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AJNR Am J Neuroradiol 2019 Feb 7. Epub 2019 Feb 7.

Neurosurgery (P.L., R.M.R.), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Background And Purpose: Identification of mesial temporal sclerosis is critical in the evaluation of individuals with temporal lobe epilepsy. Our aim was to assess the performance of FDA-approved software measures of hippocampal volume to identify mesial temporal sclerosis in patients with medically refractory temporal lobe epilepsy compared with the initial clinical interpretation of a neuroradiologist.

Materials And Methods: Preoperative MRIs of 75 consecutive patients who underwent a temporal resection for temporal lobe epilepsy from 2011 to 2016 were retrospectively reviewed, and 71 were analyzed using Neuroreader, a commercially available automated segmentation and volumetric analysis package. Read More

Cureus 2018 Nov 22;10(11):e3623. Epub 2018 Nov 22.

Otolaryngology, University of Kansas Medical Center, Kansas City, USA.

The aim of this report is to present a case of mesial temporal lobe sclerosis (MTS) causing medically refractory seizures, which was initially disguised as temporal lobe encephalocele secondary to prior otologic surgery. Temporal lobe encephaloceles are characterized by a defect within the middle cranial fossa that results in the abnormal communication of the meninges into the pneumatized skull base. After the temporal lobe encephalocele repair, the patient continued to have seizures and was subsequently diagnosed with mesial temporal lobe sclerosis. Read More

Front Neurol 2018 9;9:1143. Epub 2019 Jan 9.

Epilepsy Unit, Department of Neurology, Hospital Clinic i Provincial, Barcelona, Spain.

Antibodies to glutamic acid decarboxylase (GAD ab) have been found in patients with limbic encephalitis (LE) and chronic pharmacoresistant focal epilepsy (FE). The objectives of the study were to: (1) analyze the clinical and neuroimaging course of patients with FE+GAD ab, (2) compare these characteristics with a control group, and (3) describe the most affected cerebral areas with structural and functional imaging. Patients with FE + high titers of GAD ab and a follow-up of at least 5 years were selected. Read More

Hum Brain Mapp 2019 Jan 21. Epub 2019 Jan 21.

Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania.

Mesial temporal lobe epilepsy (TLE) is a common neurological disorder affecting the hippocampus and surrounding medial temporal lobe (MTL). Although prior studies have analyzed whole-brain network distortions in TLE patients, the functional network architecture of the MTL at the subregion level has not been examined. In this study, we utilized high-resolution 7T T2-weighted magnetic resonance imaging (MRI) and resting-state BOLD-fMRI to characterize volumetric asymmetry and functional network asymmetry of MTL subregions in unilateral medically refractory TLE patients and healthy controls. Read More

Sci Rep 2019 Jan 18;9(1):215. Epub 2019 Jan 18.

Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.

Imaging in the field of epilepsy surgery remains an essential tool in terms of its ability to identify regions where the seizure focus might present as a resectable area. However, in many instances, an obvious structural abnormality is not visualized. This has created the opportunity for new approaches and imaging innovation in the field of epilepsy, such as with Diffusion Tensor Imaging (DTI) and Diffusion Tensor Tractography (DTT). Read More

Ann Neurol 2019 Feb 17;85(2):241-250. Epub 2019 Jan 17.

Departments of Medicine and Neurology, Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Objective: We investigated the relationship between the interictal metabolic patterns, the extent of resection of F-fluorodeoxyglucose positron emission tomography ( FDG-PET) hypometabolism, and seizure outcomes in patients with unilateral drug-resistant mesial temporal lobe epilepsy (MTLE) following anterior temporal lobe (TL) resection.

Methods: Eighty-two patients with hippocampal sclerosis or normal magnetic resonance imaging (MRI) findings, concordant FDG-PET hypometabolism, and at least 2 years of postoperative follow-up were included in this 2-center study. The hypometabolic regions in each patient were identified with reference to 20 healthy controls (p < 0. Read More

J Affect Disord 2019 03 24;246:452-457. Epub 2018 Dec 24.

