Temporal lobe epilepsy is the most common type of epilepsy in clinic. In recent years, many studies have found that patients with temporal lobe epilepsy have different degrees of influence in executive function related fields. This influence may not only exist in a certain field of executive function, but may be affected in several fields, and may be related to the origin site of seizures. However, up to now, there is no unified standard for the composition of executive function, and it is widely accepted that the three core components of executive function are working memory, inhibitory control and cognitive flexibility/switching. In addition, the International League Against Epilepsy proposed a new definition in 2010, and epilepsy is a brain network disease. There is a close relationship between brain neural network and cognitive impairment. According to the cognitive field, the brain neural network can be divided into six types: default mode network, salience network, executive control network, dorsal attention network, somatic motor network and visual network. In recent years, there has been increasing evidence that four related internal brain networks are series in a range of cognitive processes. The executive dysfunction of temporal lobe epilepsy may be related to the changes of functional connectivity of neural network, and may be related to the left uncinate fasciculus. This article reviews the research progress related to executive function in temporal lobe epilepsy from working memory, inhibitory control and cognitive flexibility, and discusses the correlation between the changes of temporal lobe epilepsy neural network and executive function research.
ObjectiveTo characterize the dynamic expression of Robo3 in the rat model of temporal lobe epilepsy(TLE), and assess the potential contribution of Robo3 to epileptogenesis. MethodsMale Sprague-Dawley (SD) rats were randomly divided into the control group (n=6) and the experimental groups (n=30, 6 per group). The experimental groups were injected intraperitoneally (i.p.) with an aqueous solution of lithium-pilocarpine, and sacrificed at different time points (1, 7, 14, 30 and 60 days) following the seizure. The control group was i.p. with 0.9% sodium chloride instead of pilocarpine. Quantitative real-time PCR were used to detected the mRNA expression of Robo3 and Western bolt were used to detected the protein expression of Robo3. ResultsQuantitative real-time PCR showed that the expression of Robo3 were significantly lower in the rat temporal lobe tissues of the latent and the chronic period group as compared with the controls(P < 0.05), but no significant differences were identified between the acute period group and the controls(P > 0.05). Western blot showed that the protein expression of Robo3 were significantly lower in the rat temporal lobe tissues of the latent and the chronic period group as compared with the controls(P < 0.05), no significant differences were identified between the acute period group and the controls(P > 0.05). ConclusionsRobo3 may be involved in the pathogenesis of temporal lobe epilepsy.
ObjectiveTo explore the clinical features and surgical treatment effects of the temporal lobe epilepsy with hippocampal sclerosis.MethodsForty two patients diagnosed as temporal lobe epilepsy with hippocampal sclerosis and underwent protemporal lobectomy in Wuhan Brain Hospital from Jan. 2012 to Dec. 2018 were collected, which included 30 males and 12 females, with the age between 9 to 60 years. Their disease duration ranged from 3 to 10 years. The clinical manifestations showed complex partial seizure in 18 cases, partial-secondary –generalized seizure in 4 cases, and generalized tonic-clonic seizure in 20 cases. Based on their results of clinical manifestations, combined with MRI and VEEG results, all the patients underwent anterior temporal lobectomy (including the most parts of the hippocampus and amydala).ResultsThe postoperative pathology confirmed the diagnosis of hippocampal sclerosis. The follow-up of more than 1 year showed seizure-free in 38 cases, and significant improvement in 4 cases.ConclusionsTo the patients of temporal lobe epilepsy with hippocampal sclerosis, anterior temporal lobectomy should be performed (including the most parts of the hippocampus and amydala) if the VEEG monitoring results show that there are epileptic discharges in the ipsilateral temporal lobe. And the postoperative curative result is satisfactory.
ObjectivesPost-encephalitic epilepsy could be of great chance of pharmaco-resistant, even surgery may not achieve seizure free. The aim of this study is to mapping epileptogenic area of pharmaco-resistant post-encephalitic temporal lobe epilepsy, to find whether "temporal plus" epilepsy is the main type and its surgery outcome, based on stereo-EEG(SEEG) study.MethodWe retrospectively studied 15 patients with pharmaco-resistant temporal lobe epilepsy. Scalp EEG, seizure semiology, MRI, FDG-PET, and SEEG were reviewed for all patients. According to epileptogenic area which was analysed by SEEG, 15 patients were divided into 2 groups, temporal lobe epilepsy(TLE) group and temporal plus epilepsy(TPE) group. Clinical characteristics were compared with each group, by t-test or Fisher exact test when data needed.ResultsThere were 8 patients in TLE group, with 6 mesial TLE, 1 lateral TLE, 1 mesial-lateral TLE. And 7 patients in TPE group. Age of seizure onset (P=0.548), duration of epilepsy (P=0.099), age of remote encephalitis (P=0.385), type of semiology (P=0.315) and lateralization of MR lesions (P=1.000), interictal FDG-PET hypometabalism (P=1.000) or intracranial implantation (P=0.619) were of no statistically difference between TLE group and TPE group. Surgery was performed in all patients. Better outcome was obtained in TLE group(5/8 class Ⅰ), and poor was in TPE group(3/7class Ⅰ).ConclusionMesial-TLE and temporal plus epilepsy were common types of pharmaco-resistant post-encephalitic TLE. There was no way to differentiate clinically, except by SEEG. Mesial-TLE had a better outcome after surgery, but temporal plus epilepsy did not.