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Epilepsia 2022 Jun 15. Epub 2022 Jun 15.

Radiology Department, Stanford University, Stanford, California, USA.

Objective: We explore the possibility of using diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) to discern microstructural abnormalities in the hippocampus indicative of mesial temporal sclerosis (MTS) at the subfield level.

Methods: We analyzed data from 57 patients with refractory epilepsy who previously underwent 3.0-T magnetic resonance imaging (MRI) including DTI as a standard part of presurgical workup. Read More

Epilepsia 2022 Jun 14. Epub 2022 Jun 14.

Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.

Objective: To reveal the possible routine of brain network dynamic alterations in patients with mesial temporal lobe epilepsy (mTLE) and to establish a predicted model of seizure recurrence during interictal periods.

Methods: Seventy-nine unilateral mTLE patients with hippocampal sclerosis and 97 healthy controls from two centers were retrospectively enrolled. Dynamic brain configuration analyses were performed with resting-state functional magnetic resonance imaging (MRI) data to quantify the functional stability over time and the dynamic interactions between brain regions. Read More

Insights Imaging 2022 Jun 4;13(1):99. Epub 2022 Jun 4.

Division of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.

Objectives: MRI negative epilepsy has evolved through increased usage of 3 T and insights from surgically correlated studies. The goal of this study is to describe dedicated 3 T epilepsy MRI findings in medically refractory epilepsy (MRE) patients at a tertiary epilepsy center to familiarize radiologists with an updated spectrum and frequency of potential imaging findings in the adult MRE population.

Methods: Included were all patients with MRE admitted to the epilepsy monitoring unit who were discussed at weekly interdisciplinary imaging conferences at Toronto Western Hospital with MRI studies (3 T with dedicated epilepsy protocol) performed between January 2008 and January 2021. Read More

Epilepsia 2022 Jun 2. Epub 2022 Jun 2.

Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.

Objective: Recent work has shown that people with common epilepsies have characteristic patterns of cortical thinning, and that these changes may be progressive over time. Leveraging a large multicenter cross-sectional cohort, we investigated whether regional morphometric changes occur in a sequential manner, and whether these changes in people with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS) correlate with clinical features.

Methods: We extracted regional measures of cortical thickness, surface area, and subcortical brain volumes from T1-weighted (T1W) magnetic resonance imaging (MRI) scans collected by the ENIGMA-Epilepsy consortium, comprising 804 people with MTLE-HS and 1625 healthy controls from 25 centers. Read More

Turk J Pediatr 2022 ;64(2):302-311

Department of Pediatric Neurology, İstanbul Medipol University Faculty of Medicine, İstanbul, Turkey.

Background: This study aimed to evaluate the clinical, electrophysiological, etiological features, and treatment response in children with epileptic encephalopathy with electrical status epilepticus during slow sleep (ESES).

Methods: Clinical data, records of electroencephalograms (EEG), and brain magnetic resonance imaging (MRI) findings of 33 patients with ESES who were treated, and followed up for at least one year were retrospectively analyzed.

Results: Of all patients, 57. Read More

Acta Neuropathol 2022 Jul 12;144(1):107-127. Epub 2022 May 12.

Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, Box 29, Queen Square, London, WC1N 3BG, UK.

Mesial temporal lobe epilepsy with hippocampal sclerosis and a history of febrile seizures is associated with common variation at rs7587026, located in the promoter region of SCN1A. We sought to explore possible underlying mechanisms. SCN1A expression was analysed in hippocampal biopsy specimens of individuals with mesial temporal lobe epilepsy with hippocampal sclerosis who underwent surgical treatment, and hippocampal neuronal cell loss was quantitatively assessed using immunohistochemistry. Read More

Epilepsy Behav Rep 2022 20;18:100524. Epub 2022 Jan 20.

NYU Comprehensive Epilepsy Center, 223 East 34 Street, New York, NY 10016, USA.

Religious experiences in epilepsy patients have provoked much interest with suggestions that hyperreligiosity is associated with temporal lobe seizures. Extreme varieties of religious behavior may be more frequent in epilepsy patients during ictal activity or during post-ictal psychotic episodes. We report a 75 year-old man with epilepsy who developed a progressive decline in cognition and behavior following a religious conversion 15 years earlier. Read More

J Neurol 2022 May 5. Epub 2022 May 5.