Centro de Epilepsia de Santa Catarina (CEPESC), Hospital Universitário (HU), Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Centro de Neurociências Aplicadas (CeNAp), HU, UFSC, Florianópolis, SC, Brazil; Serviço de Neurologia, HU-UFSC, Florianópolis, SC, Brazil; Departamento de Clínica Médica, HU-UFSC, Florianópolis, SC, Brazil.

Background: Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) is the most prevalent type of surgically remediable epilepsy and highly associated with psychiatric comorbidities. This study aimed to evaluate Hospital anxiety and depression scale-anxiety subscale (HADS-A) and The State-Trait Anxiety Inventory - Trait subscale (STAI-T) accuracy for detection of anxiety disorders in patients with drug-resistant MTLE-HS.

Methods: One hundred three consecutive patients with drug-resistant MTLE-HS were enrolled. Read More

Neuroimage Clin 2018 Dec 8:101631. Epub 2018 Dec 8.

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address:

Objectives: To explore the dynamic changes of white matters following anterior temporal lobectomy (ATL) in mesial temporal lobe epilepsy (MTLE) patients who achieved seizure-free at two-year follow-up.

Methods: Diffusion tensor imaging (DTI) was obtained in ten MTLE patients at five serial time points: before surgery, three months, six months, 12 months and 24 months after surgery, as well as in 11 age- and sex-matched healthy controls at one time point. Regions with significant postoperative fractional anisotropy (FA) changes and their dynamic changes were confirmed by comparing all preoperative and postoperative data using Tract-Based Spatial Statistics (TBSS). Read More

J Clin Imaging Sci 2018 15;8:43. Epub 2018 Nov 15.

Department of Radiodiagnosis, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India.

Introduction: Magnetic resonance imaging (MRI) is the current imaging tool of choice in the investigation of patients with seizures. The advent of high-resolution MRI with a dedicated seizure protocol has significantly increased the chances of identifying a cause, resulting in a positive clinical impact on the management of these patients.

Aims: The aims of this study were to evaluate the diagnostic efficacy of standard MRI, identify whether there is an increase in the diagnostic yield with the addition of dedicated seizure protocol, and compare the diagnostic yields of MRI and electroencephalogram (EEG) individually and in combination. Read More

Neurotherapeutics 2019 Jan;16(1):182-191

Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, 33 Queen Square, London, WC1E 6BT, UK.

Laser interstitial thermal therapy (LITT) is an alternative to open surgery for drug-resistant focal mesial temporal lobe epilepsy (MTLE). Studies suggest maximal ablation of the mesial hippocampal head and amygdalohippocampal complex (AHC) improves seizure freedom rates while better neuropsychological outcomes are associated with sparing of the parahippocampal gyrus (PHG). Optimal trajectories avoid sulci and CSF cavities and maximize distance from vasculature. Read More

Epilepsia 2019 Jan 26;60(1):121-130. Epub 2018 Nov 26.

Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Objective: The epileptogenic network underlying secondarily generalized tonic-clonic seizures (sGTCS) in mesial temporal lobe epilepsy (mTLE) is not well understood. Here, we investigated alterations in the probabilistic hippocampal-thalamic pathway (pHTP) underlying sGTCS using diffusion tensor imaging and resting-state functional magnetic resonance imaging in a cohort of TLE patients with hippocampal sclerosis (HS).

Methods: We consecutively recruited 51 unilateral TLE-HS patients (26 with and 25 without sGTCS) and 22 healthy controls. Read More

Neuroradiology 2019 Feb 23;61(2):119-127. Epub 2018 Oct 23.

Department of Radiology, University of Michigan, 1500 East Medical Center Drive, 200 Hawkins Dr., Ann Arbor, MI, 48109, USA.

Purpose: To assess imaging, clinical, and pathological features of mesial temporal lobe epilepsy (mTLE) patients with amygdala enlargement (AE) in comparison with those with mesial temporal sclerosis (MTS).

