Epilepsy Surgery for Skull-Base Temporal Lobe Encephaloceles: Should We Spare the Hippocampus from Resection?
| Autor: | Travis G. Fogel, Michael Lee, Kenneth De Los Reyes, Travis Losey, Sheri L. Harder, Ravi Raghavan, Firas Bannout, Alexander Zouros |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
meningoencephalocele medicine.medical_treatment Case Report Electroencephalography lcsh:RC321-571 Temporal lobe Encephalocele 03 medical and health sciences Epilepsy 0302 clinical medicine Medicine Epilepsy surgery lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry Anterior temporal lobectomy encephalocele Temporal cortex medicine.diagnostic_test tailored surgery business.industry General Neuroscience temporal lobe epilepsy medicine.disease Skull medicine.anatomical_structure 030220 oncology & carcinogenesis Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Brain Sciences Brain Sciences, Vol 8, Iss 3, p 42 (2018) |
| ISSN: | 2076-3425 |
| Popis: | The neurosurgical treatment of skull base temporal encephalocele for patients with epilepsy is variable. We describe two adult cases of temporal lobe epilepsy (TLE) with spheno-temporal encephalocele, currently seizure-free for more than two years after anterior temporal lobectomy (ATL) and lesionectomy sparing the hippocampus without long-term intracranial electroencephalogram (EEG) monitoring. Encephaloceles were detected by magnetic resonance imaging (MRI) and confirmed by maxillofacial head computed tomography (CT) scans. Seizures were captured by scalp video-EEG recording. One case underwent intraoperative electrocorticography (ECoG) with pathology demonstrating neuronal heterotopia. We propose that in some patients with skull base temporal encephaloceles, minimal surgical resection of herniated and adjacent temporal cortex (lesionectomy) is sufficient to render seizure freedom. In future cases, where an associated malformation of cortical development is suspected, newer techniques such as minimally invasive EEG monitoring with stereotactic-depth EEG electrodes should be considered to tailor the surrounding margins of the resected epileptogenic zone. |
| Databáze: | OpenAIRE |
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