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Bruce P. Hermann - One of the best experts on this subject based on the ideXlab platform.
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cognitive prognosis in chronic Temporal Lobe Epilepsy
Annals of Neurology, 2006Co-Authors: Bruce P. Hermann, Michael Seidenberg, Christian Dow, Jana E. Jones, Paul Rutecki, Abhik Bhattacharya, Brian BellAbstract:Objective First, to determine whether patients with chronic Temporal Lobe Epilepsy have a different cognitive trajectory compared to control subjects over a prospective 4-year interval; second, to determine the proportion of patients who exhibit abnormal cognitive change and their profile of demographic, clinical Epilepsy, and baseline quantitative magnetic resonance imaging characteristics; and third, to determine the most vulnerable cognitive domains. Methods Participants with chronic Temporal Lobe Epilepsy (n = 46) attending a tertiary referral clinic and healthy control subjects (n = 65) underwent neuropsychological assessment and reevaluation 4 years later. Analysis of test–retest patterns identified individual patients with adverse cognition outcomes. Results The prospective cognitive trajectory of patients with chronic Temporal Lobe Epilepsy differs from age- and sex-matched healthy control subjects. Lack of practice effects is common, but frank adverse cognitive outcomes are observed in a subset of patients (20–25%), particularly in vulnerable cognitive domains that include memory. Cognitive declines are associated with a profile of abnormalities in baseline quantitative magnetic resonance volumetrics, lower baseline intellectual capacity, as well as longer duration of Epilepsy and older chronological age. Interpretation Cognitive prognosis is poor for a subset of patients characterized by chronicity of Epilepsy, older age, lower intellectual ability, and more baseline abnormalities in quantitative magnetic resonance volumetrics. Ann Neurol 2006;60:80–87
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Cerebellar atrophy in Temporal Lobe Epilepsy.
Epilepsy & behavior : E&B, 2005Co-Authors: Bruce P. Hermann, Katherine Bayless, Russ R. Hansen, Joy Parrish, Michael SeidenbergAbstract:Abstract Purpose The goal of this work was to determine the presence and degree of cerebellar atrophy in chronic Temporal Lobe Epilepsy, its clinical seizure correlates, and its association with general cortical atrophy. Methods Study participants were 78 persons with Temporal Lobe Epilepsy and 63 age- and gender-matched healthy controls. All subjects underwent high-resolution MRI with manual tracing of the cerebellum. Clinical seizure features and history were obtained by structured interview and review of medical records. Results The Epilepsy group exhibited significant abnormality in cerebellar volume, with mean reductions ranging from 4 to 6.6% depending on adjustments. Significantly more individual subjects with Epilepsy exhibited cerebellar atrophy compared with controls across all operational definitions or thresholds of abnormality including z ⩽ −2.0 (13% TLE, 3.4% controls) and z ⩽ 1.5 (22% TLE, 3.4% controls). Clinical seizure features reflecting both neurodevelopmental (history of initial precipitating injuries) and severity of course (longer duration, increased number of lifetime generalized tonic–clonic seizures) factors were associated with cerebellar atrophy. Atrophy of the cerebellum could be observed independent of more general (cerebral) atrophic processes. Conclusions The presence of cerebellar atrophy is a reflection of the extraTemporal abnormalities that can be observed in localization-related Temporal Lobe Epilepsy, which may be due, at least in part, to factors associated with Epilepsy chronicity.
