Temporal lobe epilepsy is one of 20 different kinds of epilepsy. Our aim was to assess the performance of fdaapproved software measures. This study aimed to investigate reorganization of memory functions in temporal lobe epilepsy and to determine whether preoperative memory functional magnetic resonance imaging may. Temporal lobe epilepsy is a chronic disorder of the nervous system characterized by recurrent, unprovoked focal seizures that originate in the temporal lobe of the brain and last about one or two minutes. Memory lateralization in medial temporal lobe epilepsy. Temporal lobe epilepsy tle is the most common form of focal partial epilepsy. Functional magnetic resonance imaging can demonstrate the functional anatomy of cognitive processes. Imaging and memory in patients with temporal lobe epilepsy. Temporal lobe epilepsy tle is a chronic disorder of the nervous system characterized by recurrent, unprovoked focal seizures that originate in the temporal lobe of the brain and last about one or two minutes. Structural and electrophysiologic abnormalities associated with human temporal lobe epilepsy tle are currently best understood in the hippocampus. From rostral to caudal, they are the, the, and the. The mr image data set consisted of 54 patients with imaging.
People with drugresistant medial temporal lobe epilepsy have a higher risk for memory and mood difficulties. The temporal lobe is one of the four lobes of the brain along with the frontal lobe, parietal lobe, and occipital lobe, and largely occupies the middle cranial fossa. Gray matter and white matter abnormalities in temporal lobe. The familial form of mesial temporal lobe epilepsy fmtle was first. As a relatively new noninvasive clinical recording system, magnetoencephalography meg has rarely been applied for determining lateralization of unilateral tle. Temporal lobe epilepsy is a common type of epilepsy that is sometimes difficult to diagnose, but once diagnosed it can be effectively treated with medications.
Various conditions may affect this anatomic region, and, therefore, classification of imaging findings into specific groups may help provide a more focused differential diagnosis. Longitudinal mri volumetric evaluation in patients with. Any suggestion of lateral temporal lobe epilepsy according to seizure. The lesion most commonly reported in surgical and autopsy series of mesial tle is hippocampal sclerosis hs, although temporal lobe encephalomalacia, neoplasia, vascular malformations, and developmental malformations often. Temporal lobe epilepsy tle is a chronic disorder of the nervous system characterized by recurrent, unprovoked focal seizures that originate in the temporal lobe of the brain and last about one or two. Summary objective thalamic abnormality in temporal lobe epilepsy tle is well known from imaging studies. Without normal medial temporal lobe function, working memory cannot be translated into longerterm storage. A focal seizure in the temporal lobe may spread to other areas in the brain when it may become a focal to bilateral seizure.
In patients with refractory temporal lobe epilepsy, evaluation of preoperative verbal and. Magnetic resonance spectroscopic imaging in temporal lobe. Sound is turned into language or music in the temporal lobe. Dataset of human medial temporal lobe neurons, scalp and. Medically intractable temporal lobe epilepsy is amenable to epilepsy surgery with a very high seizurefree rate. Focal hippocampal dysfunction initiates electrophysiologic seizures and impairs interictal cognition in patients with mesial temporal lobe epilepsy tle. I am in my 30s and just got the diagnosis temporal lobe epilepsy, which was a huge chock. Neuroquant is a leading medical device software that accurately segments brain structures and calculates each structures volume from 3d mri.
Jul 22, 2015 imaging in temporal lobe epilepsy mri epilepsy protocol imaging features of temporal lobe epilepsy. Imaging in temporal lobe epilepsy mri epilepsy protocol imaging features of temporal lobe epilepsy. We compared restingstate functional connectivity rsfc among limbic and temporal lobe regions between patients with medial temporal lobe epilepsy mtle and healthy control subjects to. Comparative lateralizing ability of multimodality mri in temporal lobe epilepsy. Objective to establish whether the metabolic changes measured by mrs correlate to hippocampal cell loss in temporal lobe epilepsy. The temporal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. Predicting the effects of temporal lobe resection article pdf available in brain 3pt 4. Magnetic resonance imaging is an essential tool in the investigation of a patient with suspected temporal lobe pathology.
We studied 72 patients with unilateral medial temporal lobe epilepsy 41 left and 20 healthy controls. Partial loss of hippocampal striation in medial temporal lobe. Multitemplate analysis of human perirhinal cortex in brain mri. The medial temporal lobe also known as the mesial temporal lobe structures are most. Magnetic resonance imagingpositive temporal lobe atrophy with temporopolar greywhite matter abnormalities usually called blurring has been frequently reported in patients with temporal lobe epilepsy associated with hippocampal sclerosis. These patients have frequent complex partial seizures originating from a sclerosed hippocampus. Data mining mr image features of select structures for lateralization. Radiological anatomy of medial temporal lobe structures medial temporal lobe structures amygdala hippocampus surrounding hippocampal region perirhinal, parahippocampal and entorhi nal. Subjects and methods we prospectively performed quantitative hippocampal mr imaging volumetry and mrs imaging in 33 patients with intractable mesial temporal lobe epilepsy who were undergoing surgery. Mri is the neuroimaging modality of choice for patients with temporal lobe epilepsy. Epilepsy surgery is an important tool for the treatment of patients with medically refractory seizures and is particularly effective in patients with medial. Feb 15, 2010 this study aimed to investigate reorganization of memory functions in temporal lobe epilepsy and to determine whether preoperative memory functional magnetic resonance imaging may predict memory changes following anterior temporal lobe resection. Jan 21, 2020 dataset of human medial temporal lobe neurons, scalp and intracranial eeg during a verbal working memory task skip to main content thank you for visiting.
