Sara Gasparini1, Edoardo Ferlazzo1, Giuseppe Pustorino1, Michele Ascoli1, Vittoria Cianci1, Chiara Sueri1, Silvio Calabrò1, Mauro Campello1, Emilio Africa1, Antonio Gangemi1, Paolo Versace1, Umberto Aguglia2. 1. From the Department of Medical and Surgical Sciences (S.G., E.F., M.A., U.A.), "Magna Græcia" University of Catanzaro; and Regional Epilepsy Center (S.G., E.F., G.P., M.A., V.C., C.S., S.C., U.A.), Unit of Neurosurgery (M.C.), and Unit of Neuroradiology (E.A., A.G., P.V.), "Great Metropolitan Hospital," Reggio Calabria, Italy. 2. From the Department of Medical and Surgical Sciences (S.G., E.F., M.A., U.A.), "Magna Græcia" University of Catanzaro; and Regional Epilepsy Center (S.G., E.F., G.P., M.A., V.C., C.S., S.C., U.A.), Unit of Neurosurgery (M.C.), and Unit of Neuroradiology (E.A., A.G., P.V.), "Great Metropolitan Hospital," Reggio Calabria, Italy. u.aguglia@unicz.it.
Abstract
OBJECTIVE: The purpose of this case-control study is to evaluate the prevalence of occult temporal encephalomeningocele (OTE) in patients with temporal lobe epilepsy (TLE) of unknown etiology presenting to an epilepsy center, independently from drug sensitivity. METHODS: We studied 95 patients with TLE (51 female, mean age 49.4 ± 17.1 years) and 151 controls (88 female, mean age 54.1 ± 21.0 years) using a 1.5T brain MRI, including balanced steady-state gradient echo sequences, targeted to the temporal lobes. RESULTS: OTE was found in 5.2% of the TLE population (9.5% of drug-resistant TLE) and in none of the controls (p = 0.008). Two patients with OTE and drug-resistant TLE became seizure-free after lesionectomy (follow-up 18-24 months). CONCLUSION: OTE is not a rare finding in unselected patients with TLE of unknown origin, provided that it is carefully searched. The absence of OTE in a large group of nonepileptic controls adds evidence to its epileptogenic role.
OBJECTIVE: The purpose of this case-control study is to evaluate the prevalence of occult temporal encephalomeningocele (OTE) in patients with temporal lobe epilepsy (TLE) of unknown etiology presenting to an epilepsy center, independently from drug sensitivity. METHODS: We studied 95 patients with TLE (51 female, mean age 49.4 ± 17.1 years) and 151 controls (88 female, mean age 54.1 ± 21.0 years) using a 1.5T brain MRI, including balanced steady-state gradient echo sequences, targeted to the temporal lobes. RESULTS: OTE was found in 5.2% of the TLE population (9.5% of drug-resistant TLE) and in none of the controls (p = 0.008). Two patients with OTE and drug-resistant TLE became seizure-free after lesionectomy (follow-up 18-24 months). CONCLUSION: OTE is not a rare finding in unselected patients with TLE of unknown origin, provided that it is carefully searched. The absence of OTE in a large group of nonepileptic controls adds evidence to its epileptogenic role.