Document Detail

Occult middle fossa encephaloceles in patients with temporal lobe epilepsy.
MedLine Citation:
PMID:  20920939     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Middle fossa encephaloceles are rare structural defects previously reported to cause complex partial seizures. Their debated etiology is either by failed union of temporal and sphenoid bone ossification centers or by erosion of the middle fossa floor secondary to pressure phenomena. Although magnetic resonance imaging (MRI) often reveals abnormalities, the actual encephalocele may not be identified preoperatively. METHODS: We present three cases of middle fossa encephaloceles that were identified intraoperatively and provide a review of the relevant literature. RESULTS: All three of our case presentations demonstrate patients with medically intractable epilepsy and intraoperative findings of middle fossa encephaloceles. In all patients, careful retrospective analysis of preoperative imaging provided clues to these encephaloceles, although none were suspected before surgery. After resection of the area all patients had improved seizure outcome. CONCLUSION: Middle fossa encephaloceles should be recognized as a potential source of epileptic pathology in patients with complex partial seizures. Although only 12 cases are reported in the literature, we believe that this phenomenon may be more common than previously recognized. We suggest that simple resection of the encephalocele alone may result in long-lasting, excellent seizure outcomes without amygdalohippocampectomy.
Richard W Byrne; Adam P Smith; David Roh; Andres Kanner
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  World neurosurgery     Volume:  73     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  541-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA.
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MeSH Terms
Cranial Fossa, Middle / pathology*,  radionuclide imaging
Encephalocele / complications,  pathology*,  radionuclide imaging
Epilepsy, Temporal Lobe / complications,  pathology*,  radionuclide imaging
Gliosis / complications,  pathology
Magnetic Resonance Imaging
Middle Aged
Neurosurgical Procedures
Positron-Emission Tomography
Seizures / therapy
Treatment Outcome

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