This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (26)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Robin L. Gilmore, MD; M. Douglas Childress, MD; Christiana Leonard, PhD; Ronald Quisling, MD; Steven Roper, MD; Stephan Eisenschenk, MD; Melissa Mahoney

Arch Neurol. 1995;52(8):819-824.

Abstract
Objective
To determine whether the occurrence of hippocampal formation (HF) volumetric asymmetry can reliably discriminate between complex partial seizures (CPSs) of a temporal lobe origin and CPSs of an extratemporal lobe origin in a prospective study of patients with intractable CPSs (approximately 70% of patients have electrographic foci in the temporal lobe [HF volumetric asymmetry on magnetic resonance imaging scans has been shown to lateralize such foci reliably]).

Design
We examined HF volumetrics on magnetic resonance imaging scans that were acquired with a 1-T magnetic resonance imaging scanner (Siemens Magnetom, Siemens Medical Systems, Iselin, NJ) by using magnetization-prepared rapid gradient echo threedimensional sequences (producing a gapless series of high-contrast 1.25-mm images). These data were compared with ictal, interictal, invasive, and noninvasive videoelectroencephalographic monitoring data, functional imaging data, and outcome data to define each patient's type of epilepsy.

Setting and Patients
Forty-one patients were recruited from a tertiary university comprehensive epilepsy program, and 22 control subjects were recruited from the neurologically normal university community.

Results
Among the control subjects, the difference in HF volumetrics (right-left HF volumetrics) was +0.085±0.253 cm³. Of the 41 patients, 25 had temporal lobe epilepsy. When we set the upper limit of normal at the mean±3 SDs, all patients beyond the upper limit had CPSs of a temporal lobe origin. Of the patients with temporal lobe epilepsy, only three fell within normal limits. No patient with CPSs of an extratemporal lobe origin fell beyond the upper limit.

Conclusion
The presence of significant HF volumetric asymmetry makes it highly unlikely that a patient's CPSs are of an extratemporal lobe origin.

Author Affiliations
From the Departments of Neurology (Drs Gilmore, Childress, and Eisenschenk, and Ms Mahoney), Neurosciences (Dr Leonard), Psychology (Dr Leonard), Radiology (Dr Quisling), and Neurosurgery (Dr Roper), College of Medicine, University of Florida, Gainesville.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Clinical prediction of postoperative seizure control: structural, functional findings and disease histories
Stefan et al.
J. Neurol. Neurosurg. Psychiatry 2009;80:196-200.
ABSTRACT | FULL TEXT  

Hippocampal involvement in secondarily generalised seizures of extrahippocampal origin
Surges et al.
J. Neurol. Neurosurg. Psychiatry 2008;79:924-929.
ABSTRACT | FULL TEXT  

The Correlation of Seizure Characteristics and Hippocampal Volumetric Magnetic Resonance Imaging Findings in Children With Idiopathic Partial Epilepsy
Eroglu et al.
J Child Neurol 2007;22:348-353.
ABSTRACT  

Electroencephalographic, Volumetric, and Neuropsychological Indicators of Seizure Focus Lateralization in Temporal Lobe Epilepsy
Moser et al.
Arch Neurol 2000;57:707-712.
ABSTRACT | FULL TEXT  

Hippocampal Volume in Patients With Alcohol Dependence
Agartz et al.
Arch Gen Psychiatry 1999;56:356-363.
ABSTRACT | FULL TEXT  

Volumetric Magnetic Resonance Imaging: Clinical Applications and Contributions to the Understanding of Temporal Lobe Epilepsy
Watson et al.
Arch Neurol 1997;54:1521-1531.
ABSTRACT  

Specificity of Volumetric Magnetic Resonance Imaging in Detecting Hippocampal Sclerosis
Watson et al.
Arch Neurol 1997;54:67-73.
ABSTRACT