Increased Intrinsic Connectivity of the Default Mode Network in Temporal Lobe Epilepsy: Evidence from Resting-State MEG Recordings.

The electrophysiological signature of resting state oscillatory functional connectivity within the default mode network (DMN) during spike-free periods in temporal lobe epilepsy (TLE) remains unclear. Using magnetoencephalographic (MEG) recordings, this study investigated how the connectivity within the DMN was altered in TLE, and we examined the effect of lateralized TLE on functional connectivity. Sixteen medically intractable TLE patients and 22 controls participated in this study.

Abdominal auras in patients with mesial temporal sclerosis.

To better clarify abdominal auras and their clinical correlates, we enrolled 331 temporal lobe epilepsy patients who received surgical treatment. Detailed descriptions of their auras were obtained before surgery and reconfirmed during postoperative outpatient follow-ups. Pathology revealed mesial temporal sclerosis (MTS) in 256 patients (77.

The duration of sustained convulsive seizures determines the pattern of hippocampal neurogenesis and the development of spontaneous epilepsy in rats.

The duration of sustained seizures (SS) plays a crucial role in the occurrence of spontaneous recurrent seizures (SRS) in experimental animals. We tested whether rats with varying durations of initial convulsive SS exhibited differential neurogenesis patterns in the hippocampal dentate gyrus that may be related to subsequent epileptogenesis. Sprague-Dawley rats with pilocarpine-induced convulsive SS were divided into short SS (30 min) and long SS (2 h) groups.

[Treatment guidelines for acute and preventive treatment of cluster headache].

The Treatment Guideline Subcommittee of the Taiwan Headache Society evaluated both the acute and the preventive treatments for cluster headache now being used in Taiwan, based on the principles of evidence- based medicine. We assessed the quality of clinical trials and levels of evidence, and referred to other treatment guidelines proposed by other countries. Throughout several panel discussions, we merged opinions from the subcommittee members and proposed a consensus on the major roles, recommended levels, clinical efficacy, adverse events and cautions of clinical practice regarding acute and preventive treatments of cluster headache.

An atypical case of Lennox-Gastaut syndrome not associated with mental retardation: a nosological issue.

The characteristic electroclinical features of Lennox-Gastaut syndrome (LGS) have been extensively reported, but the influence of the constellation of slow spike-and-wave (SSW) complexes with multiple seizure types (including atypical absence seizures [AAS] and tonic seizures [TS]) on patients with this syndrome is still unclear. We report the case of a 28-year-old woman who developed AAS and brief asymmetric TS at the age of 14 years. Her seizure disorder met diagnostic criteria for LGS (SSW on electroencephalogram and multiple seizure types), but there was no intellectual impairment and an interictal alpha EEG.

Treatment-seeking behavior of people with epilepsy in Taiwan: a preliminary study.

To understand the treatment-seeking behavior of people with epilepsy (PWE), 403 PWE were surveyed using structured face-to-face interviews. Nearly half (49.1%) of them had previously tried complementary and alternative medicine (CAM); traditional Chinese medicine (51.

Reflex absence epilepsy induced by gait.

Reflex epilepsy is characterized by seizures that are precipitated by a specific identifiable factor. We describe here the case of a 21-year-old man with notable absence epilepsy since the age of 11 who experienced generalized convulsions 2 years after onset (in the absence of antiepileptic therapy) and reflex absence seizures triggered by walking 7-10 steps. To our knowledge, this case report is the first describing reflex absence epilepsy seizures induced by gait.

Electrocorticogram changes during corpus callosotomy for uncontrolled symptomatic generalized epilepsy.

We report a 19-year-old man who presented to our facility with medically intractable, symptomatic generalized epilepsy manifesting as generalized tonic-clonic seizures (GTCs). Before he underwent an anterior callosotomy (6 cm), these seizures, which he had experienced for 11 years, seemed to have a left-sided focal origin. Intraoperatively, no epileptiform discharges were found on the electrocorticogram (ECoG) performed prior to sectioning, but more than 10 left-sided seizures were recorded after sectioning.

Gamma knife radiosurgery for the treatment of recurrent seizures after incomplete anterior temporal lobectomy.

To evaluate the efficacy and safety of gamma knife radiosurgery (GKS) in treating temporal lobe epilepsy, GKS was performed in four adult patients with recurrent complex partial seizures who underwent incomplete anterior temporal lobectomy (ATL) but were reluctant to undergo a second resective surgery. A marginal dose of 24.5-25Gy, corresponding to 65-70% isodose curve, was delivered to the treatment target that included the residual amygdala and the head and anterior body of the hippocampus.

Corpus callosotomy in a patient of hemimegalencephaly and Lennox-Gastaut syndrome.

We report the case of a girl with hemimegalencephaly (HME) and Lennox-Gastaut syndrome (LGS) treated by callosotomy at 1 year of age. Over 10 years, her seizure frequency and severity decreased markedly. Hemispherectomy is the main surgical option for HME although HME appears to correlate with a less favorable seizure outcome.

Plastic phase-locking and magnetic mismatch response to auditory deviants in temporal lobe epilepsy.

