Temporal lobe tumoral epilepsy

Zaatreh, Megdad; Firlik, Katrina S.; Spencer, Dennis D.; Spencer, Susan S.

doi:10.1212/01.wnl.0000079374.78589.1b

Cited by 124 publications

(94 citation statements)

References 31 publications

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“…There are various clinical forms of epilepsy. previous studies have reported that the majority of secondary epilepsy from hippocampal lesions belongs to MTLE, which mainly consists of partial seizures and rarely generalized seizures; furthermore, the predominant partial seizures are dominated by complex partial seizures (8,12,16). In this study, 27 patients had complex partial seizures, accounting for 50% of the total number of patients, followed by absence seizures and secondarily generalized tonic-clonic seizures; simple partial seizures were relatively rare, consistent with previous reports.…”

Section: Clinical Manifestations and Classifications Of Hippocampal Lsupporting

confidence: 91%

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Microsurgical outcomes of secondary epilepsy from hippocampal lesions: a report of 56 cases and literature review

Wang¹,

Xing²,

Ma³

et al. 2014

Turkish Neurosurgery

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ABSTRACToperative methods in the treatment of secondary epilepsy from hippocampal lesions. █ MATERIAl and METhODS Selection of PatientsThere were 56 patients enrolled in this study including 31 males and 25 females. These patients were aged 16 to 74 years (mean age, 35.1±13.5 years) and had a history of epilepsy from 2 months to 10 years (mean length, 17.2±13.1 months). The inclusion criteria for patients diagnosed as having hippocampal sclerosis was that systematic anti- █ InTRODuCTIOnMesial temporal lobe epilepsy (MTLE) is the most common type of temporal lobe epilepsy in the clinic, and it tends to develop into medically intractable epilepsy. Hippocampal lesions are the most common cause of MTLE. Currently, the treatment strategy of this epilepsy type remains clinically controversial (16). In this paper, we retrospectively analyzed the clinical data and the outcomes of the microsurgical treatment of 56 patients who had secondary epilepsy from hippocampal lesions and were treated during the period from January 2005 to January 2014. The purpose of this study was to explore the significance of microsurgery and its various AIM: To explore the treatment efficacy of microsurgery for secondary epilepsy from hippocampal lesions. MATERIAl and METhODS:The clinical data, pathological findings, surgical methods and surgical outcomes of 56 patients with secondary epilepsy from hippocampal lesions were retrospectively analyzed. RESulTS:Postoperative pathological examinations confirmed that 27 patients had gliomas, 17 patients had vascular malformations and 12 patients had hippocampal sclerosis. Twenty-nine patients underwent selective resection of the lesioned tissue and the surrounding infiltrated tissue, and 26 patients underwent a more generous removal of the anterior temporal lobe, lesioned tissue, infiltrated tissue and medial structures of the temporal lobe. Fifty patients were followed up with an average follow-up duration of 25.5 months. At postoperative one year, the remission rate of epilepsy that achieved Engel grade I was 80.8% (21/26) and 83.3% (20/24) for the selective resection and more generous resection, respectively, indicating that the difference between the two methods was insignificant.COnCluSIOn: Microsurgery is the first choice for the treatment of secondary epilepsy from hippocampal lesions. Various operative routes and methods can be selected based on the lesion natures. Long-term favorable outcome of seizure control following microsurgery can be achieved in most of the patients.

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Section: Clinical Manifestations and Classifications Of Hippocampal Lsupporting

confidence: 91%

“…The common clinical types of hippocampal lesions include tumorous lesions (16), vascular lesions (5,12), congenital lesions (6,8), traumatic lesions and others. In different treatment centers, the statistical data regarding the distribution of lesion types differ.…”

Section: Clinical Manifestations and Classifications Of Hippocampal Lmentioning

confidence: 99%

Microsurgical outcomes of secondary epilepsy from hippocampal lesions: a report of 56 cases and literature review

Wang¹,

Xing²,

Ma³

et al. 2014

Turkish Neurosurgery

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“…Although some authors reported that good seizure control can be obtained despite incomplete tumor resection, 11,12 the importance of total tumor removal for seizure control has been emphasized by many authors, especially in recent studies. 4,5,13 However, Daumas-Duport et al 14 reported…”

Section: 10mentioning

confidence: 99%

“…4,5 However, the long-term control of seizures and of the tumor is a concern in these patients, and to the best of our knowledge, very few longitudinal analyses have been reported in the literature. Furthermore, data regarding the discontinuation of antiepileptic drugs (AEDs) after surgery for tumor-related TLE are scarce.…”

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confidence: 99%

Long‐term surgical outcomes of temporal lobe epilepsy associated with low‐grade brain tumors

Phi

Kim

Cho

et al. 2009

Cancer

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“…Evidence in support of this comes from electrophysiological investigation of dentate granule cell excitability, which shows that the MTLE granule cells are hyperexcitable while those in MaTLE and PTLE are not (25). A study of the long term surgical outcome of patients with temporal lobe tumoral epilepsy (MaTLE) showed significant post operative seizure freedom was related only to gross complete tumor resection and unrelated to its pathology (26). This, too, suggests that in MaTLE the hippocampus itself is non-epileptogenic.…”

Section: Measurement Of Data and Analytical Toolsmentioning

confidence: 99%

Gene Expression in Temporal Lobe Epilepsy is Consistent with Increased Release of Glutamate by Astrocytes

Lee

Mane

Eid

et al. 2007

Mol Med

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113

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Patients with temporal lobe epilepsy (TLE) often have a shrunken hippocampus that is known to be the location in which seizures originate. The role of the sclerotic hippocampus in the causation and maintenance of seizures in temporal lobe epilepsy (TLE) has remained incompletely understood despite extensive neuropathological investigations of this substrate. To gain new insights and develop new testable hypotheses on the role of sclerosis in the pathophysiology of TLE, the differential gene expression profile was studied. To this end, DNA microarray analysis was used to compare gene expression profiles in sclerotic and nonsclerotic hippocampi surgically removed from TLE patients. Sclerotic hippocampi had transcriptional signatures that were different from non-sclerotic hippocampi. The differentially expressed gene set in sclerotic hippocampi revealed changes in several molecular signaling pathways, which included the increased expression of genes associated with astrocyte structure (glial fibrillary acidic protein, ezrin-moesin-radixin, palladin), calcium regulation (S100 calcium binding protein beta, chemokine (C-X-C motif) receptor 4) and blood-brain barrier function (Aquaaporin 4, Chemokine (C-C-motif) ligand 2, Chemokine (C-C-motif) ligand 3, Plectin 1, intermediate filament binding protein 55kDa) and inflammatory responses. Immunohistochemical localization studies show that there is altered distribution of the gene-associated proteins in astrocytes from sclerotic foci compared with nonsclerotic foci. It is hypothesized that the astrocytes in sclerotic tissue have activated molecular pathways that could lead to enhanced release of glutamate by these cells. Such glutamate release may excite surrounding neurons and elicit seizure activity.

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Temporal lobe tumoral epilepsy

Cited by 124 publications

References 31 publications

Microsurgical outcomes of secondary epilepsy from hippocampal lesions: a report of 56 cases and literature review

Microsurgical outcomes of secondary epilepsy from hippocampal lesions: a report of 56 cases and literature review

Long‐term surgical outcomes of temporal lobe epilepsy associated with low‐grade brain tumors

Gene Expression in Temporal Lobe Epilepsy is Consistent with Increased Release of Glutamate by Astrocytes

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