Seizure localization in temporal lobe epilepsy

Murro, Anthony M.; Park, Y. D.; King, Don W.; Gallagher, Brian B.; Smith, Joseph R.; Yaghmai, Farivar; Toro, Victor E.; Damián, Ricardo Figueroa; Loring, David W.; Littleton, W.

doi:10.1212/wnl.43.12.2531

Cited by 25 publications

(9 citation statements)

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“…The relation between MRI-identified mesial temporal atrophy and ictal-interictal EEG findings in patients with TLE has been under investigation at other institutions (4-6, [28][29][30]. The high specificity of MRI-identified quantitative hippocampal atrophy identifying the epileptogenic temporal lobe was also confirmed in a study performed by Cendes et al (28) at the Montreal Neurological Institute.…”

Section: Discussionmentioning

confidence: 84%

Routine EEG and Temporal Lobe Epilepsy: Relation to Long‐Term EEG Monitoring, Quantitative MRI, and Operative Outcome

et al. 1996

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Section: Discussionmentioning

confidence: 84%

Routine EEG and Temporal Lobe Epilepsy: Relation to Long‐Term EEG Monitoring, Quantitative MRI, and Operative Outcome

et al. 1996

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“…This cross-sectional method of analysis assesses outcome for each individual at a different postoperative time. Of the 22 studies that did not use this method, half assessed outcome at a specific postoperative anniversary (i.e., at the first/second postoperative year) (19,33,52,55,67,86,90,97,111,124,133). The other 11 studies used longitudinal methods of analysis, assessing outcome at successive periods.…”

Section: Resultsmentioning

confidence: 99%

“…There were 22 studies that did not use cross-sectional analysis ( Table 1). Eleven had end points of a specific postoperative anniversary, but two studies were excluded because the percentage seizure-free was missing or subjects were selected according to seizure outcome (97,124). Of the nine studies (19,33,52,55,67,86,90,111,133) that tested outcome for specific postoperative anniversaries (the studies are asterisked in Table 2), followup was at 0.5 years (two studies), 1 year (five studies), to two years (two studies).…”

Section: Seizure Outcome According To Type Of Analysis (Other Than Crmentioning

confidence: 99%

Seizure Outcome after Temporal Lobectomy: Current Research Practice and Findings

2001

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Summary:Purpose: The literature regarding seizure outcome and prognostic factors for outcome after temporal lobectomy is often contradictory. This is problematic, as these data are the basis on which surgical decisions and counseling are founded. We sought to clarify inconsistencies in the literature by critically examining the methods and findings of recent research.Methods: A systematic review of the 126 articles concerning temporal lobectomy outcome published from 1991 was conducted.Results: Major methodologic issues in the literature were heterogeneous definitions of seizure outcome, a predominance of cross-sectional analyses (83% of studies), and relatively short follow-up in many studies. The range of seizure freedom was wide (33-93%; median, 70%); there was a tendency for better outcome in more recent studies. Of 63 factors analyzed, good outcome appeared to be associated with several factors including preoperative hippocampal sclerosis, anterior temporal localization of interictal epileptiform activity, absence of preoperative generalized seizures, and absence of seizures in the first postoperative week. A number of factors had no association with outcome (e.g., age at onset, preoperative seizure frequency, and extent of lateral resection).Conclusions: Apparently conflicting results in the literature may be explained by the methodologic issues identified here (e.g., sample size, selection criteria and method of analysis). To obtain a better understanding of patterns of long-term outcome, increased emphasis on longitudinal analytic methods is required. The systematic review of possible risk factors for seizure recurrence provides a basis for planning further research. Key Words: Temporal lobe-Epilepsy, partial-Seizures-Review literature.Outcome after temporal lobectomy has been studied intensively in recent years (1,2). Reliable outcome data are the linch-pin on which surgical candidacy, patient counseling, and postoperative management are based, yet findings frequently conflict, making them difficult to interpret (3-6). This is not surprising, as research in this field is characterized by a variety of methodologic approaches (3,6).Accurate and effective interpretation of the body of knowledge regarding outcome after temporal lobectomy can be facilitated by an understanding of the approach to and practice of research in this area. The aims of this article were (a) a comprehensive overview of methodologic approaches used in current research; (b) examination of seizure freedom as reported by current studies, including the results for early compared with more recent cohorts; and (c) an exhaustive review of the findings of current research pertaining to the effect of pre-and perioperative factors on seizure outcome after temporal lobectomy. METHODSThere was no natural cutoff to delineate between "older" and "current" research. As the Palm Desert Conference surgical outcome audits (7,8) provide a landmark in outcome research, the last year of this audit, the year of 1990, provided a cut-off point. We therefore...