The magnetic equivalent (MMNm) of mismatch negativity may reflect auditory discrimination and sensory memory. To study whether temporal lobe epilepsy (TLE) affects automatic central auditory-change processing, we recorded magnetoencephalographic (MEG) responses to standard and duration-deviant sounds in 12 TLE patients and 12 age-matched controls, and repeated MEG measurement in 8 patients 6-30 months following epilepsy surgery and in 6 controls 3-8 months after their first measurement. We compared the MMNm between patients and controls, and also evaluated intertrial phase coherences as indexed by phase-locking factors (PLF) using wavelet-based analyses.

Isolated acute hearing loss as the presenting symptom of leptomeningeal carcinomatosis.

Leptomeningeal carcinomatosis is characterized by diffuse infiltration of the meninges by metastatic cancer. We report a rare case of leptomeningeal carcinomatosis with an initial presentation of isolated acute hearing loss. Progressive unsteady gait and multiple cranial nerve palsies ensued.

A comparison of seizure outcome after callosotomy in patients with Lennox-Gastaut syndrome and a positive or negative history for West syndrome.

Purpose: This retrospective study was designed to clarify the role of West syndrome in post-callosotomy seizure outcome in patients with Lennox-Gastaut syndrome.

Methods: From September 1989 to May 1999, 74 patients diagnosed with Lennox-Gastaut syndrome received anterior corpus callosotomy at Taipei Veterans General Hospital, Taiwan. All patients were followed for more than 4 years after surgery.

Selective posterior cerebral artery amobarbital test in patients with temporal lobe epilepsy for surgical treatment.

Purpose: To evaluate whether the selective posterior cerebral artery amobarbital test (PCAAT) can predict postoperative memory function in patients with temporal lobe epilepsy (TLE) for surgical treatment and its clinical safety.

Methods: The database included adult patients with intractable TLE undergoing presurgical evaluation at Taipei Veterans General Hospital between 1995 and 2002. The PCAAT was carried out on patients who had failed conventional intracarotid amobarbital test (IAT) or had IAT results that evoked a concern of postoperative memory function decline.

Prognostic value of electrocorticography findings during callosotomy in children with Lennox-Gastaut syndrome.

Objective: To analyze findings and acute changes in electrocorticograms (ECoGs) obtained during corpus callosotomy in order to identify any relationships with the postoperative outcome of seizure activity.

Methods: We retrospectively analyzed ECoGs obtained during anterior callosotomy (4-6 cm) in 48 patients with Lennox-Gastaut syndrome (32 boys and 16 girls, age 1-20 years, mean age 7.6 years) who underwent surgery between July 1993 and November 1996 to correlate recording findings with postoperative seizure activity.

[Another seizure classification--Semiological Seizure Classification].

The International League Against Epilepsy (ILAE) introduced in 1981 a seizure classification based on clinical semiology, interictal EEG findings, and ictal EEG patterns. Such classification depends heavily on detailed electroclinical correlation. After 20 years' progress in epileptology, many clinicians have found it difficult to make a "definite" seizure diagnosis clinically without a series of electrophysiological examinations, particularly in the infants, and further advancement in epileptology has findings have made the previous classification inefficient.

Lateralisation value of lower limb behaviors in complex partial seizures of temporal lobe origin: a video-EEG analysis.

Purpose: To determine the lateralising value of leg behaviors in complex partial seizures (CPS) of temporal lobe onset.

Methods: Videotapes of 123 seizures from 38 patients who were seizure-free after temporal lobectomy were reviewed. Ictal behaviors including head turning, limb automatisms, tonic/dystonic postures and the latent time for ictal behavior were analysed for their lateralising value.

Surgery of intractable temporal lobe epilepsy presented with structural lesions.

Background: Structural lesions are found in about 30% of surgical specimens resected for intractable temporal lobe epilepsy (TLE). Detailed presurgical evaluations can identify the epileptogenic foci, the structural lesions and their correlation. Different surgical approaches have variable seizure control outcomes.

Medication education for patients with epilepsy in Taiwan.

The aim of this study is to evaluate the medication knowledge achieved by conventional verbal education and the influence of drug information leaflets in patients with epilepsy. Drug compliance and sources of information of the patients were also examined. Fifty-one adults in an epilepsy outpatient clinic participated this survey.

Magnetoencephalographic analysis of bilaterally synchronous discharges in benign rolandic epilepsy of childhood.

The purpose of this study was to examine the spatial and temporal relationship between bilateral foci of bilaterally synchronous discharges in benign rolandic epilepsy of childhood (BREC) using a whole-scalp neuromagnetometer. We simultaneously recorded interictal magnetoencephalographic (MEG) and electroencephalographic (EEG) signals in six children with BREC. Interictal spikes were classified into three groups: bilaterally synchronous discharges (BSDs), unilateral discharges on right side (UD-R), and unilateral discharges on left side (UD-L).

Olfactory auras in patients with temporal lobe epilepsy.

Purpose: To investigate olfactory auras in patients with temporal lobe epilepsy (TLE).

Methods: We reviewed medical records of 217 Chinese patients who underwent temporal lobectomy for medically intractable TLE between 1987 and 1998 in Taiwan. Patients with olfactory auras asked for detailed characteristics of their auras.