The temporal lobe the auditory and memory cortexfrom the. However, to get the full benefit of effective diagnosis with current mri technology requires an optimized temporal lobe imaging protocol and an experienced mri reader. Other imaging modalities that can be used in the diagnosis of temporal lobe epilepsy include computed tomography ct scanning, positron emission tomography pet scanning, singlephoton emission ct spect scanning, mr spectroscopy, and magnetoencephalography. Mri volumetric measurement of amygdala and hippocampus in temporal lobe epilepsy. Comparative lateralizing ability of multimodality mri in. Epilepsy arising in the medial temporal lobe mtle table 1 the commonest pathology underlying this type of epilepsy is hippocampal sclerosis3,4, and the entity of mesial temporal lobe epilepsy with.
Temporal lobe epilepsy support group epilepsy foundation. Other imaging modalities that can be used in the diagnosis of temporal lobe epilepsy include computed. Clear evidence shows that neurosurgical resection is more. Medial temporal lobe atrophy in patients with refractory. In right temporal lobe epilepsy, greater right than left anterior hippocampal functional magnetic resonance imaging activation on face encoding predicted greater visual memory decline after right anterior temporal lobe resection, while greater right than left posterior hippocampal activation correlated with better visual memory outcome. Epilepsy arising in the medial temporal lobe mtle table 1 the commonest pathology underlying this type of epilepsy is hippocampal sclerosis3,4, and the entity of mesial temporal lobe epilepsy with hippocampal sclerosis mtle with hs is recognised as a distinctive constellation among the focal epilepsies5. The temporal lobe is the second largest lobe, after the larger frontal lobe, accounting 22% of the total neocortical volume 6.
The presence or absence of mesial temporal sclerosis mts. Its routine use to predict the postoperative memory decline has been limited because of the varied study paradigms, discrepancies in analysis, and interpretation of the results. Magnetic resonance imagingpositive temporal lobe atrophy with temporopolar greywhite matter abnormalities usually called blurring has been frequently reported in patients with. Highresolution functional mri hrfmri affords unique leverage on the functional properties of human medial temporal lobe mtl substructures. Temporal lobe epilepsy tle is the most common type of partial epilepsy, with often characteristic imaging and clinical findings.
As i am sure you are aware, mri has revolutionized the diagnosis and presurgical evaluation of temporal lobe epilepsy. Nov 05, 20 in patients with medial temporal lobe epilepsy mtle, the hippocampus is traditionally considered to be the site of seizure onset. Thus, the aim of this study was to compare the cerebral areas involved in eeg oscillations versus fmri signal patterns during a working memory wm task in normal controls and patients with. Clear evidence shows that neurosurgical resection is more recommendable in refractory tle than continued use of antiepileptic drugs, and precise lateralization of the focus side is thus important in clinical practice.
Am measurements in mri volumetric studies of mesial temporal structures. Taupet imaging and subregional atrophy in medial temporal lobe. Graph theoretical analysis of structural neuroimaging in. I am a temporal lobe epilepsy patient in southern california. The temporal lobe is located beneath the lateral fissure on both cerebral hemispheres of the mammalian brain the temporal lobe is involved in processing sensory input into derived meanings for the appropriate retention of visual memory, language comprehension, and emotion association. Mri volumetric measurement of amygdala and hippocampus in. It can be hard for people with tle to become completely seizure free with seizure medicines alone, though medicines may lower the number of seizures. Automated mr image classification in temporal lobe epilepsy. The main source used to search and identify the data was pubmed.
Altered structural connectome in temporal lobe epilepsy. In patients with refractory temporal lobe epilepsy, evaluation of preoperative verbal and visual memory function is important as anterior temporal lobe resections may result in material specific memory impairment, typically verbal memory decline following left and visual memory. Purpose psychosis is one of the most important psychiatric comorbidities in temporal lobe epilepsy tle, and its pathophysiology still remains unsolved. The international league against epilepsy ilae diagnostic manuals goal is to assist clinicians who look after people with epilepsy to diagnose the epilepsy syndrome and if possible the etiology of the. However, the full extent of these abnormalities has not yet been defined because dti conveys only a fraction of the information potentially accessible with diffusion mr imaging. Tle is usually diagnosed in childhood or adolescence. Medial temporal lobe the limbic system on the medial surface of the temporal lobe are three structures critical for normal human functioning. Deep inside the lobe is the amygdala, the center of emotions, vital to survival. A 3t mr imaging is necessary with an experienced mr radiologist. Various conditions may affect this anatomic region, and. Just got diagnozed with temporal lobe epilepsy and i am in. The medial temporal lobe is a critical processor of the acquisition and recall of new memories. Apr 30, 2020 as i am sure you are aware, mri has revolutionized the diagnosis and presurgical evaluation of temporal lobe epilepsy.
