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- W1977973485 abstract "To the Editor: P.N. Sylaja, et al., in their article, “Seizure Outcome after Anterior Temporal Lobectomy and Its Predictors in Patients with Apparent Temporal Lobe Epilepsy and Normal MRI” (Epilepsia 2004;45:803–8), reported excellent outcome after anterior temporal lobectomy (ATL) in a subset of patients with normal magnetic resonance imaging (MRI): those with a history of febrile seizures, strictly unilateral anterior interictal epileptiform discharges (IEDs), and concordant type 1 ictal EEG pattern. All of the patients in their group with excellent outcome had histologically proven hippocampal sclerosis. The question, therefore, arises whether subtle asymmetry of hippocampal size was missed, as the MRI criteria did not include quantitative analysis of the hippocampal volumes. Perhaps the authors should look at more patients with apparent temporal lobe epilepsy (TLE) and perform hippocampal volumetry to arrive at the conclusion that the MRI results were truly normal in this subset of patients. Ictal semiology, ictal video-EEG, and interictal EEG may point to a ictal-onset zone but may equally well include the epileptogenic zone, or indicate the area to which the epileptic discharges spread and produce ictal symptoms; the current understanding is that at least one imaging criterion should be met (whether positron emission tomography, single-photon emission computed tomography, or MRI) before a patient can be submitted for ATL. If one is to change significantly this practice, then one must be certain that even after T2 relaxometry and hippocampal volumetry, a subset of TLE patients with normal MRIs will benefit with ATL." @default.
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- W1977973485 date "2005-03-29" @default.
- W1977973485 modified "2023-10-16" @default.
- W1977973485 title "ATL in Refractory Epilepsy with Normal MRI-volumetric Criteria?" @default.
- W1977973485 doi "https://doi.org/10.1111/j.0013-9580.2005.t01-1-64204_3.x" @default.
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