Article Figures & Data
Figures
- Figure 1
- Seizure outcomes in patients in the mesial, lateral temporal, and temporal plus groups at the 2-year follow-up. In our sample, 74%, 60%, and 67%, respectively, of mesial temporal, lateral temporal, and temporal plus epilepsy cases achieved class I in Engel’s classification system.
- Figure 2
- Postoperative MRI scans of patients who achieved class I in Engel’s classification system at the 2-year follow-up. A) A 27-year-old left-handed patient with a ten-year history of epilepsy; the patient was found to have left middle temporal gyrus cavernoma. She reached Engel’s class I post-resection. B) A 22-year-old, right-handed patient with new-onset epilepsy and lesional MRI; suspected DENT vs. ganglioglioma. The pathologist confirmed DENT. At post-op follow-up, she was assessed as Engel class I. C) A 26-year-old, right-handed patient with a history of epilepsy; the patient was found to have cortical dysplasia on brain MRI and confirmed the pathologist as FCD IIa; the patient was seizure-free at post-op. D) A 20-year-old, right-handed patient with a history of DRE; the patient was found to have hippocampal sclerosis and dorsofrontal encephalomalacia, and the resection of temporal structures plus orbitofrontal resulted in seizure freedom.
Tables
Patient characteristics Types of epilepsy n (%) Total TLE n=33 TPE n=15 Age, mean (SD) 27.4 (8.7) 25.6 (8.1) 26.8 (8.4) Gender Female 12 (36) 4 (27) 16 (33) Male 21 (64) 11 (73) 32 (67) Handedness Right 29 (88) 14 (93) 43 (90) Left 4 (12) 0 (0) 4 (8) Ambidextrous 0 1 (7) 1 (2) Age of epilepsy onset mean±SD 13 (8.7) 9 (5.5) 12 (7.9) Seizure (frequency/month)mean±SD 4 (2.7) 7 (7.0) 5 (4.6) MRI Lesional 26 (67) 13 (33) 39 (81) Non-lesional 7 (78) 2 (22) 9 (19) Lateralized 20 (63) 12 (38) 32 (82) Non-lateralized 6 (86) 1 (14) 7 (18) PET scan Lateralized 28 (72) 11 (28) 39 (81) Non-lateralized 5 (56) 4 (44) 9 (19) Neuropsychology Lateralized 17 (63) 10 (37) 27 (56) Non-lateralized 16 (76) 5 (24) 21 (44) TLE - temporal lobe epilepsy, TPE - temporal plus epilepsy
- Table 2
- Correlation between pre-ictal phase and IOZ localization and lateralization value.
Pre-ictal (Aura) Types of epilepsy N (%) TLE (n= 33) TPE (n= 15) Mesial temporal (R) n=10 Mesial temporal(L) n=10 Mesial temporal (B) n=3 Lateral temporal (R) n=3 Lateral temporal (L) n=7 Orbito-frontal (R) n=6 Orbito-frontal (L) n=4 Temporo-occipital (R) n=2 Temporo-occipital (L) n=3 Total (N=48) P-value Epigastric sensation 6 (60) 3 (30) 0 1 (33) 0 1 (17) 1 (25) 0 1 (33) 13 (27) 0.246 Nausea 3 (30) 0 0 1 (33) 1 (14) 0 0 0 0 5 (10) 0.353 Palpitation & SOB 0 0 0 0 1 (14) 0 0 0 0 1 (2) 0.694 Dreaming state 1 (10) 0 0 0 0 0 0 0 0 1 (2) 0.897 Seeing familiar faces 0 0 0 0 0 0 0 0 2 (67) 2 (4) <0.001 Visual hallucination 0 0 0 0 0 0 0 1 (50) 1 (33) 2 (4) 0.008 Auditory hallucination 0 0 0 0 2 (28) 0 0 0 0 2 (4) 0.138 Fear 1 (10) 5 (50) 1 (33) 2 (66) 3 (42) 2 (33) 0 1 (50) 2 (67) 17 (35) 0.38 Anxiety 2 (20) 0 1 (33) 0 0 1 (17) 0 0 0 4 (8) 0.533 Vertigo 0 0 0 0 0 0 0 1 (50) 0 1 (2) <0.001 Dizziness 1 (10) 2 (20) 0 0 1 (14) 1 (17) 0 0 1 (33) 6 (13) 0.917 Headache 0 0 1 (33) 0 1 (14) 1 (17) 0 0 0 3 (6) 0.494 IOZ- ictal onset zone, SOB - shortness of breath, TLE- Temporal lobe epilepsy, One-way ANOVA test was used to compare the variables. *Statistically significant value (p<0.05), R - right side, L-left side, B - Bilateral
- Table 3
- Correlation between seizure symptomatology and IOZ localization and lateralization value for the ictal phase.