Methods: Clinical, imaging, and pathologic features were retrospectively reviewed in 40 mTLE patients with postoperative follow-up (10 with AE and 30 with MTS). The volumes and signal intensity of the amygdala and hippocampus were assessed in 10 AE, 10 age- and sex-matched MTS patients, and 12 controls (HC). Read More

Ann Clin Transl Neurol 2018 Oct 27;5(10):1200-1210. Epub 2018 Sep 27.

Developmental Neurosciences UCL Great Ormond Street Institute of Child Health University College London London United Kingdom.

Objective: In contrast to adult cohorts, neocortical changes in epileptic children with hippocampal damage are not well characterized. Here, we mapped multimodal neocortical markers of epilepsy-related structural compromise in a pediatric cohort of temporal lobe epilepsy and explored how they relate to clinical factors.

Methods: We measured cortical thickness, gray-white matter intensity contrast and intracortical FLAIR intensity in 22 patients with hippocampal sclerosis (HS) and 30 controls. Read More

PLoS One 2018 19;13(10):e0206095. Epub 2018 Oct 19.

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

Objectives: To investigate the long-term postoperative outcomes and predictive factors associated with poor surgical outcomes in mesial temporal lobe epilepsy (MTLE).

Materials And Methods: We enrolled patients with MTLE who underwent resective surgery at single university-affiliated hospital. Surgical outcomes were determined using a modified Engel classification at the 2nd and 5th years after surgery and the last time of follow-up. Read More

Front Neurol 2018 4;9:820. Epub 2018 Oct 4.

Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Magnetic resonance imaging (MRI) and positron emission tomography (PET) with F-fluorodeoxyglucose (FDG) are valuable tools for evaluating hippocampal sclerosis (HS); however, bias may arise during visual analyses. The aim of this study was to evaluate and compare MRI and PET post-processing techniques, automated quantitative hippocampal volume (Q-volume), and fluid-attenuated inversion-recovery (FLAIR) signal (Q-FLAIR) and glucose metabolism (Q-PET) analyses in patients with HS. We collected MRI and FDG-PET images from 54 patients with HS and 22 healthy controls and independently performed conventional visual analyses (CVA) of PET (CVA-PET) and MRI (CVA-MRI) images. Read More

J Vet Intern Med 2018 Nov 16;32(6):2037-2044. Epub 2018 Oct 16.

Department of Internal Medicine and Clinic for Horses, Dogs and Cats, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, Wrocław, Poland.

Background: In humans, temporal lobe epilepsy (TLE), is a type of focal epilepsy occurring mainly in the mesial TLE (mTLE), commonly associated with hippocampal sclerosis (HS).

Objectives: According to recent studies, TLE might also occur in dogs and could be associated with hippocampal atrophy (HA)/HS. To date, hippocampal lesions have not been correlated with electroencephalographic (EEG) findings in epileptic dogs. Read More

Epilepsia 2019 Jan 15;60(1):e1-e5. Epub 2018 Oct 15.

Department of Basic & Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

We investigated gray and white matter morphology in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (mTLE+HS) and first-degree asymptomatic relatives of patients with mTLE+HS. Using T1-weighted magnetic resonance imaging (MRI), we sought to replicate previously reported findings of structural surface abnormalities of the anterior temporal lobe in asymptomatic relatives of patients with mTLE+HS in an independent cohort. We performed whole-brain MRI in 19 patients with mTLE+HS, 14 first-degree asymptomatic relatives of mTLE+HS patients, and 32 healthy control participants. Read More

Epilepsy Res 2018 11 23;147:51-57. Epub 2018 Aug 23.

Clinical Neurology Sector, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 650, Vila Clementino, CEP 04039-002, São Paulo, SP, Brazil.

Purpose: To evaluate if the duration of epilepsy influences MRI volumes of the hippocampus, amygdala, parahippocampal gyrus, entorhinal cortex and temporal pole of both hemispheres and epileptogenic hippocampus neuronal cell density and dentate gyrus granular cells distribution in patients with refractory mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE/HS).

