Temporal lobe epilepsy in adults and possibilities of neurosurgical treatment: the role of magnetic resonance
Authors:
Hana Malíková 1; Roman Liščák 2; Zdeněk Vojtěch 3; Tomáš Procházka 3; Iva Marečková 3; Vladimír Dbalý 4; Josef Vymazal 1; Miroslav Kalina 3; Vilibald Vladyka 2
Authors‘ workplace:
Radiodiagnostické oddělení Nemocnice Na Homolce, Praha
1; Oddělení stereotaktické a radiační neurochirurgie Nemocnice Na Homolce, Praha
2; Neurologické oddělení Nemocnice Na Homolce, Praha
3; Neurochirurgické oddělení Nemocnice Na Homolce, Praha
4
Published in:
Čas. Lék. čes. 2011; 150: 254-259
Category:
Review Article
Overview
Temporal lobe epilepsy is the most common type of focal epilepsy diagnosed in adult patients. According to the location of seizure generation it is classified as mesial temporal lobe epilepsy and neocortical lateral lobe epilepsy. Diagnosis of temporal lobe epilepsy can be proved by the combination of the clinical manifestation of partial complex seizures, scalp-video EEG monitoring, results of magnetic resonance imaging (MRI) and imaging of interictal fluoro-deoxy-glucose positron emission tomography. Mesial temporal sclerosis is the most common finding on MRI. Temporal lobe epilepsy is the most surgically amenable diagnosis and results of surgery treatments are clearly superior to the prolonged medical therapy; surgical treatment of the mesial temporal epilepsy with mesial temporal sclerosis has the best clinical results. Except for standard microsurgical approaches such as anterior temporal resection and selective amygdalo-hippocampectomy, stereotactic thermocoagulation amygdalo-hippocampectomy is provided in our epilepsy centre. This alternative approach has comparable clinical outcome to the standard surgery approaches in 2 years clinical follow-ups. MRI is important not only in diagnostic procedures, but also in neuronavigation of surgery approaches, per operation control of the extent of resections and postoperative follow-ups, especially in failed epilepsy surgery.
Key words:
temporal lobe epilepsy, surgery, stereotactic, thermocoagulation, magnetic resonance.
Sources
1. Trescher WH, Lesser RP. The epilepsies. In: Bradley W G, Daroff RB, Fenichel GM, Marsden CD. Neurology in clinical practice. Boston: Butteworth-Heinemann 1996; 1625–1654.
2. Commission on Classification and Terminology of the ILAE, Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989; 30: 389–399.
3. Shorvon SD. Introduction to epilepsy surgery and its presurgical assessment. In: The Treatment of Epilepsy, 2nd ed. Oxford: Blackwell 2004; 597–598.
4. Madhavan D, Kuzniecky R. Temporal lobe surgery in patients with normal MR. Curr Opin Neurol 2007; 20: 203–207.
5. Engel J Jr. Introduction to temporal lobe epilepsy. Epilepsy Res 1996; 261: 141–150.
6. Sadler RM. The syndrome of mesial temporal lobe epilepsy with hippocampal sclerosis: clinical features and differential diagnosis. Adv Neurol 2006; 97: 27–37.
7. Wiebe S, Blume WT, Girvin JP, et al. A randomized, controlled trial of surgery for temporal lobe epilepsy. N Engl J Med 2001; 345: 311–318.
8. Spencer SS, Berg AT, Vickrey BG, et al. Initial outcomes in the multicenter study of epilepsy surgery. Neurology 2003; 61: 1680–1685.
9. McIntosh AM, Wilson SJ, Berkovic SF. Seizure outcome after temporal lobectomy: current research practice and findings. Epilepsia 2001; 42: 1288–1307.
10. Wieser HG, Ortega M, Friedman A, et al. Long-term seizure outcomes following amygdalohippocampectomy. J Neurosurg 2000; 98: 751–763.
11. Babb TL, Brown WJ. Pathological findings in epilepsy. In: Engel J Jr. Surgical treatment of the epilepsies. New York: Raven Press 1987.
12. Babb TL, Brown WJ, Pretorius J, et al. Distribution of pyramidal cell density and hyperexcitability in epileptic human hippocampal formation. Epilepsia 1984; 25: 721–728.
13. Lencz T, McCarthy G, Bronen RA. Quantitative magnetic resonance imaging in temporal lobe epilepsy: relationship to neuropathology and neuropsychological function. Ann Neurol 1992; 31: 629–637.
14. Jack CR Jr, Sharbrough FW, Cascino GC, et al. Magnetic resonance image-based hippocampal volumetry: correlation with outcome after temporal lobectomy. Ann Neurol 1992; 31: 138–146.
15. Amaral DG, Insausti R. The human hippocampal formation. In: Paxinos G. The Human Nervous System. San Diego, Calif: Academic Press 1990; 711–775.
16. Bernasconi N, Bernasconi A, Caramanos Z, et al. Mesial temporal damage in temporal lobe epilepsy: a volumentric MR study of the hippocampus, amygdala and parahippocampal region. Brain 2003; 126: 462–469.
17. Yilmazer-Hanke DM, Wolf HK, Schramm J, et al. Subregional pathology of the amygdala complex and enthorhinal region in surgical specimens from patients with pharmacoresistant temporal lobe epilepsy. J Neuropathol Exp Neurol 2000; 59: 907–920.
18. Connelly A, Jackson GD, Duncan JS, et al. Magnetic resonance spectroscopy in temporal lobe epilepsy. Neurology 1994; 44: 1411–1417.
19. Engel J Jr, Kuhl DE, Phelps ME, Crandall PH. Comparative localisation of epileptic foci in parcial epilepsy by PET and EEG. Ann Neurol 1982; 12: 529–537.
