Temporal pole abnormalities detected by 3 T MRI in temporal lobe epilepsy due to hippocampal sclerosis: No influence on seizure outcome after surgery

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Abstract

Purpose To assess the clinical significance of temporal pole abnormalities (temporopolar blurring, TB, and temporopolar atrophy, TA) detected by using 3 Tesla MRI in the preoperative workup in patients with temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS) who underwent surgery. Methods We studied 78 consecutive patients with TLE-HS who underwent surgery and were followed up for at least 2 years. Based on findings of pre-surgical 3 Tesla MRI, patients were subdivided in subgroups according to the presence of TB or TA. Subgroups were compared on demographic, clinical, neuropsychological data and seizure outcome. Results TB was found in 39 (50%) patients, while TA was found in 32 (41%) patients, always ipsilateral to HS, with a considerable degree of overlap (69%) between TB and TA (p = 0.01). Patients with temporopolar abnormalities did not significantly differ from those without TB or TA with regard to sex, age, age of epilepsy onset, duration of epilepsy, history of febrile convulsions or birth complications, side of surgery, seizure frequency at surgery, presence of GTCSs, and, in particular, seizure outcome. On the other hand, TB patients show a less frequent family history of epilepsy (p < .05) while age at epilepsy onset showed a trend to be lower in the TB group (p = .09). Patients with temporopolar atrophy did not significantly differ from those without TA on any variable, except for age at epilepsy onset, which was significantly lower for the TA group (p < .05). History of birth complications and longer duration of epilepsy also showed a trend to be associated with TA (p = .08). Multivariate analysis corroborated the association between temporopolar abnormalities and absence of family history of epilepsy and history of birth complications. Conclusions High-field 3 T MRI in the preoperative workup for epilepsy surgery confirms that temporopolar abnormalities are frequent findings in TLE-HS patients and may be helpful to lateralize the epileptogenic zone. Their presence did not influence seizure outcome.

Original languageEnglish
Pages (from-to)74-78
Number of pages5
JournalSeizure
Volume48
DOIs
Publication statusPublished - May 1 2017

Fingerprint

Temporal Lobe Epilepsy
Sclerosis
Seizures
Epilepsy
Age of Onset
Reproductive History
Atrophy
Febrile Seizures
Multivariate Analysis
Demography
Parturition

Keywords

  • Blurring
  • Epilepsy surgery
  • Hippocampal sclerosis
  • Outcome
  • Temporal lobe epilepsy
  • Temporopolar abnormalities

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

@article{2aa12a3042b244a1b2e2af1de3fb070c,
title = "Temporal pole abnormalities detected by 3 T MRI in temporal lobe epilepsy due to hippocampal sclerosis: No influence on seizure outcome after surgery",
abstract = "Purpose To assess the clinical significance of temporal pole abnormalities (temporopolar blurring, TB, and temporopolar atrophy, TA) detected by using 3 Tesla MRI in the preoperative workup in patients with temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS) who underwent surgery. Methods We studied 78 consecutive patients with TLE-HS who underwent surgery and were followed up for at least 2 years. Based on findings of pre-surgical 3 Tesla MRI, patients were subdivided in subgroups according to the presence of TB or TA. Subgroups were compared on demographic, clinical, neuropsychological data and seizure outcome. Results TB was found in 39 (50{\%}) patients, while TA was found in 32 (41{\%}) patients, always ipsilateral to HS, with a considerable degree of overlap (69{\%}) between TB and TA (p = 0.01). Patients with temporopolar abnormalities did not significantly differ from those without TB or TA with regard to sex, age, age of epilepsy onset, duration of epilepsy, history of febrile convulsions or birth complications, side of surgery, seizure frequency at surgery, presence of GTCSs, and, in particular, seizure outcome. On the other hand, TB patients show a less frequent family history of epilepsy (p < .05) while age at epilepsy onset showed a trend to be lower in the TB group (p = .09). Patients with temporopolar atrophy did not significantly differ from those without TA on any variable, except for age at epilepsy onset, which was significantly lower for the TA group (p < .05). History of birth complications and longer duration of epilepsy also showed a trend to be associated with TA (p = .08). Multivariate analysis corroborated the association between temporopolar abnormalities and absence of family history of epilepsy and history of birth complications. Conclusions High-field 3 T MRI in the preoperative workup for epilepsy surgery confirms that temporopolar abnormalities are frequent findings in TLE-HS patients and may be helpful to lateralize the epileptogenic zone. Their presence did not influence seizure outcome.",
keywords = "Blurring, Epilepsy surgery, Hippocampal sclerosis, Outcome, Temporal lobe epilepsy, Temporopolar abnormalities",
author = "Sara Casciato and Angelo Picardi and Alfredo D'Aniello and {De Risi}, Marco and Giovanni Grillea and Quarato, {Pier Paolo} and Addolorata Mascia and Grammaldo, {Liliana G.} and Meldolesi, {Giulio Nicolo’} and Roberta Morace and Vincenzo Esposito and {Di Gennaro}, Giancarlo",
year = "2017",
month = "5",
day = "1",
doi = "10.1016/j.seizure.2017.04.006",
language = "English",
volume = "48",
pages = "74--78",
journal = "Seizure : the journal of the British Epilepsy Association",
issn = "1059-1311",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Temporal pole abnormalities detected by 3 T MRI in temporal lobe epilepsy due to hippocampal sclerosis

