Yukio Kimura1,2, Noriko Sato1, Yuko Saito1,3, Kimiteru Ito1, Kouhei Kamiya1, Yasuhiro Nakata1, Masako Watanabe4, Norihide Maikusa5, Hiroshi Matsuda5, Hideharu Sugimoto2. 1. Departments of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan. 2. Department of Radiology, Jichi Medical University, Tochigi, Japan. 3. Pathology and Laboratory Medicine, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan. 4. Department of Mental Disorders, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan. 5. Imaging Neuroinformatics Analysis Section, Department of Imaging Neuroinformatics, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan.
Abstract
BACKGROUND AND PURPOSE: Amygdala enlargement (AE) has been reported as an epileptogenic focus in subtypes of temporal lobe epilepsy (TLE). The purpose of this study was to investigate the clinical, morphological, and pathological characteristics of AE. METHODS: We retrospectively reviewed the clinical data and imaging findings of 23 TLE patients with ipsilateral AE. We performed morphological MR analyses using FreeSurfer and voxel-based morphometry (VBM) in 14 of the 23 patients and in 20 controls whose images were obtained by a 3.0-Tesla MRI. A pathological study was also performed in 2 patients who underwent operations. RESULTS: All patients became seizure free or shSowed dramatic improvement by medical therapy except for two. They received operations and their pathology revealed that both patients had cortical dysplasia in from the amygdala to the ipsilateral temporal pole. The FreeSurfer analysis showed a significant difference in the amygdala volumes between the affected and nonaffected sides. VBM revealed significant increases of gray matter volumes of the temporal pole on the side of AE in seven of the 14 patients with AE (50%). CONCLUSIONS: Cortical dysplasia may be one of the pathological diagnoses in AE, and in some patients it may extend to the temporal pole.
BACKGROUND AND PURPOSE:Amygdala enlargement (AE) has been reported as an epileptogenic focus in subtypes of temporal lobe epilepsy (TLE). The purpose of this study was to investigate the clinical, morphological, and pathological characteristics of AE. METHODS: We retrospectively reviewed the clinical data and imaging findings of 23 TLEpatients with ipsilateral AE. We performed morphological MR analyses using FreeSurfer and voxel-based morphometry (VBM) in 14 of the 23 patients and in 20 controls whose images were obtained by a 3.0-Tesla MRI. A pathological study was also performed in 2 patients who underwent operations. RESULTS: All patients became seizure free or shSowed dramatic improvement by medical therapy except for two. They received operations and their pathology revealed that both patients had cortical dysplasia in from the amygdala to the ipsilateral temporal pole. The FreeSurfer analysis showed a significant difference in the amygdala volumes between the affected and nonaffected sides. VBM revealed significant increases of gray matter volumes of the temporal pole on the side of AE in seven of the 14 patients with AE (50%). CONCLUSIONS:Cortical dysplasia may be one of the pathological diagnoses in AE, and in some patients it may extend to the temporal pole.
Authors: Anny Reyes; Thomas Thesen; Ruben Kuzniecky; Orrin Devinsky; Carrie R McDonald; Graeme D Jackson; David N Vaughan; Karen Blackmon Journal: Epilepsy Res Date: 2017-03-02 Impact factor: 3.045