The different subtypes of temporal lobe seizures networks

Abstract

Temporal lobe epilepsies (TLEs) are among the forms of epilepsy most frequently encountered in surgical evaluations, characterized by a wide range of anatomical, functional, and electroclinical subtypes. Traditional classifications, such as mesial and lateral TLE, have been broadened by advances in stereoelectroencephalography (SEEG), revealing more complex forms such as mesio-lateral and temporal-plus seizures. These findings support the concept of epileptogenic networks, emphasizing interconnected regions rather than isolated focal areas in the genesis of seizures. Quantitative tools, such as the epileptogenicity index (EI), are improving the accuracy of SEEG interpretation, which is closely correlated with surgical results. Temporal-plus epilepsies, in particular, require full SEEG exploration due to their broader involvement in the network, necessitating tailored surgical approaches. A better understanding of TLEs subtypes and epileptogenic networks is an essential basis for advancing minimally invasive surgical techniques, including laser interstitial thermal therapy (LITT) and neuromodulation. These methods rely on the precise localization of epileptogenic networks. This network-based framework represents an important step towards optimizing surgical outcomes and advancing personalized epilepsy care.

Keywords: Epileptogenic networks; Epileptogenic zone (EZ); Lateral temporal seizures; Mesial temporal lobe epilepsy (MTLE); Stereoelectroencephalography (SEEG); Temporal lobe epilepsy (TLE); Temporal-PLUS EPILepsy.