J Clin Neurol.  2006 Jun;2(2):118-125. 10.3988/jcn.2006.2.2.118.

Clinico-electrical Characteristics of Lateral Temporal Lobe Epilepsy; Anterior and Posterior Lateral Temporal Lobe Epilepsy

• Lee SY
• Lee SK
• Yun CH
• Kim KK
• Chung CK

• KMID: 1700744
• DOI: http://doi.org/10.3988/jcn.2006.2.2.118

Abstract

BACKGROUND AND PURPOSE
This study aimed to determine whether there are clinicoelectrical differences between anterior lateral temporal lobe epilepsy (ALTLE) and posterior lateral temporal lobe epilepsy (PLTLE), taking medial temporal lobe epilepsy (MTLE) as a reference.
METHODS
We analyzed the historical information, ictal semiologies, and ictal EEGs of temporal lobe epilepsy patients with a documented favorable surgical outcome (Engel class I or II) at follow-up after more than one year. LTLE was defined when a discrete lesion on MRI or an ictal onset zone in invasive study was located outside the collateral sulcus. LTLE was further divided into ALTLE and PLTLE by reference to the line across the cerebral peduncle. Total 107 seizures of 13 ALTLE, 8 PLTLE and 21 MTLE patients were reviewed.
RESULTS
Initial hypomotor symptom was frequently observed in PLTLE (P<0.001). Oroalimentary automatism (OAA) was not observed initially in PLTLE. Generalized tonic-clonic seizures occurred significantly earlier in PLTLE than in ALTLE or MTLE (P< 0.001). Ictal scalp EEG was not helpful in differentiating between ALTLE and PLTLE.
CONCLUSIONS
Frequent hypomotor onset, the absence of initial oroalimentary automatism, and early generalization are characteristic findings of PLTLE, although they are insufficient to differentiate it from ALTLE or MTLE.

Keyword

Lateral temporal lobe epilepsy (LTLE); Anterior lateral temporal lobe epilepsy (ALTLE); Posterior lateral temporal lobe epilepsy (PLTLE)

MeSH Terms

Automatism
Electroencephalography
Epilepsy, Temporal Lobe*
Follow-Up Studies
Generalization (Psychology)
Humans
Magnetic Resonance Imaging
Scalp
Seizures
Tegmentum Mesencephali
Temporal Lobe*

Figure

• 

  Figure 1 The temporal lobe was compartmentalized to the medial and lateral temporal lobes by reference to the collateral sulcus (A). The lateral temporal lobe was compartmentalized to the anterior and posterior lateral temporal lobes by a line across the cerebral peduncle (B).

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