جستجوی مقالات مرتبط با کلیدواژه « temporal lobe » در نشریات گروه « پزشکی »

Epilepsy surgery has become a successful treatment option for patients with drug-resistant epilepsies.

This study aimed to assess temporal lobe epilepsy (TLE) surgery outcome and its association with epilepsy duration, the presence of pre-surgical generalized tonic-clonic seizure (GTCS), and brain MRI findings.

This retrospective study was performed from 2016 to 2020 at Loghman-Hakim Hospital, Tehran, Iran. The patients’ demographic data, epilepsy type, duration, frequency, brain image findings, the selected surgical approaches, and histopathological findings were collected. The post-operative seizure outcome was expressed one year according to the proposed International League Against Epilepsy (ILAE) classification system. The independent sample t-test, chi-square, and one-way analysis of variance were applied to analyze the differences between variables in terms of quantitative and categorical data.

A total number of 69 TLE surgeries were enrolled in our study. No differences were found in the surgical outcome base on the ILAE classification system of patients with lesional vs non-lesional MRIs (P=0.834). In patients with mesial temporal sclerosis, no correlation was found between the surgical approaches including selective amygdalohippocampectomy, anterior temporal lobectomy, and post-operative seizure outcome (P=0.142). Seven patients (10.1%) developed post-operative functional seizures.

In our study, the epilepsy duration and the presence of GTCSs before surgery had no effect on the surgery outcome. In patients with mesial temporal sclerosis, amygdalohippocampectomy, and anterior temporal lobectomy did not confer different surgical outcomes. TLE patients with normal MRI showed similar surgical outcomes as lesional patients. A significantly high proportion of our patients developed functional seizures, postoperatively

A pre-surgical evaluation of cognitive functions in patients with mesial temporal lobe epilepsy (mTLE) is critical. The limitations of the usual brain analysis model were resolved by the spatial Bayesian variable selection (SBVS) method. An Ising and Dirichlet Process (Ising-DP) model considers SBVS and the grouping of a large number of voxels. The present study aimed to identify brain areas involved in episodic memory in patients with right mTLE and controls via the Ising-DP model. The model was extended to include between-subject factors (BSFs), and the results were compared with other classical methods. The present cross-sectional study was conducted on 15 patients with right mTLE and 20 controls in Tehran, Iran, in 2018. During functional magnetic resonance imaging, the subjects were tested with the face-encoding memory task, followed by a recognition memory test. The participants demographic factors such as age, sex, marital status, area of residence, and years of schooling were considered to comprise BSFs. The independent t test, the chi-square test, and the correlation test were conducted using the SPSS software (version 20.0). The image processing was carried out using SPM (version 12.0) and MATLAB (version R2014a). The Ising-DP model appropriately (R2=0.642) detected activated hippocampal areas. The model adjusted for BSFs indicated a better fit by the significant effect of age (P[γ]>0.91), sex (P[γ]>0.87), and years of schooling (P[γ]>0.89). The heat maps exhibited decreased activation in the right hippocampal region in the patients compared with the controls (p <0.0001). Right hippocampal activity had a significant positive correlation with the recognition memory test in the mTLE group (r=0.665) and the control group (r=0.593). The Ising-DP model was sufficiently sensitive to detect activated areas in our patients with right mTLE during the face-encoding memory task. Since the model adjusted for BSFs improved sensitivity, we recommend the use of more detailed BSFs such as seizure history in future research.

Based on our experience, a noticeable number of migraineurs without history of epilepsy disclose mesial temporal sclerosis (MTS) on their brain MRI.

This prospective study was conducted to assess the frequency of MTS in migraineurs and also determine the ratio of unilateral and bilateral cases.

In this cross sectional study, the frequency of MTS in MRI of 84 migraine patients, who had symptoms for at least 2 years, assessed. Brain MRI was done with T1 and T2 weighted protocols. Two radiologists separately interpreted findings, defining MTS as presence of any of hippocampal atrophy, increased T2 signal of hippocampus, decreased T1 signal of hippocampus or loss of internal architecture. Patients who radiologists had not agreement on their diagnoses excluded. Stat analysis done using ‘N - 1’ chi squared test.

Eleven patients were excluded due to non-accordant interpretation of MRI findings by the two examining radiologists. MTS was detected in 14 out of 73 patients (19%). Bilateral involvement of mesial temporal lobe was seen in 6 (8%) patients (M: 67%, F: 33%). Five cases (7%) had unilateral left MTS (M: 67%, F: 33%) while 3 (4%) were affected with right-sided MTS (M: 33%, F: 67%). These findings highly suggest association of MTS and Migraine (P-value <0.0001).

While MTS is a prevalent finding in migraineurs, incidental finding of MTS in MRI should suspect physicians of migraine as well as temporal lobe epilepsy. MTS can be proposed as an etiology of migraine but most likely, consequence of it.

