Temporal pole MRI abnormalities in temporal lobe epilepsy. Ryvlin, P., Coste, S., Hermier, M., & Mauguière, F. Epileptic Disorders: International Epilepsy Journal with Videotape, 4 Suppl 1:S33–9, September, 2002.
Temporal pole MRI abnormalities in temporal lobe epilepsy [link]Paper  doi  abstract   bibtex   
Magnetic resonance imaging (MRI) demonstrates an abnormal aspect of the temporo-polar region in 1/3 to 2/3 of patients suffering from cryptogenic temporal lobe epilepsy. This abnormal aspect is described as a white matter increased T2 signal, resulting in a loss of gray-white matter demarcation, often associated with atrophy, as recently confirmed by quantitative volumetric measurements. These temporo-polar MRI findings appear to correctly lateralize the epileptogenic temporal lobe with a very high specificity, and have never been reported in extra-temporal lobe epilepsy nor in control subjects. They are usually associated with MRI signs of hippocampal sclerosis, but the two conditions seem to be partly distinct from a pathophysiological point of view. Pathological correlates of temporo-polar white matter increased T2 signal are controversial, but the role of an abnormal myelin seems more likely than that of ectopic neurons. A myelin dysfunction would also be consistent with the correlation observed between lateral temporal hypometabolism and temporo-polar MRI abnormalities. Whether or not these MRI findings are associated with a better seizure outcome following temporal lobectomy remains a debated issue.
@article{ryvlin_temporal_2002,
	title = {Temporal pole {MRI} abnormalities in temporal lobe epilepsy},
	volume = {4 Suppl 1},
	issn = {1294-9361},
	url = {http://www.ncbi.nlm.nih.gov/pubmed/12424089},
	doi = {12424089},
	abstract = {Magnetic resonance imaging (MRI) demonstrates an abnormal aspect of the temporo-polar region in 1/3 to 2/3 of patients suffering from cryptogenic temporal lobe epilepsy. This abnormal aspect is described as a white matter increased T2 signal, resulting in a loss of gray-white matter demarcation, often associated with atrophy, as recently confirmed by quantitative volumetric measurements. These temporo-polar MRI findings appear to correctly lateralize the epileptogenic temporal lobe with a very high specificity, and have never been reported in extra-temporal lobe epilepsy nor in control subjects. They are usually associated with MRI signs of hippocampal sclerosis, but the two conditions seem to be partly distinct from a pathophysiological point of view. Pathological correlates of temporo-polar white matter increased T2 signal are controversial, but the role of an abnormal myelin seems more likely than that of ectopic neurons. A myelin dysfunction would also be consistent with the correlation observed between lateral temporal hypometabolism and temporo-polar MRI abnormalities. Whether or not these MRI findings are associated with a better seizure outcome following temporal lobectomy remains a debated issue.},
	urldate = {2008-11-27},
	journal = {Epileptic Disorders: International Epilepsy Journal with Videotape},
	author = {Ryvlin, Philippe and Coste, Sébastien and Hermier, Marc and Mauguière, François},
	month = sep,
	year = {2002},
	pmid = {12424089},
	pages = {S33--9},
}

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