Ictal Types of epilepsy n (%) TLE (n = 33) TPE (n=15) Mesial temporal (R) n=10 Mesial temporal (L) n=10 Mesial temporal (B) n=3 Lateral temporal (R) n=3 Lateral temporal (L) n=7 Orbito-frontal (R) n=6 Orbito-frontal (L) n=4 Temporo-occipital (R) n=2 Temporo-occipital (L) n=3 Total N=48 P-value Speech arrest 0 1 (10) 0 0 0 0 0 0 0 1(2) 0.897 Ictal speech 3(30) 0 1(33) 1(33) 0 2(33) 1(25) 1(50) 1(33) 10(21) 0.526 Behavioral arrest 5(50) 6(60) 3(100) 1(33) 3(43) 2(33) 1(25) 0 1(33) 22(46) 0.513 Manual automatism Early/late 3(30)/4 (40) 4(40)/3(30) 0/1(33) 2(67)/0 4(57)/1(14) 2(33)/0 4(100)/0 1(50)/0 1(33)/1(33) 21(44)/1(21) 0.731 RT/LT/BiM 4(40) / 1(10) / 2(20) 0 / 4(40) / 3(30) 0 / 1(33) / 0 2(67) / 0/ 0 0/5(71)/0 2 (33)/0 /0 1(25)/2(50)/1(25) 1(50)/0 /0 0 /2(67)/0 10(21)/15(31)/6(13) 0.826 Oral automatism Early/late 4(40)/2(20) 4(40)/1(10) 2(67)/0 1(33)/0 4 (57) / 1(14) 0/0 1 (25) / 1 (25) 0/1 (25) 0 / 2 (67) 16(33)/8(17) 0.358 LS/Chewing 4(40)/2(20) 4(40)/1(10) 1(33)/1(33) 1(33)/0 3(43)/2(29) 0/0 2(50)/0 1(50)/0 2(67)/0 18(38)/6(13) 0.561 Dystonic posture Early/late 0/6(60) 1(10)/5(50) 0/2(67) 1(33)/1(33) 0/3(43) 0/1 (17) 0/2 (50) 0 /0 0 / 2 (67) 2(4)/22(46) 0.675 RT/LT/BiL 1(10)/5(50)/0 5(50)/0/1(10) 0/1(33)/1(10) 0/2(67)/0 3 (43)/0/0 0/1(17)/0 2(50)/0/0 0/0/0 2(67)/0/0 13(27)/9(27)/2(4) 0.521 Head turning Early/late 1(10)/3(30) 2(20)/3(30) 1(33)/0 0/1(33) 2(29)/2(29) 2(33)/2(33) 0/1(25) 1(50)/1(50) 0/3(100) 9(19)/16(33) 0.435 RT/LT 2(20)/2(20) 4(40)/1(10) 0/1(33) 0/1(33) 2(29)/2(29) 1(17)/3(50) 0/1(25) 1(50)/1(50) 2(67)/1(33) 12(25)/13(27) 0.348 Facial grimacing 0 0 0 0 0 0 1 (25) 0 0 1 (2) 0.193 Facial contraction RT/LT 1(10)/1(10) 1(10)/0 0/1(33) 0/0 0/0 0/4(67) 1 (25)/0 0/0 0/0 3(6)/6(13) 0.539 Eye blinking 2(20) 0 0 0 1(14) 1(17) 0 0 0 4(8) 0.156 Contralateral tonic 3(30) 1(10) 0 0 0 3(50) 0 0 0 7(15) 0.77 RINCH 0.806 RT hand 0 2(20) 0 0 1(14) 0 0 0 0 3 (6) Left hand 0 0 0 0 0 1 (14) 0 0 0 1 (2) Bilateral tonic-clonic 7(70) 10(100) 3 (100) 3(100) 7(100) 5(83) 4(100) 2(100) 1(33) 42(88) 0.046 BiL - Bilateral, BiM - Bimanual, LT - Left, LS - Lip smacking, RT - Right, RINCH - Rhythmic Ictal Nonclonic Hand. One-way ANOVA test was used to compare the variables. One-way ANOVA test was used to compare the variables. *Statistically significant value (p<0.05), R - right side, L-left side, B - Bilateral
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