AP-HP, Epilepsy Unit, GH Pitié-Salpêtrière-Charles Foix, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.

Background: Sturge-Weber syndrome (SWS) is a neurocutaneous disorder caused by a somatic mutation in the GNAQ gene, leading to capillary venous malformations with neurological, ocular, and cutaneous abnormalities. Descriptions of adult and elderly patients with SWS are scarce compared to those of neonates or children.

Methods: We reviewed clinical, neuro-radiological and electroencephalographical findings of adult patients diagnosed with SWS, treated in our tertiary center for rare epilepsies. Read More

Neurology 2022 May 4. Epub 2022 May 4.

Department of Neurology, Austin Hospital, Heidelberg, Victoria, Australia.

Background And Objectives: MR and PET imaging enables subgroups of Temporal Lobe Epilepsy (TLE) to be defined on the basis of structural pathology. Few studies have examined the variation in electroclinical seizure spread patterns based on imaging findings. We performed a retrospective cohort study, to investigate the electroclinical differences between three specific groups of TLE: MRI-negative PET-positive TLE (MRI-neg TLE), temporal lobe lesion TLE (Lesional TLE) and unilateral hippocampal sclerosis TLE (HS-TLE). Read More

Epilepsia 2022 06 3;63(6):1443-1474. Epub 2022 May 3.

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

The goal of this paper is to provide updated diagnostic criteria for the epilepsy syndromes that have a variable age of onset, based on expert consensus of the International League Against Epilepsy Nosology and Definitions Taskforce (2017-2021). We use language consistent with current accepted epilepsy and seizure classifications and incorporate knowledge from advances in genetics, electroencephalography, and imaging. Our aim in delineating the epilepsy syndromes that present at a variable age is to aid diagnosis and to guide investigations for etiology and treatments for these patients. Read More

Medicina (Kaunas) 2022 Mar 26;58(4). Epub 2022 Mar 26.

Samsung Medical Center, Department of Neurology, Sungkyunkwan University School of Medicine, Seoul 06355, Korea.

In the present study, a detailed investigation of substructural volume change in the hippocampus (HC) and amygdala (AMG) was performed and the association with clinical features in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) determined. The present study included 22 patients with left-sided TLE-HS (LTLE-HS) and 26 patients with right-sided TLE-HS (RTLE-HS). In addition, 28 healthy controls underwent high-resolution T2-weighted image (T2WI) and T1-weighted image (T1WI) MRI scanning. Read More

BMC Neurol 2022 Apr 8;22(1):133. Epub 2022 Apr 8.

Department of Neurology, Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar.

Background: Diabetic striatopathy is a rare neurological manifestation of nonketotic hyperglycemia that presents with contralateral hemichorea-hemiballismus. Presentation with concurrent seizures is rarely reported.

Clinical Presentation: We report a case of diabetic striatopathy presenting with focal and generalized tonic-clonic seizures (GTCS) with right hemichorea-hemiballismus induced by a ketotic hyperglycemic state. Read More

Brain 2022 04;145(3):925-938

Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA.

Focal malformations of cortical development including focal cortical dysplasia, hemimegalencephaly and megalencephaly, are a spectrum of neurodevelopmental disorders associated with brain overgrowth, cellular and architectural dysplasia, intractable epilepsy, autism and intellectual disability. Importantly, focal cortical dysplasia is the most common cause of focal intractable paediatric epilepsy. Gain and loss of function variants in the PI3K-AKT-MTOR pathway have been identified in this spectrum, with variable levels of mosaicism and tissue distribution. Read More

Eur Radiol 2022 Mar 28. Epub 2022 Mar 28.

School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.

Objectives: To investigate whether quantitative T2 mapping is complementary to [F]FDG PET in epileptogenic zone detection, thus improving the lateralization accuracy for drug-resistant mesial temporal lobe epilepsy (MTLE) using hybrid PET/MR.