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Negative symptoms and psychosocial status in Temporal Lobe Epilepsy
Epilepsy research, 2003Co-Authors: Kiesa Getz, Bruce P. Hermann, Michael Seidenberg, Brian Bell, Christian Dow, Jana E. Jones, Austin WoodardAbstract:Abstract Purpose : To determine the relationship between negative symptoms, psychosocial function and quality of life in Temporal Lobe Epilepsy. Methods : 23 patients with Temporal Lobe Epilepsy with negative symptoms were matched on gender, age, years of education, duration and age of Epilepsy onset with 23 Temporal Lobe Epilepsy patients exhibiting no negative symptoms as determined by a standardized rating system (SANS/SAPS). The matched groups were compared in regard to: (1) employment status, (2) dependence on government financial subsidy, (3) relationship/marital status, and (4) self-reported quality of life. Results : Temporal Lobe Epilepsy patients with negative symptoms exhibited higher rates of unemployment, dependence on government aid, social isolation, and poorer self-reported quality of life relative to Temporal Lobe patients without negative symptoms. Conclusions : Interictal negative symptoms are associated with significantly increased psychosocial morbidity and poorer quality of life in Temporal Lobe Epilepsy.
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The neurodevelopmental impact of childhood-onset Temporal Lobe Epilepsy on brain structure and function.
Epilepsia, 2002Co-Authors: Bruce P. Hermann, Michael Seidenberg, Brian Bell, Paul Rutecki, Raj D. Sheth, Daniel S. O'leary, Kevin H. Ruggles, Gary Wendt, Vincent A. MagnottaAbstract:Summary: Purpose: To characterize the neurodevelopmental correlates of childhood-onset Temporal Lobe Epilepsy on brain structure and cognition compared with late-onset chronic Temporal Lobe Epilepsy and healthy controls. Methods: Healthy controls (n 62) and patients with early (n 37) versus late (n 16) age at onset of Temporal Lobe Epilepsy were compared with high-resolution quantitative magnetic resonance imaging (MRI) volumetrics and comprehensive neuropsychological assessment. Results: Patients with childhood-onset Temporal Lobe Epilepsy (mean onset age, 7.8 years) exhibited widespread compromise in neuropsychological performance and substantial reduction in brain tissue volumes extending to extraTemporal regions compared with healthy controls and late-onset Temporal Lobe Epilepsy patients (mean onset age, 23.3 years). Most evident was reduced total white-matter volume among the childhood-onset patients. Reduction in brain tissue volume, especially total white-matter volume, was associated with significantly poorer cognitive status, attesting to the clinical significance of the volumetric abnormalities. Conclusions: Childhood-onset Temporal Lobe Epilepsy appears to be associated with an adverse neurodevelopmental impact on brain structure and cognition that appears generalized in nature and especially evident in white-matter tissue volume. Key Words: Temporal Lobe Epilepsy—Cognition— MRI volumetrics—Neurodevelopment.
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Neuropsychology and Temporal Lobe Epilepsy.
Cns Spectrums, 2002Co-Authors: Bruce P. Hermann, Michael SeidenbergAbstract:The purpose of this article is to review aspects of the neuropsychology of Temporal Lobe Epilepsy. Evidence will be presented to demonstrate that the cognitive consequences of this focal seizure disorder can be more generalized in nature than expected. Consistent with the extraTemporal neurocognitive findings, careful quantitative magnetic resonance imaging volumetrics have shown that structural brain changes may be detected outside the Temporal Lobes. Many factors can potentially affect cognition and brain structure. We focus on the potential neurodevelopmental impact of early-onset Temporal Lobe Epilepsy on brain structure and cognition positing that this disorder can have both immediate and lifespan implications for cognition and psychosocial status.
Norman Geschwind - One of the best experts on this subject based on the ideXlab platform.
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Personality changes in Temporal Lobe Epilepsy.
