Document Detail

Correlation between temporal pole MRI abnormalities and surface ictal EEG patterns in patients with unilateral mesial temporal lobe epilepsy.
MedLine Citation:
PMID:  17113794     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objective of this retrospective study is to analyze ictal patterns observed during continuous Video-EEG monitoring in patients with temporal lobe epilepsy (TLE) due to unilateral hippocampal sclerosis (HS), and to correlate these EEG patterns to temporal pole abnormalities observed on magnetic resonance imaging exams.
METHODS: We analyzed 147 seizures from 35 patients with TLE and unilateral HS. Ictal patterns were classified and correlated to signal abnormalities and volumetric measures of the temporal poles. Volume differences over 10% were considered abnormal.
RESULTS: The most frequent type of ictal pattern was rhythmic theta activity (RTA), encountered in 65.5% of the seizures. Rhythmic beta activity (RBA) was observed in 11% of the seizures, localized attenuation in 8%, interruption of epileptiform discharges in 6%, repetitive discharges in 5.5%, and rhythmic delta activity (RDA) in 4%. Sixty-six percent of the patients presented signal abnormalities in the temporal pole that were always ipsilateral to the HS. Sixty percent presented significant asymmetry of the temporal poles consisting of reduced volume that was also always ipsilateral to HS. Although patients with RTA as the predominant ictal pattern tended to present asymmetry of temporal poles (p=0.305), the ictal EEG pattern did not correlate with temporal pole asymmetry or signal abnormalities.
CONCLUSIONS: RTA is the most frequent initial ictal pattern in patients with TLE due to unilateral HS. Temporal pole signal changes and volumetric reduction were commonly found in this group of patients, both abnormalities appearing always ipsilateral to the HS. However, neither temporal pole volume reduction nor signal abnormalities correlated with the predominant ictal pattern, suggesting that the temporal poles are not crucially involved in the process of epileptogenesis.
Luís Otávio S F Caboclo; Eliana Garzon; Pedro A L Oliveira; Henrique Carrete; Ricardo S Centeno; Marino M Bianchin; Elza Márcia T Yacubian; Américo C Sakamoto
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-11-20
Journal Detail:
Title:  Seizure     Volume:  16     ISSN:  1059-1311     ISO Abbreviation:  Seizure     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-22     Completed Date:  2007-03-22     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  8-16     Citation Subset:  IM    
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MeSH Terms
Age of Onset
Epilepsy, Temporal Lobe / pathology*,  physiopathology
Hippocampus / pathology*
Magnetic Resonance Imaging*
Middle Aged
Retrospective Studies
Seizures / pathology*,  physiopathology
Video Recording

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