Methods: Seventy-seven patients with refractory MTLE/HS submitted to surgery were included. Histopathological analysis included: (1) quantitative: hippocampal subfields and total estimated hippocampal cell density (HCD), thickness of the dentate gyrus - normal, thinning or dispersion; (2) qualitative: type of HS and granule cells pathology in the dentate gyrus (normal, neuronal cell loss, dispersion and bilamination). Read More

Clin Neurol Neurosurg 2018 Nov 5;174:144-148. Epub 2018 Sep 5.

Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Boulevard, St. Louis, MO 63110, United States. Electronic address:

Objective: Detection of mesial temporal sclerosis (MTS) in children with epilepsy is important. We assessed whether an image-processing algorithm (Correlative Image Enhancement, CIE) could facilitate recognition of hippocampal signal abnormality in the presence of MTS by increasing contrast to noise ratio between affected hippocampus and normal gray matter.

Patients And Methods: Baseline coronal FLAIR images from brain MRIs of 27 children with epilepsy who underwent hippocampal resection were processed using CIE. Read More

Br J Radiol 2019 Jan 20;92(1093):20170869. Epub 2018 Sep 20.

1 Department of Radiology, Mayo Clinic , Rochester, MN , USA.

Autoimmune epilepsy (AE) is becoming increasingly recognized as a potentially reversible cause of frequent or medically intractable seizures and cognitive deterioration. We describe various presentations of autoimmune encephalopathy which have specifically presented with seizure and describe reported imaging findings. This is organized as a review of the more common autoantibodies which can specifically precipitate seizure according to the intracellular or extracellular location of the targeted antigen. Read More

Medicina (B Aires) 2018;78 Suppl 2:18-24

Cátedra de Neuropediatría, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.

A febrile seizure occurs in association with fever in a child aged 6 to 60 months, without central nervous system infection or other known cause of acute seizures in a child without a prior history of afebrile seizures. Febrile seizures occur in about 2-5% of children. Central nervous system infections should be considered in patients with febrile seizures, even though the frequency of this possibility is low, especially when patients do not return to baseline. Read More

Cureus 2018 Jun 29;10(6):e2894. Epub 2018 Jun 29.

Radiology, University of Miami, MIAMI, USA.

Laser thermal ablation is a novel minimally invasive neurosurgical technique that has proven to be beneficial in the treatment of a select group of neurosurgical conditions such as primary brain neoplasms, brain metastases, radiation necrosis, and epileptogenic lesions such as cortical dysplasia and mesial temporal sclerosis. The applicability of laser thermal ablation and its utility in the treatment of extra-axial (EA) brain neoplasms, mainly meningioma, is another novel use of this technique. Our article discusses the use and benefits of this technique in this particular clinical scenario. Read More

Epilepsy Behav 2018 Oct 24;87:7-13. Epub 2018 Aug 24.

Department of Radiology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ 21941-913, Brazil; Clínica de Diagnóstico por Imagem (CDPI), Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ 2640-102, Brazil.

Purpose: The aim of this study was to evaluate white matter (WM) integrity in vivo in patients with unilateral mesial temporal sclerosis (MTS).

Methods: Diffusion tensor imaging (DTI) findings from patients with left-sided MTS (L-MTS; N = 14) and right-sided MTS (R-MTS; N = 13), all taking antiepileptic medication, were compared with those from gender- and age-matched controls; DTI was performed along 30 noncollinear directions in a 1.5-T scanner. Read More

Clin EEG Neurosci 2018 Aug 17:1550059418794347. Epub 2018 Aug 17.

1 Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Dr von Haunersches Children's Hospital, University of Munich, Munich, Germany.

Patients with temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (MTS) are eligible candidates for resective epilepsy surgery. We report on 2 male patients aged 4 years with suspected TLE due to MTS who were referred for presurgical evaluation. Both patients came to medical attention within the first year of life suffering from febrile status epileptici and subsequent unprovoked seizures. Read More

Neuroreport 2018 10;29(15):1309-1314

Department of Neuroradiology.