Epilepsy & behavior : E&B, 2009Co-Authors: Norman GeschwindAbstract:Our topic tonight is the personality changes in Temporal Lobe Epilepsy. This follows naturally from the second lecture in this series on the physiological basis of emotional behavior. The personality alterations in Temporal Lobe Epilepsy are our best illustration of the anatomical and physiological organization of emotion. There are other conditions in which one sees some aspects of change in emotional behavior, but none are very common and none reveal the events contributing to change in emotional behavior as well as Temporal Lobe Epilepsy. In my last lecture we discussed the patient of Plum and Reeves who had a congenital tumor near the ventromedial nuclei of the hypothalamus. This patient had exactly the same syndrome as do animals with destruction of that region. The patient became massively obese and became very aggressive. That isolated case provides only limited insights into mechanisms. There is one disease a cardinal feature of which is change in emotional behavior, and in fact this is a disease whose name obviously means rage in all languages except English. It is a disease which in French is called rage, in German is called tollwut, which means rage, in Italian rabbia, and in English rabies. Rabies also means rage but the derivation is less obvious. The word ‘‘rabid” as applied to dogs describes the very striking change in the dog who becomes an animal who transmits the disease by biting. The effect of the lesion causes the dog to bite more readily, providing the virus a means for transmission to the next host. Oddly, rage behavior as a characteristic of rabies was always well known, but it took a very long time for people to appreciate that the localization of its lesions was giving a message about the localization of rage in the nervous system. Gastaut, the French neurologist interested in Temporal Lobe Epilepsy, pointed out that the lesions in rabies occur in the limbic system in areas similar to the ones that John Flynn reported in simulation-induced rage. Rabies is not a very good disease to study. It is an acute disease. It is invariably fatal and the changes which occur are very rapid and very dramatic. Temporal Lobe Epilepsy is therefore unique in a very special way. Among all of the psychiatric disorders known to mankind, it is the one cause of serious psychiatric symptoms whose mechanism we understand fairly well. This makes Temporal Lobe Epilepsy a tremendously important disorder, although it remains very widely neglected. If you take the large number of patients in mental hospitals with schizophrenia, you can say that this is an important and common disorder, but nobody to my knowledge knows the cause or mechanism of schizophrenia. Second, there are many organic behavior disorders in which we know the cause but not the mechanism. Consider atropine, an anticholinergic drug that is often used to treat Parkinson’s disease. It can produce a paranoid psychosis that disappears when the drug wears off or can be reversed instantly by giving an anticholinesterase agent such as phyostigimine. This is an empirical fact. But we cannot explain why someone becomes psychotic on atropine. Some people who become hypoglycemic on insulin develop extremely paranoid and curious behavior. This is an empirical fact but we do not understand the inner mechanism. The importance of Temporal Lobe Epilepsy is that the mechanism of the behavior disorder seems more apparent. As a result, as an avenue of study in psychiatry and behavioral disorders, it should be one of the major interests. However, it is not an area of active research. People study disorders of obscure etiology when they have a common disorder of clear etiology that could be studied much more fruitfully. 2
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Hypergraphia in Temporal Lobe Epilepsy
Epilepsy & Behavior, 2005Co-Authors: Stephen G. Waxman, Norman GeschwindAbstract:Abstract The phenomenon of hypergraphia, or the tendency toward extensive and, in some cases, compulsive writing, in Temporal Lobe Epilepsy is described in seven patients, in each of whom there was electroencephalographic demonstration of a Temporal Lobe focus. Unusually detailed and strikingly copious writing was evidenced in each patient. Six patients provided documentation of their extensive writing, which often was concerned with religious or moral issues. A seventh patient claimed to have written extensively, but refused to exhibit his writings. Aggressiveness, religiosity, and changes in sexual behavior in Temporal Lobe disorders have been described previously. The hypergraphia of Temporal Lobe Epilepsy appears to be part of a specific behavioral syndrome of special interest because of its association with dysfunction at specific anatomic loci.
Mark J. Cook - One of the best experts on this subject based on the ideXlab platform.
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Specificity of psychopathology in Temporal Lobe Epilepsy.
