XiaoPing Du1, Naotaka Usui2, Kiyohito Terada3, Koichi Baba3, Kazumi Matsuda3, Takayasu Tottori3, Yushi Inoue3. 1. National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan; The Third Hospital of ShanXi Medical University, ShanXi, China. 2. National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan. Electronic address: n-usui@hosp.go.jp. 3. National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
Abstract
OBJECTIVE: To identify semiological and scalp/sphenoidal electroencephalographic (EEG) features of epilepsy with amygdalar lesion (AL). METHODS: This study included 17 patients with epilepsy and distinct AL on MRI, who underwent resective surgery. There were nine female and eight male patients with ages at surgery ranging from 8 to 48 (mean 26.3) years. Postoperative seizure outcome was Engel class I or seizure-free in 12 patients, class II in four, and class III in one. Pathological examination revealed dysembryoplastic neuroepithelial tumor in eight cases, astrocytoma in two, mixed oligoastrocytoma in three, ganglioglioma in two, localized encephalitis in one, and cortical dysplasia in one. Semiology and scalp/sphenoidal EEG findings of these patients (AL group) were compared with those of 20 mesial temporal lobe epilepsy patients with hippocampal sclerosis (HS) who underwent resective surgery with favorable seizure outcome (Engel class I) (control group). RESULTS: Increased tonic components during seizure were more frequently seen in AL group (58.8%) than in control group (20%). Interictal unitemporal slow waves were more frequently found in AL group (58.8%) than in control group (20%). Ictal EEG revealed generalized (not only bitemporal) onset in six patients in AL group (35.3%), but none in control group. The generalized EEG onset patterns in AL group included spike and wave complexes, rhythmic spikes, and delta waves. CONCLUSION: Patients with AL had increased tonic components during seizure and generalized ictal EEG onset more frequently than patients with HS. These findings suggest widespread epileptic network involving subcortical structures such as the thalamus and the brainstem in patients with AL.
OBJECTIVE: To identify semiological and scalp/sphenoidal electroencephalographic (EEG) features of epilepsy with amygdalar lesion (AL). METHODS: This study included 17 patients with epilepsy and distinct AL on MRI, who underwent resective surgery. There were nine female and eight male patients with ages at surgery ranging from 8 to 48 (mean 26.3) years. Postoperative seizure outcome was Engel class I or seizure-free in 12 patients, class II in four, and class III in one. Pathological examination revealed dysembryoplastic neuroepithelial tumor in eight cases, astrocytoma in two, mixed oligoastrocytoma in three, ganglioglioma in two, localized encephalitis in one, and cortical dysplasia in one. Semiology and scalp/sphenoidal EEG findings of these patients (AL group) were compared with those of 20 mesial temporal lobe epilepsypatients with hippocampal sclerosis (HS) who underwent resective surgery with favorable seizure outcome (Engel class I) (control group). RESULTS: Increased tonic components during seizure were more frequently seen in AL group (58.8%) than in control group (20%). Interictal unitemporal slow waves were more frequently found in AL group (58.8%) than in control group (20%). Ictal EEG revealed generalized (not only bitemporal) onset in six patients in AL group (35.3%), but none in control group. The generalized EEG onset patterns in AL group included spike and wave complexes, rhythmic spikes, and delta waves. CONCLUSION:Patients with AL had increased tonic components during seizure and generalized ictal EEG onset more frequently than patients with HS. These findings suggest widespread epileptic network involving subcortical structures such as the thalamus and the brainstem in patients with AL.
Authors: Giorgi Kuchukhidze; Iris Unterberger; Elisabeth Schmid; Laura Zamarian; Christian Michael Siedentopf; Florian Koppelstaetter; Elke Gizewski; Martin Kronbichler; Gerhard Luef; Hennric Jokeit; Eugen Trinka Journal: Front Neurol Date: 2022-01-21 Impact factor: 4.003