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“…Thus, essentially the entire hippocampus from tail through head was included in these measurements. These same neuroanatomic hippocampal boundary criteria are employed by many epilepsy research groups (31)(32)(33)(34)(35)(36)(37). Subdivision of the hippocampus along its septotemporal axis into three segments labeled head, body, and tail was accomplished as follows: The hippocampal head was defined to encompass those imaging slices extending from the intralimbic gyrus forward to the anterior termination of the hippocampal formation.…”

Section: Image Processingmentioning

confidence: 99%

Medial temporal atrophy on MRI in normal aging and very mild Alzheimer's disease

Jack¹,

Petersen²,

et al. 1997

Neurology

976

636

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Magnetic resonance imaging(MRI) based volumetric measurements of medial temporal lobe (MTL) structures can discriminate between normal elderly controls and patients with Alzheimer's disease (AD) of moderate to advanced severity. In terms of clinical utility, however, a more important issue concerns the ability of the technique to differentiate between normal elderly controls and AD patients with the very mildest form of the disease. We performed MRI-based volume measurements of the hippocampus, parahippocampal gyrus, and amygdala in 126 cognitively normal elderly controls and 94 patients with probable AD. The diagnosis of AD was made according to NINDS/ADRDA criteria, and disease severity was categorized by Clinical Dementia Rating (CDR) scores. Patients with CDR = 0.5 were classified as very mild, CDR = 1 as mild, and CDR = 2 moderate disease severity.Volumes of each structure declined with increasing age in control subjects and did so in parallel for men and women. The volume of each measured MTL structure also declined with age in patients with AD. The volume of each MTL structure was significantly smaller in AD patients than control subjects (P<.001). Of the several MTL measures, the total hippocampal volume measurements were best at discriminating controls from AD cases. The mean hippocampal volumes for AD patients relative to controls by severity of disease were as follows: very mild AD (CDR 0.5) -1.75 SD below the control mean, mild AD (CDR 1) -1.99 SD, and moderate AD (CDR 2) -2.22 SD. Age and gender adjusted normalized MRI-based hippocampal volume measurements provide a sensitive marker of the MTL neuroanatomic degeneration in AD early in the disease process. KeywordsAlzheimer's Disease; Dementia; MRI; Quantitative MRI; Hippocampus Alzheimer's disease(AD) is the most common cause of dementia in individuals over 60 years of age(1-3). A well accepted biological concomitant of AD is cerebral atrophy(4). The rationale for quantitative magnetic resonance imaging (MRI) of medial temporal lobe (MTL) atrophy in the diagnosis of AD is: 1) A memory impairment is usually the earliest and most severe clinical manifestation of AD; 2) Medial temporal lobe (MTL) limbic structures are central to the integrity of declarative memory function (5); 3) MTL limbic structures are involved earliest and most extensively in the pathology of AD(6,7); and 4) several principal MTL limbic structures are amenable to accurate volumetric quantitation by MRI-the hippocampal 3) Relatively small numbers of subjects were included in individual studies. 4) Rigorous definitions of the severity of AD often were not employed. Most previous studies have included primarily subjects with AD of moderate severity. Consequently, the differences between the AD patients and control subjects with regard to MTL atrophy have been dramatic. The most important test of the utility of the technique would be in patients with very mild AD in whom the diagnostic decision making process is difficult.We report a large series of carefully evaluated and lon...

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Seizure localization in temporal lobe epilepsy

Cited by 25 publications

References 0 publications

Routine EEG and Temporal Lobe Epilepsy: Relation to Long‐Term EEG Monitoring, Quantitative MRI, and Operative Outcome

Routine EEG and Temporal Lobe Epilepsy: Relation to Long‐Term EEG Monitoring, Quantitative MRI, and Operative Outcome

Seizure Outcome after Temporal Lobectomy: Current Research Practice and Findings

Medial temporal atrophy on MRI in normal aging and very mild Alzheimer's disease

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