title: Semiological and electroencephalographic features of epilepsy with amygdalar lesion.
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.
  
  
  CONCLUSIONS
  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.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan; The Third Hospital of ShanXi Medical University, ShanXi, China.
authors.forename: XiaoPing
authors.initials: X
authors.lastname: Du
authors.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan. Electronic address: n-usui@hosp.go.jp.
authors.forename: Naotaka
authors.initials: N
authors.lastname: Usui
authors.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Terada
authors.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Baba
authors.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Matsuda
authors.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
authors.forename: Takayasu
authors.initials: T
authors.lastname: Tottori
authors.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000473:pathology* / Q000503:physiopathology*; D002648:Child; D004569:Electroencephalography; D004827:Epilepsy / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012598:Sclerosis / Q000473:pathology / Q000503:physiopathology; D012640:Seizures / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: Amygdalar lesion; EEG; Hippocampal sclerosis; Mesial temporal lobe epilepsy; Semiology