Document Detail


Small temporal pole encephaloceles: a treatable cause of "lesion negative" temporal lobe epilepsy.
MedLine Citation:
PMID:  20384762     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Epilepsy due to encephaloceles of the temporal pole may be an under recognized, treatable cause of refractory temporal lobe epilepsy (TLE). We describe three adult patients initially labeled "lesion negative" TLE. In all, video–electroencephalography (EEG) revealed ictal theta in the left temporal region and positron emission tomography (PET) showed temporal lobe hypometabolism, but neuropsychology revealed preserved verbal memory. Close inspection of structural magnetic resonance imaging (MRI) suggested subtle abnormalities at the tip of the left temporal lobe. High resolution computed tomography (CT) confirmed bony defects in the inner table of the skull. 3T MRI with fine coronal and sagittal slices indicated cerebrospinal fluid (CSF) and brain tissue protruding into the defects. All proceeded to resection of the temporal tip and became seizure free. Patients with "lesion negative" TLE should have careful review of images covering the temporal pole. If encephalocele is suspected, further imaging with high-resolution CT and MRI can be helpful. Temporal polar resection, sparing mesial structures, appears to be curative.
Authors:
Amal Abou-Hamden; Mandy Lau; Gavin Fabinyi; Samuel F Berkovic; Graeme D Jackson; L Anne Mitchell; Renate Kalnins; Greg Fitt; John S Archer
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Epilepsia     Volume:  51     ISSN:  1528-1167     ISO Abbreviation:  Epilepsia     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-10     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:  2199-202     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Austin Health, Melbourne, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Electroencephalography
Encephalocele / complications*,  diagnosis*,  surgery
Epilepsy, Temporal Lobe / diagnosis*,  etiology*,  surgery
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Magnetic Resonance Imaging
Male
Positron-Emission Tomography
Temporal Lobe / radionuclide imaging,  surgery
Video Recording
Chemical
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18

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


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