Document Detail


From mesial temporal lobe to temporoperisylvian seizures: a quantified study of temporal lobe seizure networks.
MedLine Citation:
PMID:  20738379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The determination of epileptogenic structures in partial epilepsy is crucial in the context of epilepsy surgery. In this study we have quantified the "epileptogenicity" of mesial temporal lobe structures (M), lateral neocortical regions (L), and extratemporal perisylvian structures (ET) in patients with temporal lobe epilepsy (TLE), in order to classify the brain networks involved in seizure generation.
METHODS: Thirty-four patients having TLE investigated by intracerebral recordings using stereotactic electroencephalography (EEG) (SEEG) were selected. Epileptogenicity of M, L, and ET structures was quantified according to the "epileptogenicity index" (EI), a new way to quantify rapid discharges at seizure onset, ranging from 0 (no epileptogenicity) to 1 (maximal epileptogenicity).
RESULTS: Automatic clustering using EI values from M, L, and ET separated patients into four classes: mesial group (max EI in M), lateral group (max EI in L), mesiolateral group (high EI in both M and L) and temporoperisylvian group (TPS) (high values in ET). The median number of highly epileptogenic structures (defined by EI >0.3) was four, a result confirming that most TLE is organized as "epileptogenic networks." We found that the duration of epilepsy was correlated with the number of epileptogenic structures and that surgical prognosis was also related to the extent of the epileptogenicity in the brain.
CONCLUSIONS: Several distinct epileptogenic networks are involved in seizure generation in TLE. Findings advocate for a progressive recruitment of epileptogenic structures in human brain with time.
Authors:
Fabrice Bartolomei; Delphine Cosandier-Rimele; Aileen McGonigal; Sandrine Aubert; Jean Régis; Martine Gavaret; Fabrice Wendling; Patrick Chauvel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  51     ISSN:  1528-1167     ISO Abbreviation:  Epilepsia     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2010-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2147-58     Citation Subset:  IM    
Copyright Information:
Wiley Periodicals, Inc. © 2010 International League Against Epilepsy.
Affiliation:
INSERM, U751, Laboratoire de Neurophysiologie et Neuropsychologie, Marseille, France. fabrice.bartolomei@ap-hm.fr
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MeSH Terms
Descriptor/Qualifier:
Anterior Temporal Lobectomy / methods
Anticonvulsants / therapeutic use
Brain / physiopathology*,  surgery
Brain Mapping
Cerebral Cortex / physiopathology,  surgery
Cluster Analysis
Drug Resistance
Electrodes, Implanted
Electroencephalography / statistics & numerical data
Epilepsies, Partial / diagnosis,  physiopathology*,  surgery
Epilepsy, Temporal Lobe / diagnosis,  physiopathology*,  surgery
Functional Laterality / physiology
Humans
Neocortex / physiopathology
Nerve Net / physiopathology*
Neurosurgical Procedures
Radiosurgery
Stereotaxic Techniques
Temporal Lobe / physiopathology,  surgery
Chemical
Reg. No./Substance:
0/Anticonvulsants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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