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Hadidane S, Lagarde S, Medina-Villalon S, McGonigal A, Laguitton V, Carron R, Scavarda D, Bartolomei F, Trebuchon A. Basal temporal lobe epilepsy: SEEG electroclinical characteristics. Epilepsy Res 2023; 191:107090. [PMID: 36774667 DOI: 10.1016/j.eplepsyres.2023.107090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 12/16/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Temporal lobe epilepsy is the most common type of focal drug-resistant epilepsy. Seizures with predominant involvement of basal temporal regions (BTR) are not well characterized. In this stereo electroencephalography (SEEG) study, we aimed at describing the ictal networks involving BTR and the associated clinical features. METHODS We studied 24 patients explored with SEEG in our center with BTR sampling. We analyzed their seizures using a quantitative method: the "epileptogenicity index". Then we reported the features of the patients with maximal epileptogenicity within BTR, especially ictal network involved, ictal semiology and post-surgical outcome. RESULTS We found that rhinal cortex, parahippocampal cortex and posterior fusiform gyrus were the most epileptogenic structures within the BTR (mean EI: 0.57, 0.55, 0.54 respectively). Three main groups of epileptogenic zone organization were found: anterior (23% of total seizures) posterior (30%) and global (47%, both anterior and posterior). Contralateral spread was found in 35% of left seizures and 20% of right seizures. Naming deficit was more prevalent in left BTR (71% vs 29% in right seizures; p = 0.01) whereas automatic speech production was preferentially represented in right seizures (11% vs 54%; p = 0.001). Surgery was proposed for 11 patients (45.8%), leading to seizure freedom in 72% (Engel Class I). One patient presented post-operative permanent functional deficit. CONCLUSION Basal-temporal lobe epilepsy seems to be a specific entity among the temporal epilepsy spectrum with specific clinical characteristics. Resective surgery can be proposed with good outcomes in a significant proportion of patients and is safe provided that adequate language assessment has been preoperatively made.
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Affiliation(s)
- S Hadidane
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France
| | - S Lagarde
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France
| | - S Medina-Villalon
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - A McGonigal
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - V Laguitton
- APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France
| | - R Carron
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Stereotactic and Functional Neurosurgery, Marseille, France
| | - D Scavarda
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Pediatric, Neurosurgery Department, Marseille, France
| | - F Bartolomei
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France
| | - A Trebuchon
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Timone Hospital, Epileptology Department, Clinical Neurophysiology, Marseille, France; INSERM UMR1106, Institut des Neurosciences des Systèmes, Aix-Marseille Université, Faculté de Médecine Timone, 27, Bd Jean-Moulin, 13385 Marseille Cedex 05, France; Service de Neurophysiologie Clinique, Hôpital de la Timone, 13005 Marseille, France.
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