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

Didato, Giuseppe; Chiesa, Valentina; Villani, Flavio; Pelliccia, Veronica; Deleo, Francesco; Gozzo, Francesca; Canevini, Maria Paola; Mai, Roberto; Spreafico, Roberto; Cossu, Massimo; Tassi, Laura

doi:10.1016/j.seizure.2015.07.013

Cited by 32 publications

(37 citation statements)

References 41 publications

(62 reference statements)

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“…Fourth, widespread abnormalities in white matter found in our study might have been the result of unilateral or bilateral TLE. However, we could not distinguish the 2 conditions, although both diseases are associated with different underlying networks . Future studies are needed to investigate how the 2 conditions (unilateral TLE vs bilateral TLE) may affect widespread brain regions differently.…”

Section: Discussionmentioning

confidence: 79%

Widespread abnormalities in white matter integrity and their relationship with duration of illness in temporal lobe epilepsy

et al. 2018

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SummaryObjectiveElucidation of abnormal connections throughout the whole brain is necessary to understand temporal lobe epilepsy (TLE). We examined abnormalities in whole‐brain white matter integrity and their relationship with duration of illness in patients with TLE.MethodsThe subjects were 15 patients with TLE and 17 healthy controls. Mean duration of illness in the TLE group was 21.6 years. Tract‐based spatial statistics (TBSS) were used for diffusion tensor imaging (DTI) analysis. Four diffusion tensor metrics, that is, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were calculated and then examined for differences between the TLE and healthy control groups. We also examined for correlations between DTI parameters and duration of illness in the TLE group.ResultsIn the TLE group, compared with the healthy control group, FA was reduced, and MD and RD were increased, not only in the limbic and temporal lobe regions and their directly connecting regions in both hemispheres, but also in remote white matter regions. Duration of illness showed a significant negative correlation with mean whole‐brain FA and a significant positive correlation with both mean whole‐brain MD and RD. Brain regions showing correlation between disease duration and DTI metrics also extended to the limbic area and its connecting regions, and to remote white matter regions.SignificanceThe results of this study suggest that widespread abnormalities in white matter integrity in patients with TLE are associated with long‐term disease.

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Section: Discussionmentioning

confidence: 79%

Widespread abnormalities in white matter integrity and their relationship with duration of illness in temporal lobe epilepsy

et al. 2018

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“…When the laterality of the EZ has not been determined, bilateral electrode recordings are likely easier with SEEG electrodes given that they can be implanted bilaterally without repositioning or performing a bilateral craniotomy. SEEG has been used with success for the characterization of the EZ in patients with bitemporal epilepsy [40][41][42], obviating the need for bilateral craniotomies or burr holes that would be required with SDEs. At centers using SDEs, bilateral craniotomies can be avoided by using bilateral burr holes with implantation of strip electrodes, bilaterally.…”

Section: Seeg and Sde Techniquementioning

confidence: 99%

Stereoelectroencephalography Versus Subdural Electrodes for Localization of the Epileptogenic Zone: What Is the Evidence?

Katz

Abel

2019

Neurotherapeutics

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Accurate and safe localization of epileptic foci is the crux of surgical therapy for focal epilepsy. As an initial evaluation, patients with drug-resistant epilepsy often undergo evaluation by noninvasive methods to identify the epileptic focus (i.e., the epileptogenic zone (EZ)). When there is incongruence of noninvasive neuroimaging, electroencephalographic, and clinical data, direct intracranial recordings of the brain are often necessary to delineate the EZ and determine the best course of treatment. Stereoelectroencephalography (SEEG) and subdural electrodes (SDEs) are the 2 most common methods for recording directly from the cortex to delineate the EZ. For the past several decades, SEEG and SDEs have been used almost exclusively in specific geographic regions (i.e., France and Italy for stereo-EEG and elsewhere for SDEs) for virtually the same indications. In the last decade, however, stereo-EEG has started to spread from select centers in Europe to many locations worldwide. Nevertheless, it is still not the preferred method for invasive localization of the EZ at many centers that continue to employ SDEs exclusively. Despite the increased dissemination of the SEEG method throughout the globe, important questions remain unanswered. Which method (SEEG or SDEs) is superior for identification of the EZ and does it depend on the etiology of epilepsy? Which technique is safer and does this hold for all patient populations? Should these 2 methods have equivalent indications or be used selectively for different focal epilepsies? In this review, we seek to address these questions using current invasive monitoring literature. Available meta-analyses of observational data suggest that SEEG is safer than SDEs, but it is less clear from available data which method is more accurate at delineating the EZ.

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“…Patients with BHS are an ignored group in epileptology despite their increased burden related to the bilateral hippocampal involvement and there is only a small body of literature on this group and related characteristics. 5,[8][9][10][11]22 We showed that history of FSE, mental retardation, status epilepticus, psychosis, slowing of the EEG background activity were significant clues for BHS patients in comparison to UHS group.…”

Section: Discussionmentioning

confidence: 86%

“…8 However, there were no consecutive series investigating these interesting associations in BHS versus unilateral HS (UHS) in the same study with comparative design. Recently Didato et al 9 retrospectively investigated characteristics of 48 patients with bilateral TLE in comparison with 38 patients with unilateral TLE and found that bilateral TLE cohort was significantly older at the time of epilepsy onset, showed frequent bilateral asynchronous interictal epileptiform discharges, bilateral upper limb dystonia, and less recognizable initial ictal EEG discharges. But their cohort also included patients, with lateral TLE, many other etiologies and only 39.6% of their bilateral group had HS.…”

Section: Introductionmentioning

confidence: 99%

“…But their cohort also included patients, with lateral TLE, many other etiologies and only 39.6% of their bilateral group had HS. 9 Other studies regarding BHS and UHS have highlighted the clinical findings focusing mainly on epilepsy surgery results. It was reported that patients with BHS showed slightly better subjective outcome after surgical treatment when compared to pharmacologically treated ones but they also stated significantly improved quality of life.…”

Section: Introductionmentioning

confidence: 99%

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How Different Are the Patients With Bilateral Hippocampal Sclerosis From the Unilateral Ones Clinically?

et al. 2016

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

Cited by 32 publications

References 41 publications

Widespread abnormalities in white matter integrity and their relationship with duration of illness in temporal lobe epilepsy

Widespread abnormalities in white matter integrity and their relationship with duration of illness in temporal lobe epilepsy

Stereoelectroencephalography Versus Subdural Electrodes for Localization of the Epileptogenic Zone: What Is the Evidence?

How Different Are the Patients With Bilateral Hippocampal Sclerosis From the Unilateral Ones Clinically?

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