About 6070% of focal seizures originate in the temporal lobe. Epilepsy arising in the medial temporal lobe mtle table 1 the commonest pathology underlying this type of epilepsy is hippocampal sclerosis3,4, and the entity of mesial temporal lobe epilepsy with. Adenosine kinase and adenosine receptors a 1 r and a 2a r in temporal lobe epilepsy and hippocampal sclerosis and association with risk. They represent approximately two thirds of the intractable seizure. Basic mechanisms underlying seizures and epilepsy american. Mnemonic discrimination in patients with unilateral mesial temporal lobe epilepsy relates to similarity and number of events stored in memory author links open overlay panel claudia poch a b 1 rafael toledano c d 1 irene garciamorales c e ana prieto f nuria garciabarragan d angel aledoserrano c antonio gilnagel c pablo campo f. Mesial temporal sclerosis is the most common lesion found in adults with temporal lobe epilepsy.
This type of epilepsy is characterized by refractoriness to drug treatment, so to require surgical resection of mesial temporal. The term temporal lobe epilepsy tle was included in the classification of the ilae in 1989 under the group of localization related symptomatic epilepsies characterized by seizures with sp e. Chronic deep brain stimulation in mesial temporal lobe epilepsy. To clarify the clinical picture of mesial temporal lobe epilepsy mtle in childhood, we carried out a clinical, electroencephalographic, and neuroradiologic study of 19 patients. Mesial temporal lobe epilepsy mtle, the most common epilepsy in adults, is generally intractable and is suspected to be the result of recurrent excitation or inhibition circuitry. Clinical, genetic, and mr characteristics of 68 patients with familial mesial temporal lobe epilepsy mtle were analysed at the university of campinasunicamp, brazil.
We investigated er in patients with mesial temporal lobe epilepsy mtle in order to obtain an emotionprocessing measure that can be related to behavioral regulation. Mesial temporal lobe epilepsy as a neuropsychiatric. Neuropsychology and temporal lobe epilepsy volume 7 issue 5 bruce hermann, michael seidenberg. Seizure freedom from temporal lobe epilepsy with mesial. Neuropsychology and temporal lobe epilepsy cns spectrums. Lateral, neocortical temporal lobe epilepsy tends to be associated with semiology distinct from mesial temporal sclerosis. Tle is the most common form of epilepsy with focal seizures. Mesial temporal lobe epilepsy mtle is a neurological disorder associated with histopathological changes in different subfields of the hippocampus. Temporal lobe epilepsy also called mesial temporal lobe epilepsy, the most frequent form of partial epilepsy in adults, is clinically characterized by alterations in consciousness combined by. Familial autosomal dominant lateral temporal lobe epilepsy autosomal dominant focal epilepsy with auditory features. An alternative to open surgery for patients with unilateral medically refractory mesial temporal lobe epilepsy. Diagnosis and treatment of temporal lobe epilepsy orrin devinsky, md departments of neurology, neurosurgery, and psychiatry, new york university school of medicine, new york, ny of the 1,200,000 americans with partial epilepsy, temporal lobe epilepsy tle occurs in more than 400,000.
Longitudinal follow up of 140 consecutive adult patients operated on for drug resistant temporal lobe epilepsy. Such a relation has been established by tertiary centers, where the prevalence of more severe cases. Hippocampal atrophy ha and signal changes, detected at magnetic resonance imaging, have been associated with intractable seizures. Temporal lobe epilepsy is the term used when seizures occur in the temporal lobe areas of the brain. Tle is most of all characterized by the repeated and unprovoked occurrence of epileptic seizures which take their origin in temporal lobe structures. Electroencephalography eeg has an important role in the diagnosis and classification of epilepsy. Mesial temporal lobe epilepsy is the most common surgically treated epilepsy syndrome, with efficacy demonstrated in randomized controlled trials. The dr that diagnosed me a couple years ago was laid off by the government and no other dr seems to want to talk about the epilepsy. A study combining fmri and dti wei liao,1 zhiqiang zhang,2 zhengyong pan,1 dante. Recurrent excitation and the development of seizures have been associated with aberrant mossy. Pdf clinical and neuroimaging features of good and poor. To analyse the long term results of temporal lobe epilepsy surgery in a national epilepsy surgery centre for adults, and to evaluate preoperative factors predicting a good postoperative outcome on long term follow up. Mesial temporal sclerosis and temporal lobe epilepsy. Temporal lobe epilepsy tle is frequently associated with hippocampal sclerosis, possibly caused by a primary brain injury that occurred a long time before the appearance of neurological symptoms.
Mechanisms of epileptogenesis and potential treatment targets. Mnemonic discrimination in patients with unilateral mesial. Temporal lobe epilepsy with mesial temporal sclerosis usually presents between 610 years of age but can present from infancy to the 30s. In all cases unilateral anterior temporal lobectomy had been performed. Volumetric magnetic resonance imaging evidence of bilateral hippocampal atrophy in mesial temporal lobe epilepsy. The electroencephalogram eeg of mesial tle contains interictal features often associated with anterior temporal. Long term outcome of temporal lobe epilepsy surgery. The management of epilepsy in children and adults mja. Regional neocortical thinning in mesial temporal lobe epilepsy. Hippocampal onset accounts for at least 80% of all temporal lobe seizures. Potential lesions include tumors, such as meningiomas, gangliogliomas, dysplastic neuroepithelial tumors, and gliomas. For many years it has been held that these lesions may be related to complicated febrile convulsions in. Ive been diagnosed for 2 years with temporal lobe epilepsy tle but not sure if thats really what i got. The epileptogenic region in mesial temporal lobe epilepsy mtle is known to extend beyond the.