Epilepsy & Behavior, 2013Co-Authors: Amie Foran, Stephen C. Bowden, Fiona J. Bardenhagen, Mark J. Cook, Catherine E. MeadeAbstract:An investigation into the specificity of psychopathology in Temporal Lobe Epilepsy was conducted using the Minnesota Multiphase Personality Inventory second edition (MMPI-2) profiles. Consecutive series of patients with left Temporal Lobe Epilepsy (n = 49) and those with right Temporal Lobe Epilepsy (n = 45) were compared with patients with other forms of Epilepsy (n = 46) and other heterogeneous neurological conditions (n = 69). The investigation focused on the Clinical, Content, and Subscales scales that resembled descriptions of the Interictal Dysphoric Disorder symptoms and Temporal Lobe Epilepsy Personality Traits. Patients with right Temporal Lobe Epilepsy and those with left Temporal Lobe Epilepsy did not have different patterns of scale elevation, nor did they have clinical elevations compared with patients with other types of Epilepsy or neurological controls. The MMPI-2 scales that resemble descriptions of the Interictal Dysphoric Disorder or Temporal Lobe Epilepsy Personality Syndrome were not elevated in either group of patients with Temporal Lobe Epilepsy compared with the group of patients with non-Temporal Lobe Epilepsy or heterogeneous neurological controls. This study adds to the mounting body of empirical research that has used standardized measures and matched groups, but failed to detect a special affinity between psychopathology and Temporal Lobe Epilepsy.
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familial mesial Temporal Lobe Epilepsy a benign Epilepsy syndrome showing complex inheritance
Brain, 2010Co-Authors: Mark J. Cook, Douglas E Crompton, Ingrid E Scheffer, Isabella Taylor, Penelope A Mckelvie, Danya F Vears, Kate M LawrenceAbstract:Temporal Lobe Epilepsy is the commonest partial Epilepsy of adulthood. Although generally perceived as an acquired disorder, several forms of familial Temporal Lobe Epilepsy, with mesial or lateral seizure semiology, have been described. Descriptions of familial mesial Temporal Lobe Epilepsy have varied widely from a benign Epilepsy syndrome with prominent deja vu and without antecedent febrile seizures or magnetic resonance imaging abnormalities, to heterogeneous, but generally more refractory epilepsies, often with a history of febrile seizures and with frequent hippocampal atrophy and high T₂ signal on magnetic resonance imaging. Compelling evidence of a genetic aetiology (rather than chance aggregation) in familial mesial Temporal Lobe Epilepsy has come from twin studies. Dominant inheritance has been reported in two large families, though the usual mode of inheritance is not known. Here, we describe clinical and neurophysiological features of 20 new mesial Temporal Lobe Epilepsy families including 51 affected individuals. The epilepsies in these families were generally benign, and febrile seizure history was infrequent (9.8%). No evidence of hippocampal sclerosis or dysplasia was present on brain imaging. A single individual underwent anterior Temporal Lobectomy, with subsequent seizure freedom and histopathological evidence of hippocampal sclerosis was not found. Inheritance patterns in probands' relatives were analysed in these families, together with 19 other Temporal Lobe Epilepsy families previously reported by us. Observed frequencies of epilepsies in relatives were lower than predicted by dominant Mendelian models, while only a minority (8/39) of families could be compatible with recessive inheritance. These findings strongly suggest that complex inheritance, similar to that widely accepted in the idiopathic generalized epilepsies, is the usual mode of inheritance in familial mesial Temporal Lobe Epilepsy. This disorder, which appears to be relatively common, and not typically associated with hippocampal sclerosis, is an appropriate target for contemporary approaches to complex disorders such as genome-wide association studies for common genetic variants or deep sequencing for rare variants.
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Temporal Lobe Epilepsy.
