The medial temporal lobe epilepsy is a bilateral disease – novel aspects

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VOLUME 24 , ISSUE 2 (December 2016) > List of articles

The medial temporal lobe epilepsy is a bilateral disease – novel aspects

Péter Halász *

Keywords : medial temporal lobe epilepsy (MTLE), bilateral network, secondary epilepsy, bilaterality and surgical outcome

Citation Information : Journal of Epileptology. Volume 24, Issue 2, Pages 141-155, DOI: https://doi.org/10.1515/joepi-2016-0010

License : (CC BY 4.0)

Received Date : 03-October-2016 / Accepted: 08-November-2016 / Published Online: 22-November-2016

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ABSTRACT

Introduction. Medial temporal lobe epilepsy (MTLE) is the most frequent form of epilepsy in adulthood. It is classified as local/regional epilepsy. However, there is increasing evidence of the involvement of both temporal lobes and this provides abundant arguments to question this view, and consider MTLE as one of the typical bilateral system epilepsies.

Aim. To provide a contemporary review of medial temporal lobe epilepsy, discussing the bilateral aspects, with reference to epilepsy surgery.

Methods. A literature review and a resume of the author’s own experiences with MTLE patients.

Results. Recent electrophysiological and neuroimaging data provide convincing data supporting that

MTLE is a bilateral disease. The uni-and bilateral features form a continuum and the participation rate of the two temporal lobes determine course and surgical perspective of the individual patient.

Conclusions. The contradictory data of invasive presurgical evaluations of MTLE patients suggest that there need to identify further indicatory markers of bilaterality and thus change the presurgical evaluation from the non-invasive towards the invasive ways. The mechanisms of the interrelationship between the two temporal lobes in MTLE warrants further research.

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