Methods: We acquired routine structural MRI, T2-weighted FLAIR, whole brain T2 mapping, and [F]FDG PET in 46 MTLE patients and healthy controls on a hybrid PET/MR scanner, followed with computing voxel-based z-score maps of patients in reference to healthy controls. Asymmetry indexes of the hippocampus were calculated for each imaging modality, which then enter logistic regression models as univariate or multivariate for lateralization. Read More

J Neurol 2022 Mar 25. Epub 2022 Mar 25.

Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Pearse Street, Room 5.43, Dublin 2, Ireland.

Amyotrophic lateral sclerosis (ALS) is associated with considerable clinical heterogeneity spanning from diverse disability profiles, differences in UMN/LMN involvement, divergent progression rates, to variability in frontotemporal dysfunction. A multitude of classification frameworks and staging systems have been proposed based on clinical and neuropsychological characteristics, but disease subtypes are seldom defined based on anatomical patterns of disease burden without a prior clinical stratification. A prospective research study was conducted with a uniform imaging protocol to ascertain disease subtypes based on preferential cerebral involvement. Read More

Epilepsia 2022 05 25;63(5):1081-1092. Epub 2022 Mar 25.

Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.

Objectives: Around 30% of patients undergoing surgical resection for drug-resistant mesial temporal lobe epilepsy (MTLE) do not obtain seizure freedom. Success of anterior temporal lobe resection (ATLR) critically depends on the careful selection of surgical candidates, aiming at optimizing seizure freedom while minimizing postoperative morbidity. Structural MRI and FDG-PET neuroimaging are routinely used in presurgical assessment and guide the decision to proceed to surgery. Read More

Front Neurol 2022 18;13:812432. Epub 2022 Feb 18.

Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Purpose: Hippocampal volumetry is an important biomarker to quantify atrophy in patients with mesial temporal lobe epilepsy. We investigate the sensitivity of automated segmentation methods to support radiological assessments of hippocampal sclerosis (HS). Results from FreeSurfer and FSL-FIRST are contrasted to a deep learning (DL)-based segmentation method. Read More

Brain Commun 2022 8;4(2):fcab284. Epub 2021 Dec 8.

Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA.

Temporal lobe epilepsy is associated with MRI findings reflecting underlying mesial temporal sclerosis. Identifying these MRI features is critical for the diagnosis and management of temporal lobe epilepsy. To date, this process relies on visual assessment by highly trained human experts (e. Read More

Epilepsy Behav 2022 04 18;129:108574. Epub 2022 Feb 18.

Department of Surgery, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, (FMRP-USP), Brazil.

Introduction: Mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE-HS) is a surgically remediable epilepsy with a relatively high prevalence and psychiatric comorbidities. Depressive disorders may occur in up to 25% of MTLE-HS patients suggesting a common molecular mechanism underlying both conditions.

Objective: To compare the gene expression comprising serotonin 5HT and 5HT, noradrenaline (NA) ADRA1A, and ADRA2A receptors in the hippocampus of MTLE-HS patients with and without major depression. Read More

Ann Clin Transl Neurol 2022 03 15;9(3):242-252. Epub 2022 Feb 15.

Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.

Objectives: Epileptic patients suffer from seizure recurrence after surgery due to the challenging localization. Improvement of the noninvasive imaging-based approach for a better definition of the abnormalities would be helpful for a better outcome.

Methods: The quantitative anisotropy (QA) of diffusion spectrum imaging (DSI) is a quantitative scalar of evaluating the water diffusivity. Read More

Brain Behav 2022 03 14;12(3):e2484. Epub 2022 Feb 14.

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Introduction: The differences of functional connectivity (FC) and functional asymmetry between left and right mesial temporal lobe epilepsy with hippocampal sclerosis (LMTLE and RMTLE) have not been completely clarified yet. The purpose of the present study is to investigate the FC changes and the FC asymmetric patterns of MTLE, and to compare the differences in FC and functional asymmetry between LMTLE and RMTLE.

Methods: In total, 12 LMTLE, 11 RMTLE patients, and 23 healthy controls (HC) were included. Read More

J Clin Imaging Sci 2022 21;12. Epub 2022 Jan 21.

Department of Radiodiagnosis, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, Karnataka, India.

Patients with seizures represent a challenging clinical population both in pediatrics and adults. Accurate diagnosis of the cause of a seizure is important in choosing an effective treatment modality, surgical planning, predicting a prognosis, and follow-up. Magnetic resonance (MR) imaging using a dedicated epilepsy protocol plays a key role in the workup of these patients. Read More

World Neurosurg 2022 May 30;161:e199-e209. Epub 2022 Jan 30.

Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA.

Objective: Temporal lobe epilepsy (TLE) is one of the most common causes of medically refractory focal epilepsy. Anterior temporal lobectomy (ATL) leads to improved seizure control in patients with medically refractory TLE. Various auras are associated with TLE; however, the relationships between aura type and outcome after ATL are poorly understood. Read More

NMC Case Rep J 2021 7;8(1):405-411. Epub 2021 Aug 7.

Department of Neurosurgery, Graduate School of Medicine, Kagoshima University, Kagoshima, Kagoshima, Japan.

Behçet's disease (BD) is a rare chronic inflammatory disease associated with systemic vasculitis. Involvement of the nervous system in BD is called neuro-BD (NBD). Epilepsy related to NBD is uncommon but responds well to anti-epileptic drugs. Read More

Epilepsy Res 2022 02 10;180:106858. Epub 2022 Jan 10.

Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA; Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA.

Purpose: Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is the most common drug-resistant epilepsy. Despite major advances in epilepsy research, the epileptogenesis of the MTLE-HS is not well understood. The altered neuroimmune response is one of the pathomechanisms linked to progressive epileptogenesis in MTLE-HS, and understanding its role may help design future cures for pharmaco-resistant MTLE-HS. Read More

J Neuroimaging 2022 03 29;32(2):292-299. Epub 2021 Dec 29.

Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.

Background And Purpose: MRI has a crucial role in presurgical evaluation of drug-resistant focal epilepsy patients. Whether and how much 7T MRI further improves presurgical diagnosis compared to standard of care 3T MRI remains to be established. We investigate the added value 7T MRI offers in surgical candidates with remaining clinical uncertainty after 3T MRI. Read More

Front Neurol 2021 9;12:779495. Epub 2021 Dec 9.

Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States.

To evaluate declarative memory outcomes in medically refractory epilepsy patients who underwent either a highly selective laser ablation of the amygdalohippocampal complex or a conventional open temporal lobe resection. Post-operative change scores were examined for verbal memory outcome in epilepsy patients who underwent stereotactic laser amygdalohippocampotomy (SLAH: = 40) or open resection procedures ( = 40) using both reliable change index (RCI) scores and a 1-SD change metric. Using RCI scores, patients undergoing open resection (12/40, 30. Read More

Curr Med Imaging 2022 ;18(3):285-291

Department of Radiology, College of Medicine, Yeungnam University, Daegu, South Korea.

T2/FLAIR hyperintensity in the mesial temporal lobe is the most common MR finding of herpes simplex encephalitis, but may be observed in other infectious and non-infectious diseases. The former includes herpes human virus 6 encephalitis, Japanese encephalitis, and neurosyphilis, and the latter autoimmune encephalitis, gliomatosis cerebri, bilateral or paradoxical posterior cerebral artery infarction, status epilepticus, and hippocampal sclerosis. Thus, T2/FLAIR hyperintensity in the mesial temporal lobe is not a disease-specific magnetic resonance imaging finding, and these conditions must be differentiated to ensure proper treatment. Read More

Front Integr Neurosci 2021 30;15:747237. Epub 2021 Nov 30.

Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.

Depression is the most frequent psychiatric comorbidity seen in mesial temporal lobe epilepsy (MTLE) patients with hippocampal sclerosis (HS). Moreover, the HS is the most frequent pathological hallmark in MTLE-HS. Although there is a well-documented hippocampal volumetric reduction in imaging studies of patients with major depressive disorder, in epilepsy with comorbid depression, the true role of the hippocampus is not entirely understood. Read More

Pract Neurol 2022 Apr 13;22(2):117-119. Epub 2021 Dec 13.

Chalfont Centre for Epilepsy, London, UK.

Diabetes mellitus may arise abruptly and decompensate suddenly, leading to a hyperglycaemic hyperosmolar state. Coma often ensues, although this usually reverses after the metabolic abnormalities have resolved. Acute symptomatic seizures can also occur in patients who are conscious, although these usually resolve after osmolarity and glycaemia have normalised. Read More