Epilepsy is considered as one of the most important disorders in neurology. Temporal lobe epilepsy is a form of epilepsy including two main types of mesial and lateral (neocortex).
Determination and comparison of electroencephalogram (EEG) pattern in the ictal and interictal phases of mesial and lateral temporal lobe epilepsy.
This cross-sectional descriptive study included 80 patients with mesial and lateral temporal lobe epilepsy who satisfied the inclusion criteria. The patients were monitored using EEG, and then the EEG results were compared between two groups of temporal epilepsies.
There was no significant difference between two groups of patients (mesial and lateral temporal lobe epilepsy) in terms of the type of seizure, history of tumor or trauma or hypoxia, and duration of seizure history (p>0.05). The ictal wave onset in 52.5% of the patients was in the left temporal region, and the ictal wave onset in 58.75% of patients was the slow wave. There was no significant difference between the two groups of patients in terms of ictal wave onset and its location.
According to the results, EEG is a good method for detecting temporal lobe epilepsy, but it does not help to differentiate the type of mesial and lateral temporal epilepsy. In order to distinguish between these two types, EEG alone is not helpful, and other diagnostic methods are required.

To investigate ictal onset patterns (IOP) in scalp electroencephalography (EEG) of patients with temporal lobe epilepsy (TLE) and their prognostic effect on the postoperative outcome.

We conducted a retrospective cohort study between 2011 and 2015 in our referral Epilepsy Surgery Center enrolling adult patients with refractory TLE and a visible epileptogenic lesion in magnetic resonance imaging (MRI), who underwent epilepsy surgery. Demographic, clinical and MRI findings were collected and ictal findings during video-EEG monitoring were reviewed in detail. The correlation between preoperative findings and the postsurgical outcome was analyzed.

We reviewed 303 seizures in 93 patients. Rhythmic theta and rhythmic spike/sharp and wave were respectively the most common initial ictal pattern and late significant discharges. Engel class I outcome was observed in 88.2% of patients. Female sex, aura, the absence of secondary generalization, rhythmic theta as initial ictal pattern and concordance of ictal-interictal EEG findings were correlated with favorable 1-year postsurgical outcome.

Preoperative clinical and EEG findings can provide valuable information regarding postsurgical prognosis in TLE patients.

High-grade astrocytomas are among the most common neuroepithelial brain tumors. Because of their highly malignant nature, in most cases, in addition to maximal resection, they also require adjuvant treatments, such as chemotherapy and radiotherapy. A common accompanying condition, which may occur with this type of clinical presentation, is cognitive disorders. These can be caused by the tumor itself, the treatment used or may be patient related. The aim of this study was to evaluate the level of cognitive ability in patients with astrocytoma compared to the normal population and evaluating the factors possibly affecting them.
A case-control study was performed on 30 adults referred to Imam Reza and Omid hospitals, Mashhad, Iran, during year 2014. The studied patients had astrocytomas, for which they had performed surgery. All patients had also received radiotherapy. The control group consisted of 30 healthy individuals, among the patients’ family members, who were matched for age and gender with the patients. The tools used in this study were a checklist for demographic data, and the Farsi version of Addenbrook’s cognitive questionnaire. Data were entered in the SPSS 22 software and analyzed using the Student’s t test and Mann-Whitney test. P values of ≤ 0.05 were considered significant.
Normal cognitive disorders were seen in 33.3% and 80% of the patient and control groups, respectively. Mild cognitive disability was observed in 10% of both groups; and Alzheimer’s was observed in 56.7% and 10% of the patient and control groups, respectively. A statistically significant difference was found between cognitive function, age, and gender (P = 0.0001 in both). No meaningful difference, however, was observed between cognitive score and tumor location, chemotherapy, and the time, from which treatment had ended.
With the high prevalence of cognitive disorders among patients with astrocytoma, one can conclude that the tumor itself and the surrounding factors affect the cognitive function of the patient. Results of this study showed that the type of treatment and some properties of the tumor, such as the tumor’s location, do not affect the patient’s cognitive capacity.

Visual illusions and hallucinations may accompany a wide variety of disorders with many various etiologies; therefore, they are nonspecific phenomena. In a partial seizure, a localized hyper synchronous neuronal discharge evolving into a partial seizure affecting a particular cortical region or cerebral subsystem can give rise to psychotic symptoms like visual hallucination. This case study introduces a patient with metamorphopsia, a rare visual illusion, that was treated with lamotrigine..
This case study introduces a 34-year-old man with a history of falling. After a while, his seizures became accompanied with aura and, during the attack, he saw people and objects as bloody. He was asymptomatic between the attacks, with no visceral feeling and with dysphoric mood and borderline IQ. He was resistant to various treatments. After 6 months administration of lamotrigine, he has not had any seizure attacks and the psychotic symptoms have improved..
The psychotic symptoms due to temporal lobe epilepsy can be resolved with lamotrigine administration..