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Tsalouchidou PE, Müller HH, Mintziras I, Strehlau S, Hahn W, Belke M, Zahnert F, Kräling G, Menzler K, Knake S. Increased body mass index (BMI) associated with late epilepsy onset in patients with temporal encephaloceles: a systematic review and analysis of individual patient data. Neurol Res Pract 2024; 6:35. [PMID: 38987823 PMCID: PMC11238489 DOI: 10.1186/s42466-024-00329-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/06/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVE This study investigates the association of Body Mass Index (BMI) and age of epilepsy onset, in patients with epilepsy associated with temporal encephaloceles (TEs). METHODS A comprehensive PubMed literature review was conducted using the keywords "temporal encephaloceles" and "epilepsy" for identifying articles for the analysis. Inclusion criteria encompassed all evidence levels reporting patients with TE-related epilepsy and documented BMI. Logistic regression analyses were performed to examine the effect of BMI on predicting epilepsy onset after the 25th year of age. Spearman's correlation assessed the relationship between BMI with epilepsy onset. Finally, the association between BMI and postsurgical outcomes, distinguishing between more favourable outcomes (Engel Class I and II) and less favourable outcomes (Engell Class III and IV) was explored. RESULTS Of the initially identified 88 articles, nine were included in the analysis, involving 127 patients with TE-related epilepsy and reported BMI. The mean age of epilepsy onset was 24.9 years (SD = 14.8 years), with a mean BMI of 28.0 kg/m2 (SD = 7.4 kg/m2). A significant positive correlation was observed between BMI and age of epilepsy onset (rho = 0.448, p < 0.001). Female patients had higher BMI compared to male patients (30.1 kg/m2, SD = 8.7 kg/m2 and 26.5 kg/m2, SD = 5.3 kg/m2 respectively, p = 0.008). However, the epilepsy onset did not differ significantly between male and female patients (p = 0.26). The bivariate logistic regression showed that patients with increased BMI were more likely to have an epilepsy onset after the 25th year of age, adjusted for the confounder sex (OR = 1.133, 95%-CI [1.060, 1.211], p < 0.001). Finally, a potential trend indicated a higher average BMI among patients with more favourable postsurgical outcomes than less favourable postsurgical outcomes (27.3 kg/m2, SD = 7.7 kg/m2 and 24.8 kg/m2, SD = 2.2 kg/m2 respectively, p = 0.076).
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Affiliation(s)
- Panagiota-Eleni Tsalouchidou
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, 35043, Baldingerstrasse, Marburg, Germany.
- Second Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Hans-Helge Müller
- Institute of Medical Bioinformatics and Biostatistics, Philipps University Marburg, Marburg, Germany
| | - Ioannis Mintziras
- Department of Visceral-, Thoracic- and Vascular Surgery, Philipps University Marburg, Marburg, Germany
| | - Sascha Strehlau
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, 35043, Baldingerstrasse, Marburg, Germany
| | - Wiebke Hahn
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, 35043, Baldingerstrasse, Marburg, Germany
| | - Marcus Belke
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, 35043, Baldingerstrasse, Marburg, Germany
| | - Felix Zahnert
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, 35043, Baldingerstrasse, Marburg, Germany
| | - Gunter Kräling
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, 35043, Baldingerstrasse, Marburg, Germany
| | - Katja Menzler
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, 35043, Baldingerstrasse, Marburg, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Department of Neurology, Philipps University Marburg, 35043, Baldingerstrasse, Marburg, Germany
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Zhou DJ, Woodson-Smith S, Emmert BE, Kornspun A, Larocque J, Kulick-Soper CV, Qiu MK, Ellis CA, Gugger JJ, Conrad EC, Waldman G, Ganguly T, Sinha SR, Davis KA, Stein JM, Liu GT, Gelfand M, Raghupathi R. Clinical characteristics and surgical outcomes of epilepsy associated with temporal encephalocele: A systematic review. Epilepsy Behav 2024; 158:109928. [PMID: 38959747 DOI: 10.1016/j.yebeh.2024.109928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/16/2024] [Accepted: 06/27/2024] [Indexed: 07/05/2024]
Abstract
Temporal encephaloceles (TE) are an under-identified, potentially intervenable cause of epilepsy. This systematic review consolidates the current data to identify the major clinical, neuroimaging, and EEG features and surgical outcomes of epilepsy associated with TE. Literature searches were carried out using MEDLINE, Embase, PsycINFO, Scopus, and Cochrane Library databases from inception to December 7, 2023. Studies were included if they described clinical, neuroimaging, EEG, or surgical data in ≥5 patients with TE and epilepsy. Of 562 studies identified in the search, 24 met the eligibility criteria, reporting 423 unique patients with both epilepsy and TE. Compared to epilepsy patients without TE, those with TE had a higher mean age of seizure onset and were less likely to have a history of febrile seizures. Seizure semiologies were variable, but primarily mirrored temporal lobe onset patterns. Epilepsy patients with TE had a higher likelihood of having clinical or radiographic features of idiopathic intracranial hypertension (IIH) than those without. Brain MRI may show ipsilateral mesial temporal sclerosis (16 %). CT scans of the skull base usually revealed bony defects near the TE (90 %). Brain PET scans primarily showed ipsilateral temporal lobe hypometabolism (80 %), mostly in the anterior temporal lobe (67 %). Scalp EEG mostly lateralized ipsilateral to the implicated TE (92 % seizure onset) and localized to the temporal lobe (96 %). Intracranial EEG revealed seizure onset near the TE (11 of 12 cases including TE-adjacent electrodes) with variable timing of spread to the ipsilateral hippocampus. After surgical treatment of the TE, the rate of Engel I or ILAE 1 outcomes at one year was 75 % for lesionectomy, 85 % for anterior temporal lobectomy (ATL), and 80 % for ATL with amygdalohippocampectomy. Further studies are needed to better elucidate the relationship between IIH, TE, and epilepsy, improve the identification of TE, and optimize surgical interventions.
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Affiliation(s)
- Daniel J Zhou
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah Woodson-Smith
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Brian E Emmert
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Alana Kornspun
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Joshua Larocque
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Catherine V Kulick-Soper
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Maylene K Qiu
- Holman Biotech Commons, University of Pennsylvania, Philadelphia, PA, USA
| | - Colin A Ellis
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - James J Gugger
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Erin C Conrad
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Genna Waldman
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Taneeta Ganguly
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Saurabh R Sinha
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Kathryn A Davis
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Joel M Stein
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Grant T Liu
- Departments of Neurology and Ophthalmology, Division of Neuro-Ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Michael Gelfand
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Ramya Raghupathi
- Department of Neurology, Penn Epilepsy Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
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Uda T. Neuroimaging of Brain Tumor Surgery and Epilepsy. Brain Sci 2023; 13:1701. [PMID: 38137149 PMCID: PMC10742002 DOI: 10.3390/brainsci13121701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
To make the best clinical judgements, surgeons need to integrate information acquired via multimodal imaging [...].
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Affiliation(s)
- Takehiro Uda
- Department of Neurosurgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City 545-8585, Osaka, Japan
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