Evidence of Secondary Epileptogenesis in Amygdaloid Overkindled Cats: Electroclinical Documentation of Spontaneous Seizures

Hiyoshi, Toshio; Seino, Masakazu; Kakegawa, N; Higashi, Takushi; Yagi, Kazuichi; Wada, Juhn A.

doi:10.1111/j.1528-1157.1993.tb02580.x

Cited by 28 publications

(25 citation statements)

References 20 publications

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“…19,20 Experimental studies support the hypothesis that reiteration of ictal activity may promote the formation of new recurrent excitatory circuits through phenomena of axonal sprouting and synaptic reorganization. 12,16,30 Our findings strengthen these hypotheses.…”

Section: Neurosurg Focus / Volume 21 / July 2006supporting

confidence: 92%

Drug-resistant temporal lobe epilepsy due to cavernous malformations

Paolini¹,

Morace²,

Gennaro³

et al. 2006

FOC

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Object Supratentorial cavernous angiomas may be associated with drug-resistant focal epilepsy. Surgical removal of the malformation may result in seizure control in a number of patients, although in most studies a long history and high frequency of attacks have been recognized as indicators of unfavorable seizure outcome. In the literature, there are no clear indications regarding the optimal diagnostic presurgical workup and the surgical strategy for this particular subgroup of patients with symptomatic epilepsy. In this paper the authors focus on the preoperative workup and the surgical management of the disease in eight consecutive patients undergoing surgery for drug-resistant temporal lobe epilepsy (TLE) due to cavernous malformations (CMs), and the relevant literature on this issue is also reviewed. Methods Preoperatively, all patients were assessed using a noninvasive protocol aimed at localizing the epileptogenic zone on the basis of anatomical, electrical, and clinical criteria. The presurgical assessment yielded an indication for lesionectomy in two cases, lesionectomy plus anteromesial temporal lobectomy in four cases, and lesionectomy plus extended temporal lobectomy in two cases. At follow-up examinations, seizure, neuropsychological, and psychiatric outcomes were all evaluated. Seven patients were categorized in Engel Class IA (seizure free), and one was categorized in Engel Class IB (occasional auras only). No adverse effects on neuropsychological or psychosocial functioning were observed. Conclusions Epilepsy surgery can be performed with excellent results in patients with intractable TLE caused by CMs. Noninvasive presurgical evaluation of these patients may enable a tailored approach, providing complete seizure relief in most cases.

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Section: Neurosurg Focus / Volume 21 / July 2006supporting

confidence: 92%

Drug-resistant temporal lobe epilepsy due to cavernous malformations

Paolini¹,

Morace²,

Gennaro³

et al. 2006

FOC

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“…Progressive epileptogenic changes can be examined in the animal model with a variety of techniques (3 1-34). Some observations in the kindling model demonstrated that a form of secondary epileptogenesis can occur in an experimental setting (34,35). Morrell approached this secondary epileptogenesis with studies in humans (36)(37)(38).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Anterior Temporal Lobe Resections for Mesial Temporal Lobe Epilepsy: Multivariate Analysis

