The Anatomic Substratum of the Convulsive State

Spielmeyer, W.

doi:10.1001/archneurpsyc.1930.02220110025002

Cited by 96 publications

(18 citation statements)

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“…Seizures themselves may lead to cerebellar damage. Pathologic changes in the cerebellum in patients with seizure disorders (Purkinje cell dropout, shrinkage of the molecular layer, proliferation of Bergmann astrocytes) were noted before PHT was introduced (Liebers, 1928;Spielmeyer, 1930;Zimmerman, 1938;Scholz, 1959;Norman, 1964;Margerison and Corsellis, 1966). Not all the patients had GTC (Scholz, 1959).…”

Section: Discussionmentioning

confidence: 99%

Complex Partial Seizures: Cerebellar Metabolism

et al. 1987

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We used positron emission tomography (PET) with [18F]2-deoxyglucose to study cerebellar glucose metabolism (LCMRglu) and the effect of phenytoin (PHT) in 42 patients with complex partial seizures (CPS), and 12 normal controls. Mean +/- SD patient LCMRglu was 6.9 +/- 1.8 mg glucose/100 g/min (left = right), significantly lower than control values of 8.5 +/- 1.8 (left, p less than 0.006), and 8.3 +/- 1.6 (right, p less than 0.02). Only four patients had cerebellar atrophy on CT/MRI; cerebellar LCMRglu in these was 5.5 +/- 1.5 (p = 0.054 vs. total patient sample). Patients with unilateral temporal hypometabolism or EEG foci did not have lateralized cerebellar hypometabolism. Patients receiving phenytoin (PHT) at the time of scan and patients with less than 5 years total PHT exposure had lower LCMRglu, but the differences were not significant. There were weak inverse correlations between PHT level and cerebellar LCMRglu in patients receiving PHT (r = -0.36; 0.05 less than p less than 0.1), as well as between length of illness and LCMRglu (r = -0.22; 0.05 less than p less than 0.1). Patients with complex partial seizures have cerebellar hypometabolism that is bilateral and due only in part to the effect of PHT.

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Section: Discussionmentioning

confidence: 99%

Complex Partial Seizures: Cerebellar Metabolism

et al. 1987

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“…As porções mais sensí-veis seriam CA1, também chamado setor de Sommer, e CA4 (endofolium), enquanto que, CA2 e CA3, denominado setor de Spielmeyer, demonstra resistência aos eventos isquêmicos 24 . Tal realidade pode estar fundamentada nas variações dos vasos intra-hipocampais anteriormente descritas.…”

Section: Discussionunclassified

Anatomia microcirúrgica do hipocampo na Amígdalo-hipocampectomia seletiva sob a perspectiva da técnica de Niemeyer e método pré-operatório para maximizar a corticotomia

Isolan

Azambuja

Neto

et al. 2007

Arq. Neuro-Psiquiatr.

