Surgical Anatomy of the Temporal Lobe for Epilepsy Surgery

Sindou, Marc; Guénot, Marc

doi:10.1007/978-3-7091-0641-9_6

Cited by 76 publications

(18 citation statements)

References 19 publications

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“…All patients underwent a unilateral temporal resection (16 in the left hemisphere and 11 in the right) as a surgical treatment. In most cases, the extent of the temporal resection, based on clinical reasoning, included the unco-amygdalar complex, the hippocampus, and the temporal pole from 2 to 4 cm from the tip, up to 5 cm in the case of a complete temporal lobectomy (see Figure 1 and Sindou and Guenot, 2003 for more details). All resection were restricted as to spare the Heschl's gyrus and language areas.…”

Section: Methodsmentioning

confidence: 99%

Non-verbal auditory cognition in patients with temporal epilepsy before and after anterior temporal lobectomy

Bidet-Caulet

Bouchet

et al. 2009

Front. Hum. Neurosci.

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For patients with pharmaco-resistant temporal epilepsy, unilateral anterior temporal lobectomy (ATL) – i.e. the surgical resection of the hippocampus, the amygdala, the temporal pole and the most anterior part of the temporal gyri – is an efficient treatment. There is growing evidence that anterior regions of the temporal lobe are involved in the integration and short-term memorization of object-related sound properties. However, non-verbal auditory processing in patients with temporal lobe epilepsy (TLE) has raised little attention. To assess non-verbal auditory cognition in patients with temporal epilepsy both before and after unilateral ATL, we developed a set of non-verbal auditory tests, including environmental sounds. We could evaluate auditory semantic identification, acoustic and object-related short-term memory, and sound extraction from a sound mixture. The performances of 26 TLE patients before and/or after ATL were compared to those of 18 healthy subjects. Patients before and after ATL were found to present with similar deficits in pitch retention, and in identification and short-term memorisation of environmental sounds, whereas not being impaired in basic acoustic processing compared to healthy subjects. It is most likely that the deficits observed before and after ATL are related to epileptic neuropathological processes. Therefore, in patients with drug-resistant TLE, ATL seems to significantly improve seizure control without producing additional auditory deficits.

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Section: Methodsmentioning

confidence: 99%

Non-verbal auditory cognition in patients with temporal epilepsy before and after anterior temporal lobectomy

Bidet-Caulet

Bouchet

et al. 2009

Front. Hum. Neurosci.

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show abstract

“…Thus the aim of this paper is not to describe the well known anatomical landmarks of a temporo-mesial lobectomy,8 9 and neither to detail the limbic connectivity of temporo-mesial structures involved in memory processing. We will rather attempt to describe additional and reliable landmarks given by functional white matter pathways (with special emphasis on language) in order to make the resection of the dominant temporal lobe more reproducible and safer, not only for glioma surgery, but also for corticectomies in epilepsy surgery.…”

mentioning

confidence: 99%

White matter functional connectivity as an additional landmark for dominant temporal lobectomy

Duffau

Schotten

Mandonnet

2008

Journal of Neurology, Neurosurgery & Psychiatry

104

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Dominant temporal lobectomy is classically performed based on two criteria: a perfect knowledge of the temporo-mesial microsurgical anatomy and cortical landmarks laterally. However, the functional anatomy of the subcortical white matter tracts is taken into account less, despite the risk of inducing a permanent deficit (especially aphasia) if damaged. Even if Klinger's technique allows dissection of fibres on cadaveric specimens, the exact three dimensional geometry of these fasciculi remains poorly described. Tractography, based on diffusion tensor imaging (DTI), is a powerful tool to build three dimensional images of several fasciculi, helping neurosurgeons to create a mental representation of their relationships. Moreover, intraoperative subcortical electrostimulation enables mapping of the function of these pathways. Here we review the recent findings on the white matter anatomo-functional connectivity of the dominant temporal lobe, based on combined anatomical data provided by DTI and functional information provided by intraoperative stimulation. We then discuss their implications for temporal lobectomy, by using white matter functional connectivity as an additional landmark.

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“…These include the connection between the two temporal lobes called the intertemporal portion of the anterior commissure, the connection between the two hippocampi called hippocampal commissure or fornix, the connection between the ipsilateral frontal and temporal lobes called the uncinate fascicle, and lastly diffuse associative fibers (Sindou and Guenot 2003). These connections are what allow seizures that begin in the mesial temporal lobe to spread throughout the brain during secondary generalization.…”

Section: Mtlementioning

confidence: 99%

Mesial Temporal Lobe Epilepsy: A Distinct Electroclinical Subtype of Temporal Lobe Epilepsy

Landazuri

2014

The Neurodiagnostic Journal

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Mesial temporal lobe epilepsy is a common subtype of temporal lobe epilepsy. Its most common cause is hippocampal sclerosis, which contributes to its distinct electroclinical phenotype that is seen commonly in the epilepsy monitoring unit setting. The common electrophysiological data show anterior temporal interictal sharp waves as well as rhythmic theta activity in the same localization. While the electrophysiological data can at times be misleading, its stereotyped and characteristic semiology can often allow for accurate diagnosis on its own. As patients with mesial temporal lobe epilepsy often fail medical therapy, surgical therapy can be considered. Early accurate diagnosis in these patients is essential for optimal care.

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Surgical Anatomy of the Temporal Lobe for Epilepsy Surgery

Cited by 76 publications

References 19 publications

Non-verbal auditory cognition in patients with temporal epilepsy before and after anterior temporal lobectomy

Non-verbal auditory cognition in patients with temporal epilepsy before and after anterior temporal lobectomy

White matter functional connectivity as an additional landmark for dominant temporal lobectomy

Mesial Temporal Lobe Epilepsy: A Distinct Electroclinical Subtype of Temporal Lobe Epilepsy

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