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Amygdala volumetry in "imaging-negative" temporal lobe epilepsy.
S P C Bower1, S J Vogrin, K Morris
1Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, Australia. s.bower@southernhealth.org.au
Journal of Neurology, Neurosurgery, and Psychiatry
|August 23, 2003
Summary
In "imaging-negative" temporal lobe epilepsy (TLE), abnormal amygdala enlargement was detected in some patients. Amygdala volumetry may aid in diagnosing this epilepsy type.
Area of Science:
- Neurology
- Neuroimaging
- Epilepsy Research
Background:
- Assessing amygdala abnormalities in
- imaging-negative
- epilepsy is challenging due to visual limitations.
- Temporal lobe epilepsy (TLE) can present without clear structural abnormalities on standard imaging.
- Amygdala abnormalities are sometimes suspected in these cases.
Purpose of the Study:
- To investigate amygdala volume in
- imaging-negative
- TLE patients to detect cryptic lesions.
- To determine if amygdala enlargement is a feature of
- imaging-negative
- TLE.
Main Methods:
- Reviewed video electroencephalography (EEG) data for 11 patients with EEG-lateralized TLE and normal MRI.
- Estimated amygdala volumes in these patients, 77 with hippocampal sclerosis (HS), and 77 controls.
Main Results:
- Seven of 11
- imaging-negative
- TLE patients showed significant amygdala asymmetry and enlargement, consistent with seizure lateralization.
- Amygdala enlargement was not observed in patients with hippocampal sclerosis (HS).
- Patients with amygdala enlargement had later seizure onset and fewer generalized seizures compared to HS patients.
Conclusions:
- Abnormal amygdala enlargement was identified in a subset of
- imaging-negative
- TLE cases.
- This finding suggests potential developmental abnormalities or low-grade tumors.
- Amygdala volumetry is recommended for investigating and diagnosing
- imaging-negative
- TLE.