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RESUMO -O conhecimento da anatomia microcirúrgica do hipocampo tem importância fundamental na cirurgia da epilepsia do lobo temporal. Uma das técnicas mais utilizadas na cirurgia da epilepsia é a técnica de Niemeyer. Objetivo: Descrever em detalhes a anatomia do hipocampo e mostrar uma técnica na qual pontos de referências anatômicos pré-operatórios visualizados na RNM são usados para guiar a corticotomia. Método: Foram utilizados 20 hemisférios cerebrais e 8 cadáveres para dissecções anatômicas microcirúrgi-cas do lobo temporal e hipocampo para identificação e descrição das principais estruturas do hipocampo. Foram estudados prospectivamente 32 pacientes com epilepsia do lobo temporal refratários ao tratamento clínico submetidos a amígdalo-hipocampectomia seletiva pela técnica de Niemeyer três parâmetros anatô-micos foram mensurados na RNM pré operatória e transferidos para o ato cirúrgico. Resultados: O hipocampo foi dividido em cabeça, corpo e cauda e sua anatomia microcirúrgica descrita em detalhes. As medidas adquiridas são apresentadas e discutidas. Conclusão: A complexa anatomia do hipocampo pode ser entendida de uma forma tridimensional durante dissecções microcirúrgicas. As medidas pré-operatórias mostraram-se guias anatômicos úteis para corticotomia na técnica de Niemeyer. PALAVRAS-CHAVE: anatomia cirúrgica, hipocampo, amígdalo-hipocampectomia seletiva, cirurgia da epilepsia, vascularização.Hippocampal microsurgical anatomy regarding the selective amygdalohippocampectomy in the Niemeyer's technique perspective and preoperative method to maximize the corticotomy ABSTRACT -The deep knowledge of hippocampal microsurgical anatomy is paramount in epilepsy surgery. One of the most used techniques is those proposed by Niemeyer. Purpose: To describe the hippocampal anatomy in details and to present a technique which preoperative anatomical points in MRI are identified to guide the corticotomy. Method: Microsurgical dissections were performed in twenty brain hemispheres and eight cadaveric heads to identify temporal lobe and hippocampus structures. Thirty two patients with drug-resistent temporal lobe epilepsy underwent a selective amygdalohippocampectomy with Niemeyer's technique being measured three preoperative MRI preoperative distances to guide the corticotomy. Results: The hippocampus was divided in head, body and tail and its microsurgical anatomy described in details. The MRI measurements are presented and discussed. Conclusion: The knowledge of the complex anatomy of the hippocampus can be achieved in a three-dimensional way during microsurgical dissections not. The preoperative MRI measurement is a reasonable guide to perform temporal corticotomy in Niemeyer's techinique. Dr. Gustavo Rassier Isolan -Rua Ramiro Barcelos 2171 / 31. 90035-007 Porto Alegre RS -Brasil. E-mail: gisolan@yahoo.com.br A anatomia cirúrgica do lobo temporal, especialmente de sua porção mesial, é complexa, exigindo um apurado conhecimento da equipe cirúrgica, sem o qual os resultados do tratamento serão prejudicados por altos ...

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“…Several theories concerning the AHS have been presented. Spielmeyer considered AHS to be the result of arterial spasm and anoxia during major convulsive seizures 1 . In a report on patients with TLE, Falconer introduced the term ‘mesial temporal sclerosis’ to describe the diffuse lesion found in abundance in the amygdaloid nucleus and uncus of the parahippocampal gyrus 2 .…”

Section: Introductionmentioning

confidence: 99%

“…Spielmeyer considered AHS to be the result of arterial spasm and anoxia during major convulsive seizures. 1 In a report on patients with TLE, Falconer introduced the term 'mesial temporal sclerosis' to describe the diffuse lesion found in abundance in the amygdaloid nucleus and uncus of the parahippocampal gyrus. 2 In the discussion on the origin of mesial temporal sclerosis, it was proposed that hypoxic episodes in infancy and early childhood play a more important role than birth trauma.…”

Section: Introductionmentioning

confidence: 99%

Pathological effect of seizures on the hippocampus in cases with temporal lobe epilepsy caused by brain tumors

Uesugi

Shimizu

Arai

et al. 2002

Psychiatry Clin Neurosci

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The cause of Ammon's horn sclerosis in temporal lobe epilepsy has not yet been clarified. In the present study, the pathological effect of epileptic seizures on the hippocampus was investigated in surgically treated patients with brain tumor-induced temporal lobe epilepsy. Tumors involving the hippocampus were identified as the foci of epilepsy in 13 patients (seven male and six female) and resected after epileptic discharges were found at the hippocampus on intraoperative electrocorticogram. The mean age at operation was 29.8 ± 11.5 years and the mean age of seizure onset was 19.9 ± 10.8 years. Because only three of the 13 patients who underwent temporal lobectomy for brain tumors involving the hippocampus had Ammon's horn sclerosis pathologically, it was concluded that it was very unlikely that the Ammon's horn sclerosis was produced by the epileptic seizures. Two of the three patients with pathological signs of Ammon's horn sclerosis had episodes of coma, covulsion, high fever and cyanosis in their past histories that might have portended the appearance of Ammon's horn sclerosis later in their lives.

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The Anatomic Substratum of the Convulsive State

Cited by 96 publications

References 0 publications

Complex Partial Seizures: Cerebellar Metabolism

Complex Partial Seizures: Cerebellar Metabolism

Anatomia microcirúrgica do hipocampo na Amígdalo-hipocampectomia seletiva sob a perspectiva da técnica de Niemeyer e método pré-operatório para maximizar a corticotomia

Pathological effect of seizures on the hippocampus in cases with temporal lobe epilepsy caused by brain tumors

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