Epilepsy Research and Treatment

Review Article

Determining Surgical Candidacy in Temporal Lobe Epilepsy

Table 1

Electroclinical and diagnostic differences between mTLE and nTLE.
mTLEnTLE
Clinical aspectsAuras (simple partial seizures)
 (i) Not present in approximately half of TLE patients
 (ii) Visceral sensation/fear (or both)
 (iii) Déjà vu
 (iv) Illusions/hallucinations
Complex partial seizures
  (i) Autonomic changes
  (ii) Arrest of behavior/motionless stare
  (iii) Oroalimentary automatism
  (iv) Contralateral dystonic posturing
  (v) Nose rubbing
  (vi) Dysphasia (if dominant hemisphere involved)		Same as mTLE
Preoperative testingMRI
  (i) MTS
  (ii) Other structural pathologies
  (iii) Dual pathology
  (iv) No lesion (“MRI normal”)
TLE		Same as mTLE
Neuropsychological testing
  (i) Lateralized memory impairment		Neuropsychological testing
  (i) More likely to have naming problems
Wada test
  (i) Less likely to have lateralized memory dysfunction on side of seizure onset, compared with mTLE
Scalp EEG
  (i) “Classic” anterior temporal inter-ictal spikes		Scalp EEG
  (i) No unique pattern
  (ii) Absence/multiple types of inter-ictal spikes
Intracranial recordingsSeizures originate from mesial structuresVariable with widespread electrophysiological changes