Abstract
The present study included analysis of data from 243 patients surgically treated for Temporal Lobe Epilepsy (TLE). Resection was confined to the temporal lobe, with at least two years of follow-up, and specimens sufficiently preserved to allow a precise evaluation of both lateral neocortex and hippocampus. The frequency of different types of lesion and hippocampal sclerosis (HS), isolated or associated with neocortical lesions, risk factors and surgical outcomes in relation to neuropathological findings were evaluated. We found tumours in 33% of patients, malformations of cortical development (MCD) in 45%, isolated HS in 14%, no lesion in 5% and less common lesions in 3%. HS was present in 8% of tumour cases and 70% of MCD. Statistical analysis of antecedents was significantly associated only with febrile seizures (FS). In MCD patients with no history of FS, a strong association between HS and duration of epilepsy was revealed. A Class I outcome was identified in 87% of cases with tumours and 79% in cases with MCD. In 93 patients the anti-epileptic drug therapy was withdrawn. Our findings show that MCD, which is significantly associated with HS, is the most common lesion in TLE and support the concept that an optimal outcome is obtained when mesial and neocortical structures are removed. FS are particularly relevant in patients with focal cortical dysplasia and HS.
| Original language | English |
|---|---|
| Pages (from-to) | 281-292 |
| Number of pages | 12 |
| Journal | Epileptic Disorders |
| Volume | 11 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Dec 2009 |
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ASJC Scopus subject areas
- Clinical Neurology
- Neurology
Cite this
Temporal lobe epilepsy : Neuropathological and clinical correlations in 243 surgically treated patients. / Tassi, Laura; Meroni, Alessandra; Deleo, Francesco; Villani, Flavio; Mai, Roberto; Russo, Giorgio Lo; Colombo, Nadia; Avanzini, Giuliano; Falcone, Chiara; Bramerio, Manuela; Citterio, Alberto; Garbelli, Rita; Spreafico, Roberto.
In: Epileptic Disorders, Vol. 11, No. 4, 12.2009, p. 281-292.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Temporal lobe epilepsy
T2 - Neuropathological and clinical correlations in 243 surgically treated patients
AU - Tassi, Laura
AU - Meroni, Alessandra
AU - Deleo, Francesco
AU - Villani, Flavio
AU - Mai, Roberto
AU - Russo, Giorgio Lo
AU - Colombo, Nadia
AU - Avanzini, Giuliano
AU - Falcone, Chiara
AU - Bramerio, Manuela
AU - Citterio, Alberto
AU - Garbelli, Rita
AU - Spreafico, Roberto
PY - 2009/12
Y1 - 2009/12
N2 - The present study included analysis of data from 243 patients surgically treated for Temporal Lobe Epilepsy (TLE). Resection was confined to the temporal lobe, with at least two years of follow-up, and specimens sufficiently preserved to allow a precise evaluation of both lateral neocortex and hippocampus. The frequency of different types of lesion and hippocampal sclerosis (HS), isolated or associated with neocortical lesions, risk factors and surgical outcomes in relation to neuropathological findings were evaluated. We found tumours in 33% of patients, malformations of cortical development (MCD) in 45%, isolated HS in 14%, no lesion in 5% and less common lesions in 3%. HS was present in 8% of tumour cases and 70% of MCD. Statistical analysis of antecedents was significantly associated only with febrile seizures (FS). In MCD patients with no history of FS, a strong association between HS and duration of epilepsy was revealed. A Class I outcome was identified in 87% of cases with tumours and 79% in cases with MCD. In 93 patients the anti-epileptic drug therapy was withdrawn. Our findings show that MCD, which is significantly associated with HS, is the most common lesion in TLE and support the concept that an optimal outcome is obtained when mesial and neocortical structures are removed. FS are particularly relevant in patients with focal cortical dysplasia and HS.
AB - The present study included analysis of data from 243 patients surgically treated for Temporal Lobe Epilepsy (TLE). Resection was confined to the temporal lobe, with at least two years of follow-up, and specimens sufficiently preserved to allow a precise evaluation of both lateral neocortex and hippocampus. The frequency of different types of lesion and hippocampal sclerosis (HS), isolated or associated with neocortical lesions, risk factors and surgical outcomes in relation to neuropathological findings were evaluated. We found tumours in 33% of patients, malformations of cortical development (MCD) in 45%, isolated HS in 14%, no lesion in 5% and less common lesions in 3%. HS was present in 8% of tumour cases and 70% of MCD. Statistical analysis of antecedents was significantly associated only with febrile seizures (FS). In MCD patients with no history of FS, a strong association between HS and duration of epilepsy was revealed. A Class I outcome was identified in 87% of cases with tumours and 79% in cases with MCD. In 93 patients the anti-epileptic drug therapy was withdrawn. Our findings show that MCD, which is significantly associated with HS, is the most common lesion in TLE and support the concept that an optimal outcome is obtained when mesial and neocortical structures are removed. FS are particularly relevant in patients with focal cortical dysplasia and HS.
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UR - http://www.scopus.com/inward/citedby.url?scp=76749161459&partnerID=8YFLogxK
U2 - 10.1684/epd.2009.0279
DO - 10.1684/epd.2009.0279
M3 - Article
VL - 11
SP - 281
EP - 292
JO - Epileptic Disorders
JF - Epileptic Disorders
SN - 1294-9361
IS - 4
ER -