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Variability of presentation in medial temporal lobe epilepsy: a study of 30 operated cases
Author(s) -
Adam C.,
Clemenceau S.,
Semah F.,
Hasboun D.,
Samson D.,
Aboujaoude N.,
Samson Y.,
Baulac M.
Publication year - 1996
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1996.tb00031.x
Subject(s) - hippocampal sclerosis , temporal lobe , epilepsy , electroencephalography , neuropsychology , scalp , psychology , mesial temporal lobe epilepsy , laterality , medicine , surgery , neuroscience , cognition
– To evaluate the homogeneity of patients operated on for MTLE. Material and methods – 30 consecutive patients prospectively investigated with clinical, EEG, neuropsychology, MRI, FDG‐PET criteria and eventually intracranial EEG, who underwent antero‐medial temporal resection (follow‐up: 24 months). Results – Clear and well‐lateralised MTLE was non‐invasively ascertained in 22 patients (73%). Eight patients (27%) had a less pure presentation due to divergent scalp EEG features (bitemporal, widespread or extratemporal), unusual auras or absence of MRI‐based hippocampal sclerosis or FDG‐PET hypometabolism. They were explored by invasive monitoring which confirmed medial temporal origin of seizures. Outcome was excellent in 95% of the pure cases (Engel's class I) and less favorable in the more difficult ones (65% of class I). Conclusions – MTLE criteria, including the strong contribution of brain imaging, permit to select accurately a large percentage of patients. However a consistant number of patients present a less pure presentation suggesting more complex epileptogenic networks.