title: Temporal pole abnormalities in temporal lobe epilepsy with hippocampal sclerosis: Clinical significance and seizure outcome after surgery.
abstract: OBJECTIVE
  To assess the clinical significance of temporal pole abnormalities (temporopolar blurring, TB, and temporopolar atrophy, TA) in patients with temporal lobe epilepsy (TLE) and hippocampal sclerosis (HS) with a long post-surgical follow-up.
  
  
  METHODS
  We studied 60 consecutive patients with TLE-HS and 1.5 preoperative MRI scans who underwent surgery and were followed up for at least 5 years (mean follow-up 7.3 years). Based on findings of pre-surgical MRI, patients were classified according to the presence of TB or TA. Groups were compared on demographic, clinical, neuropsychological data, and seizure outcome.
  
  
  RESULTS
  TB was found in 37 (62%) patients, while TA was found in 35 (58%) patients, always ipsilateral to HS, with a high degree of overlap (83%) between TB and TA (p<0.001). Patients with TB did not differ from those without TB with regard to history of febrile convulsions, GTCSs, age of epilepsy onset, side of surgery, seizure frequency, seizure outcome, and neuropsychological outcome. On the other hand, they were significantly older, had a longer duration of epilepsy, and displayed lower preoperative scores on several neuropsychological tests. Similar findings were observed for TA. Multivariate analysis corroborated the association between temporopolar abnormalities and age at onset, age at surgery (for TB only), and lower preoperative scores on some neuropsychological tests.
  
  
  CONCLUSIONS
  Temporopolar abnormalities are frequent in patients with TLE-HS. Our data support the hypothesis that TB and TA are caused by seizure-related damages. These abnormalities did not influence seizure outcome, even after a long-term post-surgical follow-up.
authors.affiliation: IRCCS "NEUROMED", Pozzilli, IS, Italy. Electronic address: gdigennaro@neuromed.it.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Di Gennaro
authors.affiliation: IRCCS "NEUROMED", Pozzilli, IS, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: D'Aniello
authors.affiliation: IRCCS "NEUROMED", Pozzilli, IS, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: De Risi
authors.affiliation: IRCCS "NEUROMED", Pozzilli, IS, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grillea
authors.affiliation: IRCCS "NEUROMED", Pozzilli, IS, Italy.
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Quarato
authors.affiliation: IRCCS "NEUROMED", Pozzilli, IS, Italy.
authors.forename: Addolorata
authors.initials: A
authors.lastname: Mascia
authors.affiliation: IRCCS "NEUROMED", Pozzilli, IS, Italy.
authors.forename: Liliana G
authors.initials: LG
authors.lastname: Grammaldo
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Casciato
authors.affiliation: IRCCS "NEUROMED", Pozzilli, IS, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Morace
authors.affiliation: IRCCS "NEUROMED", Pozzilli, IS, Italy; Department of Neurosurgery, Sapienza University of Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Esposito
authors.affiliation: Mental Health Unit, Centre of Epidemiology, Surveillance and Health Promotion, Italian National Institute of Health, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
mesh_terms: D000293:Adolescent; D000328:Adult; D038481:Anterior Temporal Lobectomy; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis / Q000473:pathology* / Q000523:psychology / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000473:pathology* / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012598:Sclerosis / Q000175:diagnosis / Q000473:pathology / Q000523:psychology / Q000601:surgery; D012640:Seizures / Q000175:diagnosis / Q000473:pathology / Q000523:psychology / Q000601:surgery; D013702:Temporal Lobe / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Blurring; Epilepsy surgery; Hippocampal sclerosis; Outcome; Temporal lobe epilepsy; Temporopolar abnormalities