Lowered paraoxonase 1 activities may explain the comorbidities between temporal lobe epilepsy or mesial temporal sclerosis and depression, anxiety and psychosis. Neuronal autoantibodies in mesial temporal lobe epilepsy. Temporal lobe epilepsy is a predisposing factor for sleep apnea. The disabling seizures associated with mesial temporal lobe epilepsy. For many years it has been held that these lesions may be related to complicated febrile convulsions in childhood but the association is based on retrospective data and a causeandeffect relationship has not been proved. Focal seizures are the most common form of seizure in adults and one of the most common forms of seizures in children.
Mesial temporal lobe epilepsy mtle, the most common epilepsy in adults, is generally intractable and is suspected to be the result of recurrent. Effects of chronic temporal lobe epilepsy on memory functions. Electroencephalography in mesial temporal lobe epilepsy. Mesial temporal lobe epilepsy is the most common form of human epilepsy, and its pathophysiological substrate is usually hippocampal sclerosis, the most common epileptogenic lesion encountered in patients with epilepsy.
Emotional reactivity in mesial temporal lobe epilepsy. Temporal lobe epilepsy in patients with nonlesional mri. Seizure freedom from temporal lobe epilepsy with mesial temporal lobe tumor by tumor removal alone without hippocampectomy despite remaining abnormal discharges on intraoperative. T emporal lobe epilepsy tle is the most common form of focal epilepsy, accounting for the vast majority of partial seizures. Default mode network abnormalities in mesial temporal lobe. Mesial temporal lobe epilepsy with hippocampal sclerosis. Amnesia is the rule for the blank spell and the automatism. Temporal lobe epilepsy tle is a chronic disorder of the nervous system characterized by recurrent, unprovoked focal seizures that originate in the temporal lobe of the brain and last about one or two minutes. Temporal lobe epilepsy tle is the commonest form of focal epilepsy and represents almost 23 of cases of intractable epilepsy managed surgically. Neuroananatomical correlates of cognitive phenotypes in. Temporal lobe seizures are the most frequent site of origin of partial seizures. Just got diagnozed with temporal lobe epilepsy and i am in.
In our view, this means that the neuropsychology of epilepsy. I am in my 30s and just got the diagnosis temporal lobe epilepsy. Temporal lobe epilepsy tle refers to an epilepsy syndrome with seizure arising from the temporal lobe with a high degree of involvement of the hippocampus. The interictal mesial temporal lobe epilepsy network. Partialonset epilepsies account for about 60% of all adult epilepsy cases, and temporal lobe epilepsy tle is the most common type of partial epilepsy referred for epilepsy surgery and often refractory to.
In temporal lobe epilepsy tle seizures could originate in the medial or lateral neocortical temporal. Detection of lesions in mesial temporal lobe epilepsy by. Pdf chronic deep brain stimulation in mesial temporal. Temporal lobe epilepsy tle is the most common form of adult localizationrelated epilepsy. Request pdf mesial temporal lobe epilepsy as a neuropsychiatric syndrome of systemic lupus erythematosus in this study, we aimed to investigate the types of seizures and epilepsy associated. The most common form of partial epilepsy, temporal lobe epilepsy remains a mystery regarding cause and effective seizure treatment methods. Finally, recent data clearly show both that there is a fair degree of reorganization of these networks in patients with temporal lobe epilepsy tle and that even when seizures are exclusively in mesial temporal regions, there is more widespread anatomic and functional disturbance. Mesial temporal lobe epilepsy in childhood murakami. Temporal lobe epilepsy, bipolar i, or something else. A questionnaire study in videoeeg monitoring unit use of antiepileptic drugs during pregnancy and lactation. Pdf lowered paraoxonase 1 activities may explain the. Familial mesial temporal lobe epilepsy pdf paperity. Epilepsy surgery such as laser ablation or temporal lobectomy may be an option, especially when the cause of the seizures is an abnormality in the brain such as mesial temporal sclerosis. Pathophysiogenesis of mesial temporal lobe epilepsy.
Previous research characterized three cognitive phenotypes in temporal lobe epilepsy. It can provide information for predicting the response to antiseizure drugs and to identify the surgically remediable epilepsies. The electroencephalogram eeg of mesial tle contains interictal features often associated with anterior temporal epileptiform discharges with a maximal voltage over the basal temporal. Temporal lobe epilepsy is the type of epilepsy that accounts for the most common form of seizures called focal seizures.
Objective our aim was to investigate the prevalence of neuronal autoantibodies nabs in a large consecutive series with mesial temporal lobe epilepsy with hippocampal sclerosis mtlehs and to. Psychiatric disorders were investigated in 74 patients with drugresistant temporal lobe epilepsy complex partial epilepsy. A history of febrile seizures especially complex febrile seizures is common in tle and is frequently associated with mesial temporal sclerosis the commonest form of tle. Postictal noserubbing is commonly seen in temporal lobe epilepsy, and in 90% of cases is ipsilateral to the focus11. It has been attempted to link seizure semiology to activation of different anatomical regions of the. Frontal lobe epilepsy is the term for recurring seizures beginning in the frontal lobe. Proceedings of the epilepsy foundations 2017 cannabinoids in epilepsy therapy workshop.
245 99 559 611 947 98 837 727 786 214 987 570 382 945 808 603 310 283 904 832 842 794 684 1478 944 798 193 414 839 1029 696 471 1273