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The patient had a normal magnetic resonance imaging and temporal lobe epilepsy secondary to a porencephalic cyst but showed structural lesions (hippocampal sclerosis).

Matsubara T, Ayuzawa S, Aoki T, Fujiomto A, Osuka S, Matsumura A - Epilepsy Behav Case Rep (2013)

Bottom Line: We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst.Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus.Hippocampal sclerosis was histopathologically confirmed (dual pathology).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Tsukuba University Hospital, Japan.

ABSTRACT
Patients with a porencephalic cyst frequently develop intractable temporal lobe epilepsy (TLE). We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst. Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus. Temporal lobectomy brought an end to the patient's seizures. Hippocampal sclerosis was histopathologically confirmed (dual pathology). Careful evaluation of hippocampal epileptogenicity is required, and temporal lobectomy, which is less invasive than hemispherectomy, can be a treatment of choice for patients with mTLE secondary to a porencephalic cyst.

No MeSH data available.


Related in: MedlinePlus

Histopathological examination reveals hippocampal neural loss at the CA1 area and granule cell dispersion, confirming a diagnosis of grade II–III HS. (A; HE × 100, B; Kleihauer–Betke (KB) stain × 100).
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f0020: Histopathological examination reveals hippocampal neural loss at the CA1 area and granule cell dispersion, confirming a diagnosis of grade II–III HS. (A; HE × 100, B; Kleihauer–Betke (KB) stain × 100).

Mentions: Although clinical features, EEG, and interictal SPECT suggested that the patient's seizures were due to mesial TLE (mTLE), MRI showed no abnormalities in the hippocampus, suggesting that the porencephalic cyst was the potential epileptogenic focus. To further determine the epileptogenic focus, long-term ECoG was performed, using subdural grid electrodes covering the left mesial temporal region, lateral temporal cortex, and parietal cortex surrounding the porencephalic cyst. We recorded 3 seizures over 7 days. All ictal discharges originated from the left mesial temporal region, and none originated in the area surrounding the porencephalic cyst (Fig. 3). We concluded that the left hippocampus was the epileptogenic focus. We performed left anterior temporal lobectomy and amygdalohippocampectomy. Histopathological examination revealed hippocampal neural loss at the CA1 area and granule cell dispersion, confirming a diagnosis of grade II–III HS (Fig. 4) [8]. Five years after surgery, the patient is completely seizure-free (Engel class I) without any morbidity.


The patient had a normal magnetic resonance imaging and temporal lobe epilepsy secondary to a porencephalic cyst but showed structural lesions (hippocampal sclerosis).

Matsubara T, Ayuzawa S, Aoki T, Fujiomto A, Osuka S, Matsumura A - Epilepsy Behav Case Rep (2013)

Histopathological examination reveals hippocampal neural loss at the CA1 area and granule cell dispersion, confirming a diagnosis of grade II–III HS. (A; HE × 100, B; Kleihauer–Betke (KB) stain × 100).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4150633&req=5

f0020: Histopathological examination reveals hippocampal neural loss at the CA1 area and granule cell dispersion, confirming a diagnosis of grade II–III HS. (A; HE × 100, B; Kleihauer–Betke (KB) stain × 100).
Mentions: Although clinical features, EEG, and interictal SPECT suggested that the patient's seizures were due to mesial TLE (mTLE), MRI showed no abnormalities in the hippocampus, suggesting that the porencephalic cyst was the potential epileptogenic focus. To further determine the epileptogenic focus, long-term ECoG was performed, using subdural grid electrodes covering the left mesial temporal region, lateral temporal cortex, and parietal cortex surrounding the porencephalic cyst. We recorded 3 seizures over 7 days. All ictal discharges originated from the left mesial temporal region, and none originated in the area surrounding the porencephalic cyst (Fig. 3). We concluded that the left hippocampus was the epileptogenic focus. We performed left anterior temporal lobectomy and amygdalohippocampectomy. Histopathological examination revealed hippocampal neural loss at the CA1 area and granule cell dispersion, confirming a diagnosis of grade II–III HS (Fig. 4) [8]. Five years after surgery, the patient is completely seizure-free (Engel class I) without any morbidity.

Bottom Line: We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst.Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus.Hippocampal sclerosis was histopathologically confirmed (dual pathology).

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Tsukuba University Hospital, Japan.

ABSTRACT
Patients with a porencephalic cyst frequently develop intractable temporal lobe epilepsy (TLE). We report a surgically-treated male patient with intractable mesial TLE (mTLE) secondary to a porencephalic cyst. Although magnetic resonance imaging showed no hippocampal abnormalities, long-term video-electrocorticography revealed seizure onset discharges in the hippocampus. Temporal lobectomy brought an end to the patient's seizures. Hippocampal sclerosis was histopathologically confirmed (dual pathology). Careful evaluation of hippocampal epileptogenicity is required, and temporal lobectomy, which is less invasive than hemispherectomy, can be a treatment of choice for patients with mTLE secondary to a porencephalic cyst.

No MeSH data available.


Related in: MedlinePlus