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Review
. 2021 Dec 24:12:798228.
doi: 10.3389/fneur.2021.798228. eCollection 2021.

Determination of the Initial Abnormal Discharge Site in Temporal Lobe Epilepsy Through Combined EEG and Neuroimaging. What Is Next?

Ana A Rentería-Palomo  1 , Jose L Montes-Ochoa  1 , Adriana Martinez-Mayorga  1 , Jorge Guillermo Reyes-Vaca  1 , Ildefonso Rodríguez-Leyva  1
Affiliations
Review

Determination of the Initial Abnormal Discharge Site in Temporal Lobe Epilepsy Through Combined EEG and Neuroimaging. What Is Next?

Ana A Rentería-Palomo et al. Front Neurol. .

Abstract

Objective: The objective of this study was to determine the relationship between atrophy of the hippocampus and severity of epilepsy in patients with temporal lobe epilepsy (TLE) as the first step to evaluate the possibility of surgery for epilepsy and analyze why patients cannot undergo epilepsy surgery. Methods: Volumetric MRI of the hippocampus was performed in 51 consecutive patients (29 men; mean age 40) with TLE. TLE diagnosis, lateralization, and severity (mild, moderate, severe) of seizures were based on a comprehensive evaluation that included neurologic examination and EEG in all patients. Patients with evidence of a lesion other than hippocampal sclerosis were not included in the study. We assessed the relationship between hippocampal volumes and electrophysiological evidence of seizure severity. Results: According to the affected side based on the EEG, a statistically significant difference (p < 0.001) in volume and a positive correlation between epilepsy and hippocampal atrophy were found. Conclusion: Our results confirm that volume loss to the hippocampus in patients with TLE correlates with the severity of epilepsy based on the EEG. Therefore, surgical treatment is considered early when hippocampal atrophy is evident in patients with refractory TLE. However, in Latin American countries, it is a challenge to get a patient to undergo epilepsy surgery. Therefore, we try to analyze the sad situation in our hospital.

Keywords: EEG; MRI; TLE; epileptic seizure; hippocampal volume.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Tables show the correlation among volume, voxels, and hippocampal atrophy, comparing the affected side against its control (itself). Again, the results show a high sadistic significance.
Figure 2
Figure 2
Correlation between voxel and volume with severity of the findings in the EEG. The results are presented for each IE group: mild, moderate, and severe, and each affected side, left and right.
See this image and copyright information in PMC

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