Advertisement

Neuroradiology

, Volume 48, Issue 7, pp 460–464 | Cite as

White matter abnormalities in the anterior temporal lobe suggest the side of the seizure foci in temporal lobe epilepsy

  • Y. AdachiEmail author
  • A. Yagishita
  • N. Arai
Diagnostic Neuroradiology

Abstract

Introduction

White matter abnormalities in the anterior temporal lobe (WAATL) are sometimes observed on magnetic resonance (MR) images of patients with temporal lobe epilepsy (TLE). Our purpose was to determine whether WAATL could indicate if the seizure foci are ipsilateral on electroencephalograms (EEG) in TLE patients.

Methods

We reviewed 112 consecutive patients with medically intractable TLE. We compared the side of seizure foci on EEG (preoperative and intraoperative) and MR images.

Results

Both loss of gray–white matter demarcation and increased signal intensity changes in the anterior white matter (positive WAATL) were observed in 54 of 112 patients (48.2%) with TLE. WAATL were present on the same side as the seizure foci on preoperative intracranial EEG with subdural electrodes (iEEG) and on intraoperative electrocorticography (ECG) in all the patients. In 47 patients, MR images showed WAATL and focal lesions that were possibly epileptogenic for TLE. In 2 of the 47 patients, the seizure foci on iEEG and ECG were contralateral to the focal lesion; in the remaining 45 patients, the seizure foci on surface EEG (sEEG) and ECG and the focal lesion were on the same side. In three patients, no focal lesions were seen but WAATL were present on the same side as the seizure foci on sEEG and ECG. In four patients, MR images showed focal lesions for which epileptogenicity was questionable, and WAATL on the same side as the seizure foci on EEG.

Conclusion

WAATL are clinically useful because they indicate the side of the seizure foci.

Keywords

Cortical dysplasia Corticomedullary junction Ectopic neuron Microdysgenesis 

Notes

Conflict of interest statement

We declare that we have no conflict of interest.

References

  1. 1.
    Mitchell LA, Harvey AS, Coleman LT, Mandlstam SA, Jackson DG (2003) Anterior temporal changes on MR imaging with children with hippocampal sclerosis: an effect of seizures on the immature brain? AJNR Am J Neuroradiol 24:1670–1677PubMedGoogle Scholar
  2. 2.
    Briellmann RS, Syngeniotis A, Fleming S, et al (2004) Increased anterior temporal lobe T2 times in cases of hippocampal sclerosis: a multi-echo T2 relaxometry study at 3T. AJNR Am J Neuroradiol 25:389–394PubMedGoogle Scholar
  3. 3.
    Coste S, Ryvlin P, Hemier M, et al (2002) Temporopolar changes in temporal lobe epilepsy: a quantitative MRI-based study. Neurology 59:855–861PubMedGoogle Scholar
  4. 4.
    Mitchell LA, Jackson GD, Kalnins RM, et al (1999) Anterior temporal abnormality in temporal lobe epilepsy: a quantitative MRI and histopathologic study. Neurology 52:327–336PubMedGoogle Scholar
  5. 5.
    Meinersm LC, Witkamp TD, de Kort GA, et al (1999) Relevance of temporal lobe white matter changes in hippocampal sclerosis. Invest Radiol 34:38–45CrossRefGoogle Scholar
  6. 6.
    Trescher WH, Lesser RP (1996) The epilepsies. In: Bradley WG, Daroff RB, Fenichel GM, Marsden CD (eds) Neurology in clinical practice: the neurological disorders, 2nd edn, vol.2. Butterworth-Heinemann, Boston, pp 1625–1654Google Scholar
  7. 7.
    Lesser RP, Gordon B, Fisher JR, Hart J, Uematsu S (1992) Subdural grid electrodes in surgery of epilepsy. In: Luders HS (ed) Epilepsy surgery. Raven Press, New York, pp 399–408Google Scholar
  8. 8.
    Yagishita A, Arai N, Maehara T, Shimizu H, et al (1997) Focal cortical dysplasia: appearance on MR images. Radiology 203:553–559PubMedGoogle Scholar
  9. 9.
    Arai N, Umitsu R, Komori T, et al (2003) Peculiar form of cerebral microdysgenesis characterized by white matter neurons with perineuronal and perivascular glial satellitosis: a study using a variety of human autopsied brains. Pathol Int 53:345–352PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of NeuroradiologyTokyo Metropolitan Neurological HospitalFuchuJapan
  2. 2.Department of Clinical NeuropathologyTokyo Metropolitan Neurological InstituteFuchuJapan

Personalised recommendations