Journal of neurosurgery, 2005Co-Authors: Ross Carne, Stephen C. Bowden, Terence J. O'brien, Christine Kilpatrick, Lachlan Macgregor, Rodney J. Hicks, Michael Murphy, Andrew H. Kaye, Mark J. CookAbstract:Abstract Object. The syndrome of medial Temporal Lobe Epilepsy (MTLE) may occur in patients in whom magnetic resonance (MR) images demonstrate normal findings. In these patients, there is no evidence of hippocampal sclerosis on neuroimaging, and histopathological examination of the resected hippocampus does not reveal significant neuron loss. In this paper the authors describe the distinct clinical features of this MTLE subtype, referred to as paradoxical Temporal Lobe Epilepsy (PTLE). Methods. The authors selected 12 consecutive patients with preoperative findings consistent with MTLE in whom MR imaging did not demonstrate any hippocampal abnormality. Onset of hippocampal seizure was confirmed by long-term intracranial monitoring. There were six female and six male patients with a mean age of 32 ± 11 years (mean ± standard deviation [SD]) at presentation. These patients' seizure histories, available hippocampal volumetric measurements, and hippocampal cell densities in different subfields were reviewed. ...
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Image guided audit of surgery for Temporal Lobe Epilepsy.
Journal of neurology neurosurgery and psychiatry, 1994Co-Authors: Neil Kitchen, Mark J. Cook, Simon Shorvon, David R. Fish, David G. T. ThomasAbstract:Studies on surgery for Temporal Lobe Epilepsy are hampered by lack of information about the actual surgery that has taken place. A method is described for accurately measuring the volumes of resection by MRI after surgery. Ten cases of surgically treated Temporal Lobe Epilepsy (nine non-tailored resections, one selective amygdalohippocampectomy) are presented to show the technique. Indices of extent of resection in both the mesiobasal and lateral Temporal Lobe compartments have been measured, compared, and evaluated. By comparison with identical preoperative volumetric MRI the hippocampal resections have been correlated with the demonstrated hippocampal volume loss, thought to be of relevance in the aetiology of Temporal Lobe Epilepsy. Detailed postoperative audit in this manner is vital in providing a rational basis for follow up studies of outcome.
Samuel F Berkovic - One of the best experts on this subject based on the ideXlab platform.
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Benign mesial Temporal Lobe Epilepsy
Nature Reviews Neurology, 2011Co-Authors: Angelo Labate, Samuel F Berkovic, Antonio Gambardella, Eva Andermann, Umberto Aguglia, Fernando Cendes, Frederick AndermannAbstract:Benign mesial Temporal Lobe Epilepsy (bMTLE), which is defined as at least 24 months of seizure freedom with or without antiepileptic medication, has probably been under-recognized because of a literature bias toward refractory Epilepsy cases. Seizure onset in bMTLE tends to be in adolescence or adulthood, and patients frequently have a family history of febrile seizures and Epilepsy. Long-term seizure freedom is observed with or without antiepileptic medication. On brain MRI, nearly 40% of patients with long-standing bMTLE show evidence of hippocampal sclerosis, a feature usually associated with refractory Temporal Lobe Epilepsy. Prospective studies are needed to determine the features that allow prediction of a benign course, and to clarify the significance of hippocampal MRI changes. Labate et al . argue that benign mesial Temporal Lobe Epilepsy (bMTLE)—defined as at least 24 months of seizure freedom with or without antiepileptic medication—has been under-recognized because of a bias in the literature towards refractory forms of Epilepsy. Here, the authors discuss emerging concepts on bMTLE, some of which were formulated during an international workshop held in Italy.
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benign mesial Temporal Lobe Epilepsy
Nature Reviews Neurology, 2011Co-Authors: Angelo Labate, Samuel F Berkovic, Antonio Gambardella, Eva Andermann, Umberto Aguglia, Fernando Cendes, Frederick AndermannAbstract:Benign mesial Temporal Lobe Epilepsy (bMTLE), which is defined as at least 24 months of seizure freedom with or without antiepileptic medication, has probably been under-recognized because of a literature bias toward refractory Epilepsy cases. Seizure onset in bMTLE tends to be in adolescence or adulthood, and patients frequently have a family history of febrile seizures and Epilepsy. Long-term seizure freedom is observed with or without antiepileptic medication. On brain MRI, nearly 40% of patients with long-standing bMTLE show evidence of hippocampal sclerosis, a feature usually associated with refractory Temporal Lobe Epilepsy. Prospective studies are needed to determine the features that allow prediction of a benign course, and to clarify the significance of hippocampal MRI changes.
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Surgical treatment of Temporal Lobe Epilepsy
Journal of neurology neurosurgery and psychiatry, 2002Co-Authors: Samuel F BerkovicAbstract:It is important that presurgical evaluation of patients with Temporal Lobe Epilepsy is carried out by multidisciplinary teams The paper published in this issue by Jutila et al (this issue, pp 486–94) adds to the literature regarding surgical treatment of Temporal Lobe Epilepsy.1 This paper presents results from a national centre for adults in Finland. The strength of this report is that it has long term follow up from a relatively defined population. The benefit of Temporal …
Michael Seidenberg - One of the best experts on this subject based on the ideXlab platform.
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cognitive prognosis in chronic Temporal Lobe Epilepsy
Annals of Neurology, 2006Co-Authors: Bruce P. Hermann, Michael Seidenberg, Christian Dow, Jana E. Jones, Paul Rutecki, Abhik Bhattacharya, Brian BellAbstract:Objective First, to determine whether patients with chronic Temporal Lobe Epilepsy have a different cognitive trajectory compared to control subjects over a prospective 4-year interval; second, to determine the proportion of patients who exhibit abnormal cognitive change and their profile of demographic, clinical Epilepsy, and baseline quantitative magnetic resonance imaging characteristics; and third, to determine the most vulnerable cognitive domains. Methods Participants with chronic Temporal Lobe Epilepsy (n = 46) attending a tertiary referral clinic and healthy control subjects (n = 65) underwent neuropsychological assessment and reevaluation 4 years later. Analysis of test–retest patterns identified individual patients with adverse cognition outcomes. Results The prospective cognitive trajectory of patients with chronic Temporal Lobe Epilepsy differs from age- and sex-matched healthy control subjects. Lack of practice effects is common, but frank adverse cognitive outcomes are observed in a subset of patients (20–25%), particularly in vulnerable cognitive domains that include memory. Cognitive declines are associated with a profile of abnormalities in baseline quantitative magnetic resonance volumetrics, lower baseline intellectual capacity, as well as longer duration of Epilepsy and older chronological age. Interpretation Cognitive prognosis is poor for a subset of patients characterized by chronicity of Epilepsy, older age, lower intellectual ability, and more baseline abnormalities in quantitative magnetic resonance volumetrics. Ann Neurol 2006;60:80–87
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Cerebellar atrophy in Temporal Lobe Epilepsy.
Epilepsy & behavior : E&B, 2005Co-Authors: Bruce P. Hermann, Katherine Bayless, Russ R. Hansen, Joy Parrish, Michael SeidenbergAbstract:Abstract Purpose The goal of this work was to determine the presence and degree of cerebellar atrophy in chronic Temporal Lobe Epilepsy, its clinical seizure correlates, and its association with general cortical atrophy. Methods Study participants were 78 persons with Temporal Lobe Epilepsy and 63 age- and gender-matched healthy controls. All subjects underwent high-resolution MRI with manual tracing of the cerebellum. Clinical seizure features and history were obtained by structured interview and review of medical records. Results The Epilepsy group exhibited significant abnormality in cerebellar volume, with mean reductions ranging from 4 to 6.6% depending on adjustments. Significantly more individual subjects with Epilepsy exhibited cerebellar atrophy compared with controls across all operational definitions or thresholds of abnormality including z ⩽ −2.0 (13% TLE, 3.4% controls) and z ⩽ 1.5 (22% TLE, 3.4% controls). Clinical seizure features reflecting both neurodevelopmental (history of initial precipitating injuries) and severity of course (longer duration, increased number of lifetime generalized tonic–clonic seizures) factors were associated with cerebellar atrophy. Atrophy of the cerebellum could be observed independent of more general (cerebral) atrophic processes. Conclusions The presence of cerebellar atrophy is a reflection of the extraTemporal abnormalities that can be observed in localization-related Temporal Lobe Epilepsy, which may be due, at least in part, to factors associated with Epilepsy chronicity.
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Negative symptoms and psychosocial status in Temporal Lobe Epilepsy
Epilepsy research, 2003Co-Authors: Kiesa Getz, Bruce P. Hermann, Michael Seidenberg, Brian Bell, Christian Dow, Jana E. Jones, Austin WoodardAbstract:Abstract Purpose : To determine the relationship between negative symptoms, psychosocial function and quality of life in Temporal Lobe Epilepsy. Methods : 23 patients with Temporal Lobe Epilepsy with negative symptoms were matched on gender, age, years of education, duration and age of Epilepsy onset with 23 Temporal Lobe Epilepsy patients exhibiting no negative symptoms as determined by a standardized rating system (SANS/SAPS). The matched groups were compared in regard to: (1) employment status, (2) dependence on government financial subsidy, (3) relationship/marital status, and (4) self-reported quality of life. Results : Temporal Lobe Epilepsy patients with negative symptoms exhibited higher rates of unemployment, dependence on government aid, social isolation, and poorer self-reported quality of life relative to Temporal Lobe patients without negative symptoms. Conclusions : Interictal negative symptoms are associated with significantly increased psychosocial morbidity and poorer quality of life in Temporal Lobe Epilepsy.
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The neurodevelopmental impact of childhood-onset Temporal Lobe Epilepsy on brain structure and function.
Epilepsia, 2002Co-Authors: Bruce P. Hermann, Michael Seidenberg, Brian Bell, Paul Rutecki, Raj D. Sheth, Daniel S. O'leary, Kevin H. Ruggles, Gary Wendt, Vincent A. MagnottaAbstract:Summary: Purpose: To characterize the neurodevelopmental correlates of childhood-onset Temporal Lobe Epilepsy on brain structure and cognition compared with late-onset chronic Temporal Lobe Epilepsy and healthy controls. Methods: Healthy controls (n 62) and patients with early (n 37) versus late (n 16) age at onset of Temporal Lobe Epilepsy were compared with high-resolution quantitative magnetic resonance imaging (MRI) volumetrics and comprehensive neuropsychological assessment. Results: Patients with childhood-onset Temporal Lobe Epilepsy (mean onset age, 7.8 years) exhibited widespread compromise in neuropsychological performance and substantial reduction in brain tissue volumes extending to extraTemporal regions compared with healthy controls and late-onset Temporal Lobe Epilepsy patients (mean onset age, 23.3 years). Most evident was reduced total white-matter volume among the childhood-onset patients. Reduction in brain tissue volume, especially total white-matter volume, was associated with significantly poorer cognitive status, attesting to the clinical significance of the volumetric abnormalities. Conclusions: Childhood-onset Temporal Lobe Epilepsy appears to be associated with an adverse neurodevelopmental impact on brain structure and cognition that appears generalized in nature and especially evident in white-matter tissue volume. Key Words: Temporal Lobe Epilepsy—Cognition— MRI volumetrics—Neurodevelopment.
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Neuropsychology and Temporal Lobe Epilepsy.
Cns Spectrums, 2002Co-Authors: Bruce P. Hermann, Michael SeidenbergAbstract:The purpose of this article is to review aspects of the neuropsychology of Temporal Lobe Epilepsy. Evidence will be presented to demonstrate that the cognitive consequences of this focal seizure disorder can be more generalized in nature than expected. Consistent with the extraTemporal neurocognitive findings, careful quantitative magnetic resonance imaging volumetrics have shown that structural brain changes may be detected outside the Temporal Lobes. Many factors can potentially affect cognition and brain structure. We focus on the potential neurodevelopmental impact of early-onset Temporal Lobe Epilepsy on brain structure and cognition positing that this disorder can have both immediate and lifespan implications for cognition and psychosocial status.