This study aims to investigate the diffusion metrics of left versus right temporal lobe epilepsy in a well-defined subgroup of patients with mesial temporal lobe epilepsy (mTLE) because of unilateral hippocampal sclerosis while taking into account interhemispheric differences. Eighteen patients with TLE [nine left temporal lobe epilepsy (LTLE) and nine right temporal lobe epilepsy (RTLE)] and a norm group of 36 nonepileptic individuals were scanned with a multiband accelerated diffusion tensor imaging protocol at 3T. The scalar diffusion tensor parameters fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) and, after projection on a symmetric skeleton, their hemispheric difference (dFA, dMD, and dRD) were analyzed using tract-based spatial statistics. Read More

Pediatr Neurosurg 2018 15;53(5):322-329. Epub 2018 Aug 15.

Division of Neurosurgery, Children's National Medical Center, Washington, District of Columbia, USA.

Introduction: MR-guided laser interstitial thermal therapy (MRgLITT) has emerged as a safe and effective treatment option for the ablation of epileptic foci. Its minimally invasive nature makes it attractive due to decreased morbidity and hospital stay.

Objective: To report the efficacy and safety of MRgLITT as a minimally invasive procedure for the ablation of epileptic foci in the pediatric population of medically refractory lesional epilepsy. Read More

J Epilepsy Res 2018 Jun 30;8(1):6-11. Epub 2018 Jun 30.

Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.

Lesional mesial temporal lobe epilepsy (mTLE) concerns a lesion other than mesial hippocampal sclerosis present in the mesial temporal lobe and causing seizures. The lesions are usually composed of focal cortical dysplasia (FCD) or are tumorous. These are good candidates for surgical treatment. Read More

Epilepsy Behav Case Rep 2018 23;10:71-77. Epub 2018 May 23.

Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.

•Mesial temporal sclerosis (MTS) is a potential late complication of hematological malignancies.•Seizures are usually drug resistant with MTS yet seizure freedom may be achieved by surgery.•Early evaluation for epilepsy surgery is warranted for drug resistant seizures due to AML. Read More

PLoS One 2018 1;13(8):e0199137. Epub 2018 Aug 1.

Radiology and Research Administration, Henry Ford Health System, Detroit, Michigan, United States of America.

Purpose: This study systematically investigates the predictive power of volumetric imaging feature sets extracted from select neuroanatomical sites in lateralizing the epileptogenic focus in mesial temporal lobe epilepsy (mTLE) patients.

Methods: A cohort of 68 unilateral mTLE patients who had achieved an Engel class I outcome postsurgically was studied retrospectively. The volumes of multiple brain structures were extracted from preoperative magnetic resonance (MR) images in each. Read More

Epilepsy Behav Case Rep 2018 8;10:8-13. Epub 2018 Feb 8.

University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Introduction: Drug-resistant epilepsy (DRE) occurs in 20-30% of all patients who develop epilepsy and can occur from diverse causes. Cyclosporine-A (CSA) is an immunosuppressive drug utilized to prevent graft-versus-host disease (GvHD) in transplant patients and is known to cause neurotoxicity, including seizures. In some cases, however, patients can develop DRE. Read More

Noro Psikiyatr Ars 2018 4;55(2):135-139. Epub 2018 May 4.

Haydarpaşa Numune Education and Research Hospital, Department of Neurology, İstanbul, Turkey.

Introduction: To determine the lateralization of lesion by non-invasive methods through correlation of cranial magnetic resonance imaging (MRI) and electroencephalography (EEG) findings in patients with mesial temporal sclerosis (MTS).

Methods: This study included 40 patients (Age range, 19 to 55 years) among 1850 patients who were attending outpatient epilepsy clinic of Haydarpaşa Numune Hospital between the years 2000 and 2013. Exclusion criteria were surgery due to MTS, metabolic and systemic disorders, indefinite diagnosis, and inadequate MRI and EEG evaluations. Read More

J Med Case Rep 2018 Jul 15;12(1):208. Epub 2018 Jul 15.

Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore, Singapore.

Background: Urea cycle disorders are secondary to defects in the system converting ammonia into urea, causing accumulation of ammonia and other byproducts which are neurotoxic. Ornithine transcarbamylase deficiency is the most common of the urea cycle disorders and frequently presents with coma or seizures during hyperammonemia. However, seizures can also occur without metabolic decompensation. Read More

J Neurosurg Pediatr 2018 Sep 22;22(3):270-275. Epub 2018 Jun 22.

4Department of Neurological Surgery, University of Washington; and.

OBJECTIVE Functional connectivity magnetic resonance imaging (fcMRI) is a form of fMRI that allows for analysis of blood oxygen level-dependent signal changes within a task-free, resting paradigm. This technique has been shown to have efficacy in evaluating network connectivity changes with epilepsy. Presurgical data from patients with unilateral temporal lobe epilepsy were evaluated using the fcMRI technique to define connectivity changes within and between the diseased and healthy temporal lobes using a within-subjects design. Read More

Radiology 2018 09 19;288(3):804-812. Epub 2018 Jun 19.

From the Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science (C.L., X.C., Y.L., H.Y., Q.D., H.H., J.Z.), Department of Neurology, The First Affiliated Hospital (K.W., D.W.), State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering (H.Y.), and Center for Innovative and Collaborative Detection and Treatment of Infectious Diseases (J.Z.), Zhejiang University, 38 Zheda Rd, Hangzhou, Zhejiang 310027, China; and the Department of Imaging Sciences, University of Rochester, Rochester, NY (J.Z.).

Purpose To improve diagnosis of hippocampal sclerosis (HS) in patients with mesial temporal lobe epilepsy (MTLE) by using MR fingerprinting and compare with visual assessment of T1- and T2-weighted MR images. Materials and Methods For this prospective study performed between April and November 2016, T1 and T2 maps were obtained and tissue segmentation performed in consecutive patients with drug-resistant MTLE with unilateral or bilateral HS. T1 and T2 maps were compared between 33 patients with MTLE (23 women and 10 men; mean age, 32. Read More

Acad Radiol 2018 Jun 12. Epub 2018 Jun 12.

Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus Box 8131, 510 S Kingshighway Blvd, St. Louis, MO 63110. Electronic address:

Rationale And Objectives: To test whether an image-processing algorithm can aid in visualization of mesial temporal sclerosis on magnetic resonance imaging by selectively increasing contrast-to-noise ratio (CNR) between abnormal hippocampus and normal brain.

Materials And Methods: In this Institutional Review Board-approved and Health Insurance Portability and Accountability Act-compliant study, baseline coronal fluid-attenuated inversion recovery images of 18 adults (10 females, eight males; mean age 41.2 years) with proven mesial temporal sclerosis were processed using a custom algorithm to produce corresponding enhanced images. Read More

Epilepsia 2018 07 12;59(7):1421-1432. Epub 2018 Jun 12.

Vivian L. Smith Department of Neurosurgery, McGovern Medical School, Houston, TX, USA.

Objectives: Laser interstitial thermal therapy (LITT) is a minimally invasive surgical technique for focal epilepsy. A major appeal of LITT is that it may result in fewer cognitive deficits, especially when targeting dominant hemisphere mesial temporal lobe (MTL) epilepsy. To evaluate this, as well as to determine seizure outcomes following LITT, we evaluated the relationships between ablation volumes and surgical or cognitive outcomes in 43 consecutive patients undergoing LITT for MTL epilepsy. Read More

Epilepsy Res 2018 09 26;145:31-39. Epub 2018 May 26.

Cognition and Behavioural Neurology Subsection, Dept. of Neurology, Sree Chitra Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India; R Madhavan Nayar Centre for Comprehensive Epilepsy Care, Dept of Neurology, Sree Chitra Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. Electronic address:

Objectives: To validate concurrent utility of within-scanner encoding and delayed recognition-memory paradigms to ascertain hippocampal activations during task-based memory fMRI.

