[Non-invasive examinations successfully select patients with medial temporal lobe epilepsy for anterior temporal lobectomy].
We retrospectively analyzed 8 patients with intractable medial temporal lobe epilepsy (MTLE) who underwent the anterior temporal lobectomy with hippocampectomy (ATL) without invasive examinations such as chronic subdural electrode recording. Five patients had a history of febrile convulsion. While all 8 patients had oral automatism, automatism of ipsilateral limbs with dystonic posture of contralateral limbs was demonstrated in 2 patients. Bilateral temporal paroxysmal activities on interictal EEG was observed in 4 patients and all patients had clear ictal onset zone on unilateral anterior temporal region. MRI demonstrated unilateral hippocampal sclerosis in 5 cases. Interictal FDG-PET depicted hypometabolism of the unilateral temporal lobe in all cases, however, ECD-SPECT failed to reveal the hypoperfusion of the unilateral temporal lobe in a case. Postoperatively, 7 cases became seizure free, and one had rare seizure. Non-invasive examinations, especially ictal EEG and concordant FDG-PET findings, in patients with oral automatism in seizure semiology, successfully select patients with MTLE for ATL.
Morioka
T
T
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Nishio
S
S
Kawamura
T
T
Fukui
K
K
Sasaki
M
M
Fukui
M
M
D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000502:physiology; D002648:Child; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018579:Patient Selection; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon