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The Amygdala and Temporal Lobe Simple Partial Seizures: A Prospective and Quantitative MRI Study
Author(s) -
Van Paesschen Wim,
King Martin D.,
Duncan John S.,
Connelly Alan
Publication year - 2001
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1046/j.1528-1157.2001.042007857.x
Subject(s) - sensation , temporal lobe , amygdala , epilepsy , magnetic resonance imaging , lobe , psychology , medicine , audiology , radiology , neuroscience , anatomy
Summary: Purpose: To determine whether specific temporal lobe simple partial seizures (SPSs) are associated with an abnormal amygdala T 2 (AT 2 ) ipsilateral to the seizure focus in patients with intractable unilateral temporal lobe epilepsy (TLE). AT 2 relaxation time mapping is a sensitive method for the detection of abnormal tissue in the amygdala in patients with refractory TLE. The relation between an abnormal AT 2 in the epileptic temporal lobe and amygdala seizure onset has not been established. Methods: Fifty patients with intractable unilateral TLE and concordant data during presurgical evaluation were included. Patients with a foreign‐tissue lesion on standard magnetic resonance imaging (MRI) were excluded. All had AT 2 mapping. Fifteen types of SPSs were ascertained prospectively, systematically, and blinded to the results of AT 2 mapping. The SPSs of patients with a normal AT 2 (n = 25) were compared with those of patients with an abnormal AT 2 ipsilateral to the seizure focus (n = 25). Results: The group of patients with an abnormal AT 2 reported a median of six types of SPSs (range 1–11), in comparison with a median of three types of SPSs (range, 0–7) for the group with a normal AT 2 (p<0.01). Déjà vu, a warm sensation, an indescribable strange sensation, a cephalic sensation, and fear were associated with an abnormal AT 2 . The combination of déjà vu, a cephalic sensation, a warm sensation, a gustatory hallucination, and an indescribable strange sensation discriminated best between the 25 patients with a normal and the 25 patients with an abnormal AT 2 . Conclusions: A high number and the types of different SPSs provide clinical evidence for early involvement of the amygdala during seizures in patients with refractory unilateral TLE and an abnormal AT 2 in the epileptic temporal lobe