The present study describes the case of a 27-year-old, right-handed female with bilateral mesial temporal lobe epilepsy. Electroencephalogram (EEG) monitoring from implanted electrodes displayed two different and independent onsets on the two sides of the mesial temporal structures, which specifically included clinical generalized tonic clonic seizure (GTCS) discharges originating from the left mesial temporal lobe, as well as complex partial seizure (CPS) discharges arising from the right mesial region. However, fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) showed a unilateral abnormality, as in right mesial temporal lobe sclerosis. A decision was made to resect one side of the mesial temporal lobe, in order to avoid memory function impairment, and, relying on the MRI results, the right side was selected. However, surgery did not leave the patient seizure-free. The CPSs gradually eased, while the GTCSs originating from the left side became severely aggravated. In describing this case, the drawbacks of current epileptic diagnostic methods and surgical strategies for bitemporal lobe epilepsy are discussed, and the requirement for more treatment options is emphasized.
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http://dx.doi.org/10.3892/etm.2013.1462 | DOI Listing |
Neurosurg Rev
January 2025
Department of neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Epilepsy is a common neurological disease that is treated with medications; however, patients with drug-resistant epilepsy, commonly intractable temporal lobe epilepsy, tend to have better control with surgical treatment. While the mainstay of surgical treatment is anterior temporal lobectomy, it carries risk of potential adverse effects hence minimally invasive techniques are now being used as an alternative to open surgery. This systematic review and meta-analysis compare the efficacy and safety of three of the most used techniques: laser interstitial thermal therapy (LITT), radiofrequency ablation (RFA) and stereotactic radiosurgery (SRS).
View Article and Find Full Text PDFEpilepsia Open
January 2025
Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Musicogenic epilepsy (ME) is characterized by seizures triggered by music. The epileptogenic focus in this rare reflex epilepsy is often in the temporal lobe, although the precise localization is still unclear. A correlation between ME and the presence of GAD65 antibodies indicates a potential immunological pathogenic mechanism.
View Article and Find Full Text PDFFront Syst Neurosci
January 2025
Neurology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Introduction: Evidence increasingly shows that facial emotion recognition (FER) is impaired in refractory mesial temporal lobe epilepsy (rMTLE), especially in patients with a right focus. This study explores FER in both mild (mMTLE) and refractory forms, examining the influence of epileptic focus lateralization on FER.
Methods: 50 MTLE patients, categorized by epilepsy severity and focus lateralization, were compared with healthy controls.
Acta Neurochir (Wien)
January 2025
Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands.
Purpose: In resective epilepsy surgery for drug-resistant focal epilepsy (DRE), good seizure outcome is strongly associated with visualization of an epileptogenic lesion on MRI. Standard clinical MRI (≤ 3 Tesla (T)) may fail to detect subtle lesions. 7T MRI enhances detection and delineation, the potential benefits of increasing field strength to 9.
View Article and Find Full Text PDFJ Clin Exp Neuropsychol
January 2025
Department of Neurology, Medical University of South Carolina, Charleston, USA.
Objective: To examine neuropsychological characteristic differences between typical and atypical language dominance in adult persons with epilepsy (PWE) and mesial temporal sclerosis (MTS), including exploring the impact of selected clinical variables on detection of atypical language and neuropsychological performance.
Methods: Adults with intractable epilepsy and MTS ( = 39) underwent comprehensive, pre-surgical evaluation including fMRI and neuropsychological assessment. Participants with concordant lateralization of MTS and seizure onset were included.
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