Complex Partial Seizures of Hippocampal and Amygdalar Origin

Maldonado, Héctor; Delgado‐Escueta, Antonio V.; Walsh, Gregory O.; Swartz, Barbara E.; Rand, Robert W.

doi:10.1111/j.1528-1157.1988.tb03741.x

Cited by 82 publications

(39 citation statements)

References 19 publications

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“…Taken together with the less frequent presence of staring and OAs, this previously unreported finding suggests that BTLE patients may have different brain networks from those of UTLE patients, possibly leading to more frequent neocortical than mesial seizure onset and discharge propagation [33][34][35].…”

Section: Discussionmentioning

confidence: 90%

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

Didato

Chiesa

Villani

et al. 2015

Seizure

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Section: Discussionmentioning

confidence: 90%

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

Didato

Chiesa

Villani

et al. 2015

Seizure

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“…The authors identified three clinical phases during most of the 76 seizures recorded, beginning with a motionless stare early in the event, followed by stereotypical movements, and with loss of consciousness later in the seizure (Escueta et al, 1977). Another study of 72 hippocampal or amygdalar seizures found that motionless staring or oroalimentary automatisms were the first behavioral manifestations during the majority of events (60%), with fewer seizures beginning with nonfocal discrete movements, perseverative stereotyped automatisms, or vocalizations (Maldonado et al, 1988). In general, whereas automatisms and other behavioral manifestations usually emerge early in a complex-partial seizure, while responsiveness may remain intact, consciousness in TLE is most profoundly affected late in the seizure and during the postictal period (Blumenfeld and Taylor, 2003).…”

Section: Behavioral Semiology Of Temporal Lobe Seizuresmentioning

confidence: 99%

Consciousness and epilepsy: why are complex-partial seizures complex?

Englot

Blumenfeld

2009

Progress in Brain Research

103

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Why do complex-partial seizures in temporal lobe epilepsy (TLE) cause a loss of consciousness? Abnormal function of the medial temporal lobe is expected to cause memory loss, but it is unclear why profoundly impaired consciousness is so common in temporal lobe seizures. Recent exciting advances in behavioral, electrophysiological, and neuroimaging techniques spanning both human patients and animal models may allow new insights into this old question. While behavioral automatisms are often associated with diminished consciousness during temporal lobe seizures, impaired consciousness without ictal motor activity has also been described. Some have argued that electrographic lateralization of seizure activity to the left temporal lobe is most likely to cause impaired consciousness, but the evidence remains equivocal. Other data correlates ictal consciousness in TLE with bilateral temporal lobe involvement of seizure spiking. Nevertheless, it remains unclear why bilateral temporal seizures should impair responsiveness. Recent evidence has shown that impaired consciousness during temporal lobe seizures is correlated with large-amplitude slow EEG activity and neuroimaging signal decreases in the frontal and parietal association cortices. This abnormal decreased function in the neocortex contrasts with fast polyspike activity and elevated cerebral blood flow in limbic and other subcortical structures ictally. Our laboratory has thus proposed the “network inhibition hypothesis,” in which seizure activity propagates to subcortical regions necessary for cortical activation, allowing the cortex to descend into an inhibited state of unconsciousness during complex-partial temporal lobe seizures. Supporting this hypothesis, recent rat studies during partial limbic seizures have shown that behavioral arrest is associated with frontal cortical slow waves, decreased neuronal firing, and hypometabolism. Animal studies further demonstrate that cortical deactivation and behavioral changes depend on seizure spread to subcortical structures including the lateral septum. Understanding the contributions of network inhibition to impaired consciousness in TLE is an important goal, as recurrent limbic seizures often result in cortical dysfunction during and between epileptic events that adversely affects patients’ quality of life.

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“…Except for gestural automatism, these were also the most frequently identifi ed phenomena in the present study. These manifestations are also common in adults with mesial temporal lobe epilepsy 24 . Epigastric phenomenon and fear, although being frequent manifestations in adults 12,25 , present lower incidence among children, maybe due to the diffi culty of the child to report these sensations.…”

Section: Discussionmentioning

confidence: 99%

Mesial temporal sclerosis in children

Brandão

Manreza

2007

Arq. Neuro-Psiquiatr.

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-Mesial temporal sclerosis is the most frequent cause of drug-resistant temporal lobe epilepsy but has a satisfactory response to surgery, and is considered infrequent in children. Objective: To evaluate the clinical, electrographic and radiological spectrum of the disease in children. Method: Retrospective study by review of charts of 44 children with a diagnosis of mesial temporal sclerosis on magnetic resonance imaging, attended at the "Hospital das Clínicas" of the University of São Paulo Faculty of Medicine. Results: Febrile seizure was identified in the history of 54% of the patients. Injuries at the left side predominated in patients with schooling difficulties (p=0.049), in those with the first seizures between six months and five years (p=0.021) and in those with complex febrile seizure (p=0.032). Thirteen patients were submitted to surgery and of these, eight remained without seizures. Conclusion: Febrile seizure may be related in a more direct way to the presence of left-side mesial temporal sclerosis.KEY WORDS: temporal lobe epilepsy, child, adolescent, sclerosis, hippocampus. Esclerose mesial temporal em criançasRESUMO -Em adultos, esclerose mesial temporal é a causa mais freqüente de epilepsia do lobo temporal intratável por medicamentos e que responde satisfatoriamente a cirurgia, sendo considerada pouco freqüen-te em criança. Objetivo: Avaliar o espectro clínico, eletrográfico e radiológico desta patologia em crianças. Método: Estudo retrospectivo, por revisão de prontuário de 44 crianças com diagnóstico de esclerose mesial temporal na ressonância magnética, atendidos no Hospital das Clínicas da Faculdade de Medicina de São Paulo. Resultado: Foi identificado que 54% dos pacientes apresentaram antecedente de crise febril. Lesão no lado esquerdo predominou nos pacientes com dificuldade escolar (p=0.049), naqueles com primeiras crises entre seis meses e cinco anos (p=0,021) e naqueles com crise febril complicada (p=0,032). Treze pacientes foram operados, dos quais oito ficaram livres de crises. Conclusão: Crise febril pode estar relacionada de uma forma mais direta à presença de esclerose mesial temporal no lado esquerdo. PALAVRAS-CHAVE: epilepsia do lobo temporal, criança, adolescente, esclerose, hipocampo.

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Complex Partial Seizures of Hippocampal and Amygdalar Origin

Cited by 82 publications

References 19 publications

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

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

Consciousness and epilepsy: why are complex-partial seizures complex?

Mesial temporal sclerosis in children

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