20. Henry TR, Babb TL, Engel J Jr, et al. Hippocampall neuronal loss and regional hypometabolism in temporal lobe epilepsy. Ann Neurol 1994; 36: 925–927.
21. O’Brien JT, Newton MR, Cook MJ, et al. Hippocampal atrophy is not a major determinant of regional hypometabolism in temporal lobe epilepsy. Epilepsia 1997; 38: 74–80.
22. Carne RP, O’Brien TJ, Kilpatrick CJ, et al. MR-negative PET-positive temporal lobe epilepsy: a distinct surgically remediable syndrom. Brain 2004; 127: 2276–2285.
23. Riederer F, Lanzenberger R, Kaya H, et al. Network atrophy in temporal lobe epilepsy. A voxel-based morphometry study. Neurology 2008; 71: 419–425.
24. Salanova V, Markand O, Worth R. Temporal lobe epilepsy: analysis of patiens with dual patology. Acta Neurol Scan 2004; 109: 126–131.
25. Spencer D, Inserni J. Temporal lobectomy In: Luders H. Epilepsy surgery. New York: Raven Press 1991; 533–545.
26. Helmstaedter C, Elger CE, Hufnagel A, et al. Different Effects of Left Anterior Temporal Lobectomy, Selective Amygdalohippocampectomy, and Temporal Cortical Lesionectomy on Verbal learning, Memory, and Recognition. J Epilepsy 1996; 9: 39–45.
27. Helmstaedter C, Kurthen M. Memory and epilepsy: characteristics, course, and influence of drugs and surgery. Curr Opin Neurol 2001; 14: 211–216.
28. Niemeyer P. The transventricular amygdalohippocampectomy in temporal lobe epilepsy. In: Baldwin M, Bailey P. Temporal lobe epilepsy. Springfield: Charles C Thomas 1958; 461–482.
29. Yasargil MG, Teddy PJ, Roth P. Selective amygdalohippocampectomy. Operative anatomy and surgical technique. Adv Tech Stand Neurosurg 1985; 12: 93–123.
30. Yasargil MG, Wieser HG, Valavanis A, et al. Surgery and results of selective amygdalohippocampectomy in one hundred patients with nonlesional limbic epilepsy. Neurosurg Clin North Am 1993; 4: 243–261.
31. Clusmann H, Schramm J, Kral T, et al. Prognostic factors and outcome after different types of resection for temporal lobe epilepsy. J Neurosurg 2002; 97: 1131–1141.
32. Lacruz ME, Alarcon G, Akanuma N, et al. Neuropsychological effects associated with temporal lobectomy and amygdalohippocampectomy depending on Wada test failure. J Neurol Neurosurg Psychiatry 2004; 75: 600–607.
33. Hamberger MJ, Drake EB. Cognitive functioning following epilepsy surgery. Curr Neurol Neurosci Rep 2006; 6: 319–326.
34. Helmstaedter C, Richter S, Röske S, et al. Differential effects of temporal pole resection with amygdalohippocampectomy versus selective amygdalohippocampectomy on material-specific memory in patients with mesial temporal lobe epilepsy. Epilepsia 2008; 49: 88–97.
35. Talairach J, David M, Tournoux F. L’exploration chirurgical stéréotaxique du lobe temporal dans l’épilepisie temporal. Paris: Masson 1958.
36. Talaraich J, Szikla G. Destruction partielle amygdalo-hippocampique per l’yttrium 90 dans la traitment de certaines epilepsies á expression rhinencephaliue. Neurochirurgie 1965; 11: 236–240.
37. Talairach J, Bancaud J, Szikla G, et al. Approche nouvelle de la neurochirurgie de l’epilepsie: méthodologie stéréotaxique et resultants thérapeutiques. Neurochirurgie 1974; 20: 92–98.
38. Vladyka V. Surgical treatment of epilepsy and its application in temporal epilepsy. Cesk Neurol Neurochir 1978; 41: 95–106.
39. Parrent AG, Blume WT. Stereotactic amygalohippocampotomy for the treatment of medial temporal lobe epilepsy. Epilepsia 1999; 40: 1408–1416.
40. Malikova H, Vojtech V, Liscak R, et al. Stereotactic radiofrequency amygdalohippocampectomy for the treatment of mesial temporal lobe epilepsy: correlation of MR with clinical seizure outcome. Epilepsy Res 2009; 83: 235–242.
41. Malikova H, Vojtech Z, Liscak R, et al. Microsurgical and Stereotactic Radiofrequency Amygdalohippocampectomy for the Treatment of Mesial Temporal Lobe Epilepsy: Different Volume Reduction, Similar Clinical Seizure Control. Stereotact Funct Neurosurg 2010; 88: 42–50.
42. Liscak R, Malikova H, Kalina M, et al. Stereotactic Radiofrequency Amygdalohippocampectomy in the Treatment of Mesial Temporal Lobe Epilepsy. Acta Neurochir 2010; 152(8): 1291–1298.
43. Schramm J. Temporal lobe epilepsy surgery and the quest for optimal extent of resection: A review. Epilepsia 2008; 49(8): 1296–1307.
44. McKhann GM 2nd, Schoenfeld-McNeill J, Born DE, et al. Intraoperative hippocampal electrocorticography to predict the extent of hippocampal resection in temporal lobe epilepsy surgery. J Neurosurg 2000; 9: 44–52.
Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain managementArticle was published in
Journal of Czech Physicians
Most read in this issue
- Early repolarisation syndrome and idiopathic ventricular fibrillation
- Temporal lobe epilepsy in adults and possibilities of neurosurgical treatment: the role of magnetic resonance
- Nonconvulsive status epilepticus
- Measurement of exhaled nitric oxide in the diagnosis of asthma