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Olfactory auras caused by a very focal isolated epileptic network in the amygdala.

Hamasaki T, Otsubo H, Uchikawa H, Yamada K, Kuratsu J - Epilepsy Behav Case Rep (2014)

Bottom Line: Epileptic olfactory auras manifesting as simple partial seizures are rare.Intracranial depth electrodes revealed a very focal isolated epileptogenic zone in the amygdala.Olfactory auras were successfully treated by focus resection.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Kumamoto University Medical School, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.

ABSTRACT
Epileptic olfactory auras manifesting as simple partial seizures are rare. We report a patient who presented with olfactory auras after hemorrhage from a cavernous angioma in the left mesial temporal region. His olfactory auras persisted 12 years after two surgeries for a cavernous angioma. Intracranial depth electrodes revealed a very focal isolated epileptogenic zone in the amygdala. Olfactory auras were successfully treated by focus resection.

No MeSH data available.


Related in: MedlinePlus

Consecutive CT scan, MR images, and skull X-ray with depth electrodes. (A, B) CT scan (A) and coronal MRI (B) acquired at the start of the seizures. A hematoma is seen in the left medial temporal lobe. (C) Coronal MRI after hematoma evacuation in the first surgery. The arrow indicates the parahippocampal gyrus located mesially to the surgical cavity. (D) Lateral skull X-ray shows the bilateral intracranial electrodes inserted via the occipital lobes. The left and right depth electrodes feature 10 and 6 contacts, respectively. Both depth electrodes are stereotactically located from the hippocampus to the amygdala. (E) The fusion image of MRI and CT identifies the location of L2 of the left depth electrode. The arrow indicates L2 placed in the inferomedial part of the previous surgical cavity. (F) Coronal MRI after the third surgery. The arrow indicates the cavity of the resected left prepiriform cortex and the residual mesial–cortical part of the amygdala.
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f0005: Consecutive CT scan, MR images, and skull X-ray with depth electrodes. (A, B) CT scan (A) and coronal MRI (B) acquired at the start of the seizures. A hematoma is seen in the left medial temporal lobe. (C) Coronal MRI after hematoma evacuation in the first surgery. The arrow indicates the parahippocampal gyrus located mesially to the surgical cavity. (D) Lateral skull X-ray shows the bilateral intracranial electrodes inserted via the occipital lobes. The left and right depth electrodes feature 10 and 6 contacts, respectively. Both depth electrodes are stereotactically located from the hippocampus to the amygdala. (E) The fusion image of MRI and CT identifies the location of L2 of the left depth electrode. The arrow indicates L2 placed in the inferomedial part of the previous surgical cavity. (F) Coronal MRI after the third surgery. The arrow indicates the cavity of the resected left prepiriform cortex and the residual mesial–cortical part of the amygdala.

Mentions: This 42-year-old right-handed male had been healthy before he experienced the sudden onset of headache, nausea, and the subsequent perception of a foul smell at the age of 27 years. Computed tomography (CT) showed a small hemorrhage in the left mesial temporal lobe (Fig. 1A). His neurological examinations were normal. He had a mild headache and experienced a putrid odor several times a day without loss of consciousness. Magnetic resonance imaging (MRI; Fig. 1B) showed a fresh 20-mm diameter hemorrhage in the left amygdala.


Olfactory auras caused by a very focal isolated epileptic network in the amygdala.

Hamasaki T, Otsubo H, Uchikawa H, Yamada K, Kuratsu J - Epilepsy Behav Case Rep (2014)

Consecutive CT scan, MR images, and skull X-ray with depth electrodes. (A, B) CT scan (A) and coronal MRI (B) acquired at the start of the seizures. A hematoma is seen in the left medial temporal lobe. (C) Coronal MRI after hematoma evacuation in the first surgery. The arrow indicates the parahippocampal gyrus located mesially to the surgical cavity. (D) Lateral skull X-ray shows the bilateral intracranial electrodes inserted via the occipital lobes. The left and right depth electrodes feature 10 and 6 contacts, respectively. Both depth electrodes are stereotactically located from the hippocampus to the amygdala. (E) The fusion image of MRI and CT identifies the location of L2 of the left depth electrode. The arrow indicates L2 placed in the inferomedial part of the previous surgical cavity. (F) Coronal MRI after the third surgery. The arrow indicates the cavity of the resected left prepiriform cortex and the residual mesial–cortical part of the amygdala.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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Show All Figures
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f0005: Consecutive CT scan, MR images, and skull X-ray with depth electrodes. (A, B) CT scan (A) and coronal MRI (B) acquired at the start of the seizures. A hematoma is seen in the left medial temporal lobe. (C) Coronal MRI after hematoma evacuation in the first surgery. The arrow indicates the parahippocampal gyrus located mesially to the surgical cavity. (D) Lateral skull X-ray shows the bilateral intracranial electrodes inserted via the occipital lobes. The left and right depth electrodes feature 10 and 6 contacts, respectively. Both depth electrodes are stereotactically located from the hippocampus to the amygdala. (E) The fusion image of MRI and CT identifies the location of L2 of the left depth electrode. The arrow indicates L2 placed in the inferomedial part of the previous surgical cavity. (F) Coronal MRI after the third surgery. The arrow indicates the cavity of the resected left prepiriform cortex and the residual mesial–cortical part of the amygdala.
Mentions: This 42-year-old right-handed male had been healthy before he experienced the sudden onset of headache, nausea, and the subsequent perception of a foul smell at the age of 27 years. Computed tomography (CT) showed a small hemorrhage in the left mesial temporal lobe (Fig. 1A). His neurological examinations were normal. He had a mild headache and experienced a putrid odor several times a day without loss of consciousness. Magnetic resonance imaging (MRI; Fig. 1B) showed a fresh 20-mm diameter hemorrhage in the left amygdala.

Bottom Line: Epileptic olfactory auras manifesting as simple partial seizures are rare.Intracranial depth electrodes revealed a very focal isolated epileptogenic zone in the amygdala.Olfactory auras were successfully treated by focus resection.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Kumamoto University Medical School, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.

ABSTRACT
Epileptic olfactory auras manifesting as simple partial seizures are rare. We report a patient who presented with olfactory auras after hemorrhage from a cavernous angioma in the left mesial temporal region. His olfactory auras persisted 12 years after two surgeries for a cavernous angioma. Intracranial depth electrodes revealed a very focal isolated epileptogenic zone in the amygdala. Olfactory auras were successfully treated by focus resection.

No MeSH data available.


Related in: MedlinePlus