experienced fear aura preoperatively. Fear aura appeared more frequently during temporal and frontal lobe seizures, but did not lateralize the seizure onset zone. There were no significant baseline differences between patients with and without fear aura. No correlation was found between postoperative outcome and the presence of auras. Occurrence of fear aura failed to show predictive value in surgical outcome whether in pooled or subgroup analysis. Interpretation This study advances our understanding of the origin of fear aura, and is helpful for presurgical evaluation and outcome prediction. Without lateralizing value, fear aura is more commonly seen with temporal or frontal origin. When taken as a whole, auras do not have a significant impact on seizure outcome in focal epilepsy. Patients with fear aura are no more likely to become seizure‐free than those without fear aura.

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Section: Discussionsupporting

confidence: 93%

Section: Prognostic Value Of Auras and Fear Aura In Epilepsy Surgerysupporting

confidence: 91%

The localization and lateralization of fear aura and its surgical prognostic value in patients with focal epilepsy

Cao

Tao

Wang

et al. 2022

Ann Clin Transl Neurol

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“…[17] Aura sıklığı çalışmalarda değişkenlik göstermekte olup, %22-83 oranlarında bildirilmiştir. [18,19] Çalışmamızda hastaların %62.9'unda, nöbetlerin %70.2'sinde saptanmış olup, soldan iktal başlangıç gösteren hastalarda daha sıktır. Auranın varlığı lateralizasyon açısından değerli bulunmamıştır.…”

Section: Discussionunclassified

“…[21] Vertiginöz auralar her düzlemde dönme veya hareket hissi içerir, genellikle görsel veya işitsel semptomlarla ilişkilidir. [18] Kahane ve ark. [27] kortikal elektrofizyolojik çalışmalar ile parietal operkulum ve superior-orta temporal girusun orta ve arka kısmı da dahil olmak üzere sylvian fissürünün altında ve üstünde uzanan lateral kortikal temporoparietal alanda kolayca vestibüler semptomlar ortaya çıkarmışlardır.…”

Section: Discussionunclassified

“…Kişi tutarlı bir şekilde işitsel veya vertiginöz aura tanımlıyorsa, MRG'de hipokampal değişiklikler gözlense bile ekstratemporal odak için daha geniş kapsamlı bir tarama işlemi yapılması önerilmiştir. [18] Peri PİVS'lerin lateralizasyon değerinin zamansal bağlantılı olduğu ileri sürülmüştür. [8,9] Peri-iktal su içme nöbet sırasında veya nöbet sonrası iki dakika içinde ortaya çıkan bir vejetatif semptomdur.…”

Section: Discussionunclassified

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Temporal lob epilepsisinde semiyolojinin lateralizasyon değeri

Türe¹

2019

Epilepsi

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Objectives: This study aims to determine the prevalence of lateralized semiological findings in patients with temporal lobe epilepsy and to assess the contribution of relatively rare symptoms to lateralization, as well as classical lateralizing findings. Methods:The records of the 329 patients who were monitored by video-EEG for evaluation of epilepsy surgery were retrospectively reviewed in this study. The lateralization of the seizures was evaluated with ictal EEG and semiological findings. The records of 128 patients with unilateral temporal lobes were analyzed.Results: In our study, 343 seizures of the 128 patients were analyzed. Aura was identified on 241 patients (70.2%). The presence of aura was not associated with lateralization. Vertigo (p=0.02) and deja vu (p=0.04) indicated right temporal lobe in all seizures. One of the most frequently observed ictal clinical findings was oroalimenter automatism, but its presence was not significant for lateralization. Peri-ictal vegetative symptoms of ictal cough, vomiting, water drinking, hypersalivation and the urinary urge are rarely seen in the right temporal lobe-induced seizures were seen more frequently (p<0.05). Most of the ictal motor findings showed contralateral hemispheres. Clonic jerk ended the ipsilateral focus in all seizures (p=0.004). Conclusion:The presence of peri-ictal vegetative symptoms may help lateralize the epileptic focus to the right hemisphere when evaluated with other classical findings. Analysis of the seizure semiology that involves the phenomenon of lateralized seizures is a significant component of preoperative evaluation.

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