Methods: Memory paradigms were designed for faces, word-pairs and abstract designs. A deep-encoding task was designed comprising of a total of 9 cycles run within a 1. Read More

World Neurosurg 2018 Aug 23;116:e801-e805. Epub 2018 May 23.

Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. Electronic address:

Background: Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy. Focal cortical dysplasia is the most common dual pathology found in association with the hippocampal sclerosis. In this study, the effect of dual pathology on freedom from seizure was sought in patients with TLE. Read More

Cureus 2018 Mar 11;10(3):e2308. Epub 2018 Mar 11.

Department of Neurological Surgery, University of California San Francisco.

Stereotactic radiosurgery (SRS) is a promising treatment for medically intractable mesial temporal lobe epilepsy. SRS for epilepsy has had an acceptable safety profile with reports of radiation-induced vascular malformations confined to central nervous system pathologies with prominent angiogenesis - namely, primary brain tumors, metastases, and arteriovenous malformations. Theoretical risks for radiation-induced lesions following radiosurgery for epilepsy have yet to be established. Read More

Epilepsia 2018 06 19;59(6):1234-1244. Epub 2018 Apr 19.

In Vivo Molecular Imaging Laboratory (IMIV), French National Institute of Health and Medical Research (INSERM), French Alternative Energies and Atomic Energy Commission (CEA), French National Center for Scientific Research (CNRS), Paris Saclay University, Frédéric Joliot Hospital service, Orsay, France.

Objective: Mesiotemporal lobe epilepsy is the most common type of drug-resistant partial epilepsy, with a specific history that often begins with status epilepticus due to various neurological insults followed by a silent period. During this period, before the first seizure occurs, a specific lesion develops, described as unilateral hippocampal sclerosis (HS). It is still challenging to determine which drugs, administered at which time point, will be most effective during the formation of this epileptic process. Read More

EJNMMI Res 2018 Apr 12;8(1):31. Epub 2018 Apr 12.

Department of Neurology, Laboratory for Epilepsy Research, University Hospitals and KU Leuven, Leuven, Belgium.

Background: Epilepsy surgery often causes changes in cognition and cerebral glucose metabolism. Our aim was to explore relationships between pre- and postoperative cerebral metabolism as measured with F-fluorodeoxyglucose positron emission tomography (FDG-PET) and neuropsychological test scores in patients with left mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS), who were rendered seizure-free after epilepsy surgery.

Results: Thirteen patients were included. Read More

Epilepsy Behav 2018 05 4;82:144-149. Epub 2018 Apr 4.

Unidade de Pesquisa e Tratamento das Epilepsias, Department of Neurology and Neurosurgery of Universidade Federal de São Paulo (UNIFESP), Rua Pedro de Toledo, 650, Vila Clementino, 04039-002 São Paulo, SP, Brazil. Electronic address:

Objective: The objectives of this study were to verify in a series of patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) if those with low intellectual quotient (IQ) levels have more extended areas of atrophy compared with those with higher IQ levels and to analyze whether IQ could be a variable implicated on a surgical outcome.

Material And Methods: Patients (n=106) with refractory MTLE-HS submitted to corticoamygdalohippocampectomy (CAH) (57 left mesial temporal lobe epilepsy (MTLE); 45 males) were enrolled. To determine if the IQ was a predictor of seizure outcome, totally seizure-free (SF) versus nonseizure-free (NSF) patients were evaluated. Read More

Seizure 2018 May 27;58:13-16. Epub 2018 Mar 27.

University Clinic of Neurology, Medical Faculty, Ss. Cyril and Methodius University, Vodnjanska str. 17, MK-1000, Skopje, Macedonia.

Purpose: The traditional perception of mesial temporal lobe epilepsy (MTLE) as a predominantly acquired disorder is challenged due to emerging evidence of familial aggregation. In this study, we ascertained the extent of familial occurrence of epilepsy in MTLE patients, as well as phenotypic heterogeneity in affected relatives.

