Neocortical Temporal Lobe Epilepsy

Bercovici, Eduard; Kumar, Balagobal Santosh; Mirsattari, Seyed M.

doi:10.1155/2012/103160

Cited by 16 publications

(11 citation statements)

References 117 publications

(169 reference statements)

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“…Ipsilateral TL was affected on both FDG‐PET and DIR‐WM only at dorsolateral areas in a patient with lateral TLE, without significant involvement of the ATL. This result is consistent with a previous report (Bercovici et al., ) and may indicate difference between medial and lateral TLE patients. However, in our study, there was only this patient who had lateral TLE, and this result cannot be generalized.…”

Section: Discussionsupporting

confidence: 94%

Evaluation of focus laterality in temporal lobe epilepsy: A quantitative study comparing double inversion‐recovery MR imaging at 3T with FDG‐PET

et al. 2013

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Emiko Morimoto is a radiologist and tries to shed light on epilepsy from an imaging viewpoint. SUMMARYPurpose: To quantitatively compare the diagnostic capability of double inversionrecovery (DIR) with F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of seizure focus laterality in temporal lobe epilepsy (TLE). Methods: This study was approved by the institutional review board, and written informed consent was obtained. Fifteen patients with TLE and 38 healthy volunteers were enrolled. All magnetic resonance (MR) images were acquired using a 3T-MRI system. Voxel-based analysis (VBA) was conducted for FDG-PET images and white matter segments of DIR images (DIR-WM) focused on the whole temporal lobe (TL) and the anterior part of the temporal lobe (ATL). Distribution of hypometabolic areas on FDG-PET and increased signal intensity areas on DIR-WM were evaluated, and their laterality was compared with clinically determined seizure focus laterality. Correct diagnostic rates of laterality were evaluated, and agreement between DIR-WM and FDG-PET was assessed using j statistics. Key Findings: Increased signal intensity areas on DIR-WM were located at the vicinity of the hypometabolic areas on FDG-PET, especially in the ATL. Correct diagnostic rates of seizure focus laterality for DIR-WM (0.80 and 0.67 for the TL and the ATL, respectively) were slightly higher than those for FDG-PET (0.67 and 0.60 for the TL and the ATL, respectively). Agreement of laterality between DIR-WM and FDG-PET was substantial for the TL and almost perfect for the ATL (j = 0.67 and 0.86, respectively). Significance: High agreement in localization between DIR-WM and FDG-PET and nearly equivalent detectability of them show us an additional role of MRI in TLE.

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Section: Discussionsupporting

confidence: 94%

Evaluation of focus laterality in temporal lobe epilepsy: A quantitative study comparing double inversion‐recovery MR imaging at 3T with FDG‐PET

et al. 2013

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“…A history of FS, CNS infection, perinatal complications, or head injury is less common (Gil‐Nagel and Risinger, ). Seizures in patients with NTLE appear five or ten years later than in MTS (Gil‐Nagel and Risinger, ; Bercovici et al ., ). This study reveals that the presence of mesial epilepsy is a risk factor for severe‐course TLE and a protective factor for mild‐course TLE.…”

Section: Discussionmentioning

confidence: 97%

How many adults with temporal epilepsy have a mild course and do not require epilepsy surgery?

Hernández-Ronquillo

Buckley

Ladino

et al. 2016

Epileptic Disorders

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Aims. Temporal lobe epilepsy (TLE) is the most common type of drug‐resistant epilepsy in adults and commonly requires surgical treatment. While an overwhelming preponderance of literature supports the notion that a large percentage of patients with TLE benefit from surgery, there is a paucity of outcome data on patients who demonstrate a sustained response to pharmacological treatment. In this study, we present an adult cohort of patients with TLE, with the purpose of identifying the proportion of patients with a mild course of the disease, as well as potential risk factors. Methods. A prospective cohort study of all patients with TLE assessed and followed by the Saskatchewan Epilepsy Program, from 1 March 2007 to Jan 29th 2014. Patients were dichotomized as having a mild (seizure freedom without surgical intervention) or severe (surgical intervention required and/or failure to achieve seizure remission) course. Descriptive statistics, odds ratios and confidence intervals were calculated to identify predictors of seizure freedom. Results. The cohort consisted of 159 patients. Mean patient age at last follow‐up visit was 46±14.4 (range: 19–88) years. Mean follow‐up period was 43.4±22.6 (6 to 84) months. Forty‐six patients (29%) demonstrated mild‐course TLE while 113 (71%) had a severe course of TLE. Patients with a mild course of TLE were more likely to be older (p = 0.002), have late‐onset epilepsy (p < 0.001) with shorter evolution (p < 0.001). A good response to the first antiepileptic drug (OR: 6.8; 95% CI: 2.5–19; p < 0.001) was associated with a mild course of TLE. Conclusions. Although a majority of patients with TLE eventually require surgery, operative treatment is not necessary for all patients. This study identifies prognostic factors that may help patients and clinicians characterize long‐term outcome.

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“…He also stressed on the role of slow cortical activity in these patients. Neocortical temporal and mesial temporal epilepsies however differ little in their mode of generation of experiential phenomenon 18. This is likely based on the reciprocal connections in the two 19,20.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Ictal Consciousness in Temporal and Extra Temporal Epilepsy: Observations from a Tertiary Care Hospital in India

et al. 2016

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Background and PurposeDifferences in consciousness during seizures depend on the location of the seizure onset.MethodsThe present study evaluates ictal consciousness using the ictal consciousness inventory (ICI) in drug refractory mesial temporal (MTLE), neocortical temporal (NTLE) and extra temporal epilepsy (ETLE). This was a cross sectional cohort study with 45 patients with mesial temporal epilepsy, 47 with extra temporal and 11 patients with neocortical temporal epilepsy. The ICI a 20 item questionnaire was used to calculate the scores for level (L, question 1–10) and content (C, question 11–20) of consciousness.ResultsThe patients in mesial temporal group had higher ICI-L scores, p = 0.0129 as compared to the extra temporal group, but no difference was observed in the content of consciousness. The ICI-L and C scores were not different in the mesial temporal and the neocortical temporal group (p = 0.53 and 0.65) respectively.ConclusionsPatients with mesial temporal epilepsy had a higher level of consciousness than the extra temporal group but there was no difference in the content. Also there was no difference in the level and content of consciousness between mesial and the neocortical temporal group.

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Neocortical Temporal Lobe Epilepsy

Cited by 16 publications

References 117 publications

Evaluation of focus laterality in temporal lobe epilepsy: A quantitative study comparing double inversion‐recovery MR imaging at 3T with FDG‐PET

Evaluation of focus laterality in temporal lobe epilepsy: A quantitative study comparing double inversion‐recovery MR imaging at 3T with FDG‐PET

How many adults with temporal epilepsy have a mild course and do not require epilepsy surgery?

Evaluation of Ictal Consciousness in Temporal and Extra Temporal Epilepsy: Observations from a Tertiary Care Hospital in India

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