et al. 1999

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Summary:Purpose: Even though there have been several studies on the prognostic factors of temporal lobe epilepsy (TLE) after lobectomy, no studies have been performed for homogeneous mesial TLE. Furthermore, most studies on the predictors of outcome of epileptic surgery were based on univariate analyses and did not consider modem epileptic surgery investigation modalities such as brain magnetic resonance imaging (MRI) and positron emission tomography (PET). We attempted to identify the prognostic factors in anterior temporal lobectomy (ATL) for mesial TLE with multivariate analysis.Methods: Ninety-three patients with mesial TLE (54 men and 39 women, mean age at surgery, 2X.3 ? 8.2 years) were included in the study. The primary outcome variable was the status of patients in the second postoperative year, classified as either seizure free (except aura), or not seizure free. Clinical, electroencephalographic, MRI, PET, Wada test, and pathological data were considered.Results: Seventy-eight (84.0%) patients had remission of seizures. With univariate analysis, age at surgery (p < 0.001), epilepsy duration before surgery (p = 0.04), and ipsilateral hippocampal sclerosis on MRI (p = 0.02) were found to be significant. By using multivariate analysis, age at surgery (p = 0.001) and ipsilateral hippocampal sclerosis on MRI (p = 0.03) were found to be the most significant prognostic factors.Conclusions: Age at surgery and hippocampal sclerosis are independent prognostic factors for ATL in mesial TLE. These findings suggest that mesial TLE may be a progressive disorder, and surgical outcome is better when early ATL is performed. Key Words: Anterior temporal lobectomy-Mesial temporal lobe epilepsy-Prognostic factors.The prototype of a surgically remediable epileptic syndrome is medically refractory mesial temporal lobe epilepsy (MTLE) (1). Anterior temporal lobectomy (ATL) for MTLE is a very effective measure to control seizures, and the probability for seizure remission is known to be between 70 and 90% (2). Nonetheless, up to -30% of patients continue to experience seizures after ATL. Therefore determining prognostic factors is very important in finding the ideal candidates for surgery. The number of potential predictors for seizure remission has grown as additional measures of brain structure and function have become available, and current studies focus on this point.Even though some authors have performed multivariate analysis for prognosis in epileptic surgery (3-7) all Accepted June I, 1998. Address correspondence and reprint requests to Dr. S. K. Lee at Department of Neurology, College of Medicine, Seoul National University Hospital, 28 Yonkeun-Dong, Chongno-ku, Seoul, 1 10-744, Korea. E-mail: sangunlee@medicine.snu.ac.kr except two consisted of a mixture of patients who had temporal or extratemporal surgery. The one exception (4) consisted of patients who had had ATL before the advent of the use of magnetic resonance imaging (MRI) for presurgical evaluation. Recently Radhakrishnan et al. (3) reported the prognostic...

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“…Secondary epileptogenesis has been mentioned in animal experiments and humans [19][20][21] . In many animal studies, some interval after kindling the primary focus, a second epileptogenic lesion occurred.…”

Section: Discussionmentioning

confidence: 99%

“…However, proving the presence of this kind of secondary epileptogenesis is very difficult in humans. Previous reports have stated that removal of the primary focus can lead to freedom from seizure [20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

The lateralizing and surgical prognostic value of a single 2-hour EEG in mesial TLE

Lee

Kim

Hong

et al. 2000

Seizure

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We investigated 109 patients who received anterior temporal lobectomy for intractable mTLE by post-operative follow-up for at least 11/2 years. We reviewed pre-operative 2-hour interictal EEGs, counted interictal epileptiform discharges (IEDs), and compared the lateralization of IEDs with the side of surgery and surgical outcome. Twenty of 22 patients who had no spikes and 44 of 51 who had unitemporal spikes became seizure free after surgical resection. The correct lateralization of the epileptogenic side was possible in 90. 9% of the patients with unitemporal IEDs. In 12 seizure-free patients of 15 patients with less than 70% predominance of IED in one temporal lobe, the positive predictive value of the lateralization was 41.7%. In 16 seizure-free patients of 21 with more than 70% preponderance of IED in one lobe, the positive predictive value was 81.3%. Surgical outcome of patients with unitemporal and bitemporal IEDs were not significantly different. Interictal scalp EEG can be used as a lateralizing tool in mTLE when the temporal IEDs appear with more than 70% preponderance in one side. Although the presence of bitemporal IEDs often causes confusion in terms of the correct lateralization, it does not affect the surgical outcome.

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Evidence of Secondary Epileptogenesis in Amygdaloid Overkindled Cats: Electroclinical Documentation of Spontaneous Seizures

Cited by 28 publications

References 20 publications

Drug-resistant temporal lobe epilepsy due to cavernous malformations

Drug-resistant temporal lobe epilepsy due to cavernous malformations

Prognostic Factors in Anterior Temporal Lobe Resections for Mesial Temporal Lobe Epilepsy: Multivariate Analysis

The lateralizing and surgical prognostic value of a single 2-hour EEG in mesial TLE

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