T2 - No influence on seizure outcome after surgery

AU - Casciato, Sara

AU - Picardi, Angelo

AU - D'Aniello, Alfredo

AU - De Risi, Marco

AU - Grillea, Giovanni

AU - Quarato, Pier Paolo

AU - Mascia, Addolorata

AU - Grammaldo, Liliana G.

AU - Meldolesi, Giulio Nicolo’

AU - Morace, Roberta

AU - Esposito, Vincenzo

AU - Di Gennaro, Giancarlo

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Purpose To assess the clinical significance of temporal pole abnormalities (temporopolar blurring, TB, and temporopolar atrophy, TA) detected by using 3 Tesla MRI in the preoperative workup in patients with temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS) who underwent surgery. Methods We studied 78 consecutive patients with TLE-HS who underwent surgery and were followed up for at least 2 years. Based on findings of pre-surgical 3 Tesla MRI, patients were subdivided in subgroups according to the presence of TB or TA. Subgroups were compared on demographic, clinical, neuropsychological data and seizure outcome. Results TB was found in 39 (50%) patients, while TA was found in 32 (41%) patients, always ipsilateral to HS, with a considerable degree of overlap (69%) between TB and TA (p = 0.01). Patients with temporopolar abnormalities did not significantly differ from those without TB or TA with regard to sex, age, age of epilepsy onset, duration of epilepsy, history of febrile convulsions or birth complications, side of surgery, seizure frequency at surgery, presence of GTCSs, and, in particular, seizure outcome. On the other hand, TB patients show a less frequent family history of epilepsy (p < .05) while age at epilepsy onset showed a trend to be lower in the TB group (p = .09). Patients with temporopolar atrophy did not significantly differ from those without TA on any variable, except for age at epilepsy onset, which was significantly lower for the TA group (p < .05). History of birth complications and longer duration of epilepsy also showed a trend to be associated with TA (p = .08). Multivariate analysis corroborated the association between temporopolar abnormalities and absence of family history of epilepsy and history of birth complications. Conclusions High-field 3 T MRI in the preoperative workup for epilepsy surgery confirms that temporopolar abnormalities are frequent findings in TLE-HS patients and may be helpful to lateralize the epileptogenic zone. Their presence did not influence seizure outcome.

AB - Purpose To assess the clinical significance of temporal pole abnormalities (temporopolar blurring, TB, and temporopolar atrophy, TA) detected by using 3 Tesla MRI in the preoperative workup in patients with temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS) who underwent surgery. Methods We studied 78 consecutive patients with TLE-HS who underwent surgery and were followed up for at least 2 years. Based on findings of pre-surgical 3 Tesla MRI, patients were subdivided in subgroups according to the presence of TB or TA. Subgroups were compared on demographic, clinical, neuropsychological data and seizure outcome. Results TB was found in 39 (50%) patients, while TA was found in 32 (41%) patients, always ipsilateral to HS, with a considerable degree of overlap (69%) between TB and TA (p = 0.01). Patients with temporopolar abnormalities did not significantly differ from those without TB or TA with regard to sex, age, age of epilepsy onset, duration of epilepsy, history of febrile convulsions or birth complications, side of surgery, seizure frequency at surgery, presence of GTCSs, and, in particular, seizure outcome. On the other hand, TB patients show a less frequent family history of epilepsy (p < .05) while age at epilepsy onset showed a trend to be lower in the TB group (p = .09). Patients with temporopolar atrophy did not significantly differ from those without TA on any variable, except for age at epilepsy onset, which was significantly lower for the TA group (p < .05). History of birth complications and longer duration of epilepsy also showed a trend to be associated with TA (p = .08). Multivariate analysis corroborated the association between temporopolar abnormalities and absence of family history of epilepsy and history of birth complications. Conclusions High-field 3 T MRI in the preoperative workup for epilepsy surgery confirms that temporopolar abnormalities are frequent findings in TLE-HS patients and may be helpful to lateralize the epileptogenic zone. Their presence did not influence seizure outcome.

KW - Blurring

KW - Epilepsy surgery

KW - Hippocampal sclerosis

KW - Outcome

KW - Temporal lobe epilepsy

KW - Temporopolar abnormalities

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DO - 10.1016/j.seizure.2017.04.006

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C2 - 28431291

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VL - 48

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JO - Seizure : the journal of the British Epilepsy Association

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SN - 1059-1311

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