Correct lateralization of temporal lobe epilepsy tle is critical for improving surgical outcomes. Temporal lobe epilepsy is associated with regional abnormalities in tissue microstructure, as demonstrated by dti. Mesial temporal lobe epilepsy is one of the most common forms of epilepsy. In this study, we assessed the added value of diffusional kurtosis imaging, an. Improved detection of subtle mesial temporal sclerosis american. Aug 28, 2002 epilepsy surgery is an important tool for the treatment of patients with medically refractory seizures and is particularly effective in patients with medial temporal lobe epilepsy mtle. Thalamotemporal impairment in temporal lobe epilepsy. The medial temporal lobe is a critical processor of the acquisition. Mar 30, 2017 imaging and memory in patients with temporal lobe epilepsy. Although classically, tle has been theorized to relate to isolated.
Mesial temporal lobe epilepsy an overview of surgical techniques. Epilepsy surgery is an important tool for the treatment of patients with medically refractory seizures and is particularly effective in patients with medial temporal lobe epilepsy mtle. Frontiers similar and differing distributions between. I would like to start a support group, so that those of us with tle can meet and talk about our experiences.
Automatic lateralization of temporal lobe epilepsy based. Volumetric imaging in the evaluation of temporal lobe epilepsy. Despite the fact that structural and metabolic alterations of the medial temporal lobe 12, 30 and thalamus 1, 12. Apr 25, 2014 thus, the aim of this study was to compare the cerebral areas involved in eeg oscillations versus fmri signal patterns during a working memory wm task in normal controls and patients with refractory mesial temporal lobe epilepsy mtle associated with hippocampal sclerosis hs. Dataset of human medial temporal lobe neurons, scalp and intracranial eeg during a verbal working memory task skip to main content thank you for visiting. In patients with refractory temporal lobe epilepsy, evaluation of. Role of functional mri in presurgical evaluation of memory. But it basically means years of misdiagnosis so i am quite confused. In patients with medial temporal lobe epilepsy mtle, the hippocampus is traditionally considered to be the site of seizure onset.
Although classically, tle has been theorized to relate to isolated injury of temporal structures, such as the hippocampus and amygdala, more recent studies have demonstrated widespread cortical atrophy, involving both temporal and extratemporal areas. However, temporal lobe epilepsygliosis showed increased volume in the dentate gyrus bilaterally, and more focal and subtle increases in t2 intensity and mean diffusivity. Validation of a commercially available software for. Failure of standard magnetic resonance imaging in patients. However, to get the full benefit of effective diagnosis with current. Temporal lobe epilepsy radiology reference article. It causes seizures that stem from the medial or lateral temporal lobes of the brain.
Accounting for the confound of meninges in segmenting entorhinal and perirhinal cortices in t1weighted mri. Here we propose a framework for using restingstate brainnetwork features and support vector machine svm for tle lateralization. May 24, 2017 temporal lobe epilepsy is one of 20 different kinds of epilepsy. Radiologic interpretations of the mr imaging and pathology from subsequent. Temporal lobe epilepsy tle is a common form of epilepsy that. Health, general magnetic resonance imaging comparative analysis medical research medicine, experimental temporal lobe epilepsy. The svm analysis was done with the libsvm software package in a. Accounting for the confound of meninges in segmenting entorhinal and perirhinal. Radiologic interpretations of the mr imaging and pathology from. Frontiers relationship between seizure frequency and. The wm reductions were observed in adjacent areas of gm in medial temporal lobes. It can be hard for people with tle to become completely seizure free with seizure medicines alone, though medicines. Neuroimaging for patient selection for medial temporal. Epilepsy is one of the most common neurologic conditions in the world and is of a major public health concern.
Measurements were analyzed with a semiautomated software program and. Improved detection of subtle mesial temporal sclerosis. The human medial temporal lobe is composed of the hippocampus, the amygdala, and the surrounding cortex, including the entorhinal, perirhinal, and parahippocampal cortices. Tle is the most common form of epilepsy with focal seizures. Hippocampal sclerosis is the most common cause of mesial temporal lobe epilepsy. The diagnosis of hippocampal sclerosis using magnetic resonance imaging mri is an important part of the evaluation of patients with refractory temporal lobe epilepsy. It is my hope that we can find enough similarities between us that we can help each other to feel better about our situation and medical condition. As a relatively new noninvasive clinical recording system, magnetoencephalography meg has rarely been. Damage to the medial temporal lobe region in patients with medial temporal lobe epilepsy mtle, as described by neuropathological studies, is not confined to the hippocampus, 3, 4 but. Tle is diagnosed by taking a medical history, blood tes.
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