Abstract

BackgroundTemporal lobe epilepsy (TLE) and idiopathic generalized epilepsy (IGE) patients have each been associated with extensive brain atrophy findings, yet to date there are no reports of head to head comparison of both patient groups. Our aim was to assess and compare between tissue-specific and structural brain atrophy findings in TLE to IGE patients and to healthy controls (HC).MethodsTLE patients were classified in TLE lesional (L-TLE) or non-lesional (NL-TLE) based on presence or absence of MRI temporal structural abnormalities. High resolution 3 T MRI with automated segmentation by SIENAX and FIRST tools were performed in a group of patients with temporal lobe epilepsy (11 L-TLE and 15 NL-TLE) and in15 IGE as well as in 26 HC. Normal brain volume (NBV), normal grey matter volume (NGMV), normal white matter volume (NWMV), and volumes of subcortical deep grey matter structures were quantified. Using regression analyses, differences between the groups in both volume and left/right asymmetry were evaluated. Additionally, laterality of results was also evaluated to separately quantify ipsilateral and contralateral effects in the TLE group.ResultsAll epilepsy groups had significantly lower NBV and NWMV compared to HC (p < 0.001). L-TLE had lower hippocampal volume than HC and IGE (p = 0.001), and all epilepsy groups had significantly lower amygdala volume than HC (p < = 0.004). In L-TLE, there was evidence of atrophy in both ipsilateral and contralateral structures.ConclusionsOur study revealed that TLE and IGE patients demonstrated similar overall tissue-specific brain atrophy, although specific structures differences were appreciated. L-TLE also appeared to behave differently than NL-TLE, with atrophy not limited to the ipsilateral side.

Highlights

  • Introduction to temporal lobe epilepsyEpilepsy Res 1996, 26:141–150. 2

  • The idiopathic generalized epilepsy (IGE) are typically divided in the following sub-syndromes: childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), and IGE with generalized tonic-clonic seizures [17]

  • The inclusion criteria for Temporal lobe epilepsy (TLE) patients consisted of: age >18 years at time of magnetic resonance imaging (MRI), diagnosis of TLE supported by history, documented seizures on epilepsy monitoring unit (EMU) long term monitoring (LTM) video electroencephalogram (EEG), and having underwent a 3 T MRI using a standard epilepsy protocol at a single site within 12 months of the LTM

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Summary

Introduction

Introduction to temporal lobe epilepsyEpilepsy Res 1996, 26:141–150. 2. Temporal lobe epilepsy (TLE) and idiopathic generalized epilepsy (IGE) patients have each been associated with extensive brain atrophy findings, yet to date there are no reports of head to head comparison of both patient groups. Our aim was to assess and compare between tissue-specific and structural brain atrophy findings in TLE to IGE patients and to healthy controls (HC). Identifying the specific structures and neuronal pathways affected in TLE can IGE are a group of age-related epilepsies with complex genetic backgrounds, subdivided according to the predominant seizure types (absence, myoclonic, or generalized tonic-clonic) and age of onset. Specific structural atrophies were reported independently in both TLE and IGE, there are no reports of head to head comparison of both patient groups using the same atrophy analysis measures

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