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Endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele
BACKGROUND: Temporal lobe epilepsy (TLE) associated with temporal lobe encephalocele is rare, and the precise epileptogenic mechanisms and surgical strategies for such cases are still unknown. Although the previous studies have reported good seizure outcomes following chronic subdural electrode reco...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Scientific Scholar
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422469/ https://www.ncbi.nlm.nih.gov/pubmed/34513146 http://dx.doi.org/10.25259/SNI_542_2021 |
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author | Mukae, Nobutaka Kuga, Daisuke Murakami, Daisuke Komune, Noritaka Miyamoto, Yusuke Shimogawa, Takafumi Sakata, Ayumi Shigeto, Hiroshi Iwaki, Toru Morioka, Takato Mizoguchi, Masahiro |
author_facet | Mukae, Nobutaka Kuga, Daisuke Murakami, Daisuke Komune, Noritaka Miyamoto, Yusuke Shimogawa, Takafumi Sakata, Ayumi Shigeto, Hiroshi Iwaki, Toru Morioka, Takato Mizoguchi, Masahiro |
author_sort | Mukae, Nobutaka |
collection | PubMed |
description | BACKGROUND: Temporal lobe epilepsy (TLE) associated with temporal lobe encephalocele is rare, and the precise epileptogenic mechanisms and surgical strategies for such cases are still unknown. Although the previous studies have reported good seizure outcomes following chronic subdural electrode recording through invasive craniotomy, only few studies have reported successful epilepsy surgery through endoscopic endonasal lesionectomy. CASE DESCRIPTION: An 18-year-old man developed generalized convulsions at the age of 15 years. Despite treatment with optimal doses of antiepileptic drugs, episodes of speech and reading difficulties were observed 2–3 times per week. Long-term video electroencephalogram (EEG) revealed ictal activities starting from the left anterior temporal region. Magnetic resonance imaging revealed a temporal lobe encephalocele in the left lateral fossa of the sphenoidal sinus (sphenoidal encephalocele). Through the endoscopic endonasal approach, the tip of the encephalocele was exposed. A depth electrode was inserted into the encephalocele, which showed frequent spikes superimposed with high-frequency oscillations (HFOs) suggesting intrinsic epileptogenicity. The encephalocele was resected 8 mm from the tip. Twelve months postoperatively, the patient had no recurrence of seizures on tapering of the medication. CONCLUSION: TLE associated with sphenoidal encephalocele could be controlled with endoscopic endonasal lesionectomy, after confirming the high epileptogenicity with analysis of HFOs of intraoperative EEG recorded using an intralesional depth electrode. |
format | Online Article Text |
id | pubmed-8422469 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Scientific Scholar |
record_format | MEDLINE/PubMed |
spelling | pubmed-84224692021-09-09 Endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele Mukae, Nobutaka Kuga, Daisuke Murakami, Daisuke Komune, Noritaka Miyamoto, Yusuke Shimogawa, Takafumi Sakata, Ayumi Shigeto, Hiroshi Iwaki, Toru Morioka, Takato Mizoguchi, Masahiro Surg Neurol Int Case Report BACKGROUND: Temporal lobe epilepsy (TLE) associated with temporal lobe encephalocele is rare, and the precise epileptogenic mechanisms and surgical strategies for such cases are still unknown. Although the previous studies have reported good seizure outcomes following chronic subdural electrode recording through invasive craniotomy, only few studies have reported successful epilepsy surgery through endoscopic endonasal lesionectomy. CASE DESCRIPTION: An 18-year-old man developed generalized convulsions at the age of 15 years. Despite treatment with optimal doses of antiepileptic drugs, episodes of speech and reading difficulties were observed 2–3 times per week. Long-term video electroencephalogram (EEG) revealed ictal activities starting from the left anterior temporal region. Magnetic resonance imaging revealed a temporal lobe encephalocele in the left lateral fossa of the sphenoidal sinus (sphenoidal encephalocele). Through the endoscopic endonasal approach, the tip of the encephalocele was exposed. A depth electrode was inserted into the encephalocele, which showed frequent spikes superimposed with high-frequency oscillations (HFOs) suggesting intrinsic epileptogenicity. The encephalocele was resected 8 mm from the tip. Twelve months postoperatively, the patient had no recurrence of seizures on tapering of the medication. CONCLUSION: TLE associated with sphenoidal encephalocele could be controlled with endoscopic endonasal lesionectomy, after confirming the high epileptogenicity with analysis of HFOs of intraoperative EEG recorded using an intralesional depth electrode. Scientific Scholar 2021-07-27 /pmc/articles/PMC8422469/ /pubmed/34513146 http://dx.doi.org/10.25259/SNI_542_2021 Text en Copyright: © 2021 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Mukae, Nobutaka Kuga, Daisuke Murakami, Daisuke Komune, Noritaka Miyamoto, Yusuke Shimogawa, Takafumi Sakata, Ayumi Shigeto, Hiroshi Iwaki, Toru Morioka, Takato Mizoguchi, Masahiro Endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele |
title | Endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele |
title_full | Endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele |
title_fullStr | Endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele |
title_full_unstemmed | Endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele |
title_short | Endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele |
title_sort | endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422469/ https://www.ncbi.nlm.nih.gov/pubmed/34513146 http://dx.doi.org/10.25259/SNI_542_2021 |
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