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Temporal Lobe Epilepsy with Unilateral Amygdala Enlargement: Morphometric MR Analysis with Clinical and Pathological Study
Author(s) -
Kimura Yukio,
Sato Noriko,
Saito Yuko,
Ito Kimiteru,
Kamiya Kouhei,
Nakata Yasuhiro,
Watanabe Masako,
Maikusa Norihide,
Matsuda Hiroshi,
Sugimoto Hideharu
Publication year - 2014
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12106
Subject(s) - pathological , medicine , cortical dysplasia , temporal lobe , epilepsy , voxel based morphometry , voxel , amygdala , magnetic resonance imaging , pathology , radiology , white matter , psychiatry
ABSTRACT BACKGROUND AND PURPOSE Amygdala enlargement (AE) has been reported as an epileptogenic focus in subtypes of temporal lobe epilepsy (TLE). The purpose of this study was to investigate the clinical, morphological, and pathological characteristics of AE. METHODS We retrospectively reviewed the clinical data and imaging findings of 23 TLE patients with ipsilateral AE. We performed morphological MR analyses using FreeSurfer and voxel‐based morphometry (VBM) in 14 of the 23 patients and in 20 controls whose images were obtained by a 3.0‐Tesla MRI. A pathological study was also performed in 2 patients who underwent operations. RESULTS All patients became seizure free or shSowed dramatic improvement by medical therapy except for two. They received operations and their pathology revealed that both patients had cortical dysplasia in from the amygdala to the ipsilateral temporal pole. The FreeSurfer analysis showed a significant difference in the amygdala volumes between the affected and nonaffected sides. VBM revealed significant increases of gray matter volumes of the temporal pole on the side of AE in seven of the 14 patients with AE (50%). CONCLUSIONS Cortical dysplasia may be one of the pathological diagnoses in AE, and in some patients it may extend to the temporal pole.