Keiko Usui1, Akio Ikeda2, Takashi Nagamine3, Jun Matsubayashi3, Riki Matsumoto4, Harukazu Hiraumi5, Jun Kawamata4, Masao Matsuhashi3, Ryosuke Takahashi4, Hidenao Fukuyama3. 1. Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan; National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan. 2. Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: akio@kuhp.kyoto-u.ac.jp. 3. Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan. 4. Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan. 5. Department of Otolaryngology, Head and Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Abstract
OBJECTIVE: Lateralization of functionally abnormal cortical area in autosomal dominant lateral temporal lobe epilepsy (ADLTE). METHODS: A sound pulse of pure tone was delivered monaurally to the ears alternately. Auditory evoked magnetic fields (AEF) were measured by using whole-head magnetoencephalography (MEG) system. RESULTS: Significantly large N100m signals (a magnetic counterpart of N1/N100 in EEG) were detected in three out of five patients, either in the left or in the right hemisphere, contralateral to the auditory stimulation. The peak latency, location and orientation of distinct N100m exhibited no clear difference from those of normal controls. CONCLUSIONS: Unilateral cortical abnormality exists in some of the patients in ADLTE. Patients with abnormally large N100m had seizures apparently provoked by auditory stimuli, suggesting that the appearance of significantly large N100m is associated with the epileptogenicity. Based on the detailed examination using MRI and FDG-PET for two of the patients, the authors hypothesize hyperexcitability caused by the decreased inhibitory functions, larger number of synchronously activated neurons, or the elongation of neuronal firing in the pathological temporal cortex in ADLTE. SIGNIFICANCE: The present study revealed clear abnormalities in the auditory cortex that have not been well detected by conventional EEG in patients with ADLTE.
OBJECTIVE: Lateralization of functionally abnormal cortical area in autosomal dominant lateral temporal lobe epilepsy (ADLTE). METHODS: A sound pulse of pure tone was delivered monaurally to the ears alternately. Auditory evoked magnetic fields (AEF) were measured by using whole-head magnetoencephalography (MEG) system. RESULTS: Significantly large N100m signals (a magnetic counterpart of N1/N100 in EEG) were detected in three out of five patients, either in the left or in the right hemisphere, contralateral to the auditory stimulation. The peak latency, location and orientation of distinct N100m exhibited no clear difference from those of normal controls. CONCLUSIONS: Unilateral cortical abnormality exists in some of the patients in ADLTE. Patients with abnormally large N100m had seizures apparently provoked by auditory stimuli, suggesting that the appearance of significantly large N100m is associated with the epileptogenicity. Based on the detailed examination using MRI and FDG-PET for two of the patients, the authors hypothesize hyperexcitability caused by the decreased inhibitory functions, larger number of synchronously activated neurons, or the elongation of neuronal firing in the pathological temporal cortex in ADLTE. SIGNIFICANCE: The present study revealed clear abnormalities in the auditory cortex that have not been well detected by conventional EEG in patients with ADLTE.