Methods: We identified and reevaluated patients with MTLE, treated at Epilepsy Department for a period of two years. Read More

Epilepsia 2018 04 12;59(4):814-824. Epub 2018 Mar 12.

Division of Epilepsy and Neuromodulation Neurosurgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA, USA.

Objective: Surgical resection of the mesial temporal structures brings seizure remission in 65% of individuals with drug-resistant mesial temporal lobe epilepsy (MTLE). Laser interstitial thermal therapy (LiTT) is a novel therapy that may provide a minimally invasive means of ablating the mesial temporal structures with similar outcomes, while minimizing damage to the neocortex. Systematic trajectory planning helps ensure safety and optimal seizure freedom through adequate ablation of the amygdalohippocampal complex (AHC). Read More

EBioMedicine 2018 Mar 21;29:38-46. Epub 2018 Feb 21.

Department of Pathology, Brain Research Institute, Niigata University, 1 Asahimachi, Chuo-ku, Niigata 951-8585, Japan.

Mesial temporal lobe epilepsy (MTLE) is the most frequent focal epileptic syndrome in adults, and the majority of seizures originate primarily from the hippocampus. The resected hippocampal tissue often shows severe neuronal loss, a condition referred to as hippocampal sclerosis (HS). In order to understand hippocampal epileptogenesis in MTLE, it seems important to clarify any discrepancies between the clinical and pathological features of affected patients. Read More

Oper Neurosurg (Hagerstown) 2018 Nov;15(5):E69-E72

Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.

Background And Importance: Laser interstitial thermal therapy (LiTT) has increasingly been used as a treatment option for medically refractory epilepsy, tumors, and radiation necrosis. The use of LiTT requires intraoperative magnetic resonance (MR) thermography. This can become an issue in patients with other implanted therapeutic devices such as pacemakers and vagal nerve stimulators due to concerns regarding increases in the specific absorption rate (SAR). Read More

World Neurosurg 2018 May 6;113:366-372.e3. Epub 2018 Feb 6.

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.

Background: A stereotactically placed laser fiber can deliver thermal energy to an epileptogenic focus in the brain. This procedure is done under intraoperative (thermography) magnetic resonance imaging (MRI) guidance. Thermoablation can lead to edema in the surrounding area and can cause a secondary insult. Read More

Ann Neurol 2018 Mar 3;83(3):575-587. Epub 2018 Mar 3.

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

Objective: To evaluate the outcomes 1 year and longer following stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy in a large series of patients treated over a 5-year period since introduction of this novel technique.

Methods: Surgical outcomes of a consecutive series of 58 patients with mesial temporal lobe epilepsy who underwent the surgery at our institution with at least 12 months of follow-up were retrospectively evaluated. A subgroup analysis was performed comparing patients with and without mesial temporal sclerosis. Read More

Epilepsia 2018 03 2;59(3):595-606. Epub 2018 Feb 2.

Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA.

Objective: Selective laser amygdalohippocampotomy (SLAH) using magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is emerging as a treatment option for drug-resistant mesial temporal lobe epilepsy (MTLE). SLAH is less invasive than open resection, but there are limited series reporting its safety and efficacy, particularly in patients without clear evidence of mesial temporal sclerosis (MTS).

Methods: We report seizure outcomes and complications in our first 30 patients who underwent SLAH for drug-resistant MTLE between January 2013 and December 2016. Read More

Brain 2018 Feb;141(2):391-408

Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK.

Progressive functional decline in the epilepsies is largely unexplained. We formed the ENIGMA-Epilepsy consortium to understand factors that influence brain measures in epilepsy, pooling data from 24 research centres in 14 countries across Europe, North and South America, Asia, and Australia. Structural brain measures were extracted from MRI brain scans across 2149 individuals with epilepsy, divided into four epilepsy subgroups including idiopathic generalized epilepsies (n =367), mesial temporal lobe epilepsies with hippocampal sclerosis (MTLE; left, n = 415; right, n = 339), and all other epilepsies in aggregate (n = 1026), and compared to 1727 matched healthy controls. Read More