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Introduction: Epilepsy
Published in Candace M. Kent, David M. Chan, Analysis of a Model for Epilepsy, 2022
Candace M. Kent, David M. Chan
Regardless of how mesial temporal lobe epilepsy is defined, hippocampal sclerosis results in mild to moderate cognitive impairment with memory deficits, as diagnosed by neuropsychological testing [48]. The prescribed treatment for mesial temporal lobe epilepsy is either medical, with the administration of one or more antiepileptic drugs, or surgical, with resection (i.e., removal) of the diseased tissue of the affected temporal lobe.
Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Temporal lobe epilepsy is a common cause of complex partial seizures and is associated with mesial temporal or hippocampal sclerosis. MRI findings which suggest the diagnosis are hippocampal T2 signal hyperintensity and volume loss. The mesial temporal lobes are best assessed on coronal acquisitions and T2 or FLAIR sequences are most helpful. Nuclear medicine can also have a role with SPECT and PET studies demonstrating hyperperfusion immediately following a seizure. It can be important to identify as the ictal focus can be treated surgically if seizures continue despite anti-epileptic medication.
Psychiatric Diagnosis is Not a Diagnosis of Exclusion
Published in Paul Ian Steinberg, Psychoanalysis in Medicine, 2020
No abnormalities of affect, thought process or content, or sensorium were observed during psychiatric examination of Mr. F. The most appropriate diagnosis appeared to be a transient delirium of unknown etiology, with temporal lobe epilepsy being the psychiatrist’s favored diagnosis. Not satisfied that his symptoms represented a psychiatric disturbance or an adequately diagnosed medical condition, the psychiatrist referred Mr. F to a general internist. The latter initially diagnosed temporal lobe epilepsy. Eventually, however, Mr. F’s episodes were related to a fasting condition, and hyperinsulinemia with hypoglycemia was documented. His paranoid symptoms were replicated in hospital during fasting hypoglycemia. They were relieved by glucose ingestion, fulfilling Whipple’s triadic criteria for insulinoma. No tumor was found by arteriography, ultrasound, or abdominal CT scan. The insulinoma was identified when Mr. F underwent specialized investigation in another country, by transhepatic portal venous sampling, which indicated, employing differential insulin gradients, an insulin-secreting tumor in the pancreas head. A benign islet cell was surgically removed.
Design and evaluation of chrysin-loaded nanoemulsion against lithium/pilocarpine-induced status epilepticus in rats; emphasis on formulation, neuronal excitotoxicity, oxidative stress, microglia polarization, and AMPK/SIRT-1/PGC-1α pathway
Published in Expert Opinion on Drug Delivery, 2023
Mina Y. George, Marwa O. El-Derany, Yasmine Ahmed, Malvina Zaher, Caroline Ibrahim, Habiba Waleed, Hajar Khaled, Gehad Khaled, Ahmed Saleh, Huda Alshafei, Rahma Alshafei, Nirmeen Ahmed, Sara Ezz, Nouran Ashraf, Shaimaa S. Ibrahim
Besides, Li/Pilo animal model is also useful in evaluating cognitive impairment seen in epilepsy patients. This was proven by the reduction seen in the spontaneous alternations and probe trial in y maze and Moris water maze tests, respectively in epileptic rats. On the other hand, CH pretreatment enhanced and corrected such cognitive impairment as demonstrated by increased spatial memory functioning in y maze and Moris water maze tests. This finding is in agreement with other studies reporting the ability of CH to counteract cognitive impairment in rats [32,70]. It is worth mentioning that locomotor activity and TAE in y maze test did not change among the groups. Such behavioral changes were further confirmed by histological examination of hippocampus regions; CA1, CA3, and dentate gyrus. Neuronal damage was found to be a common feature of temporal lobe epilepsy patients which may contribute to the process of epileptogenesis. CH pretreatment showed protective effects against such histopathological changes in all studied hippocampal areas. It is worthy to note that CH NE IN administration demonstrated superior protection especially for dentate gyrus region.
Better long-term speech outcomes in stroke survivors who received early clinical speech and language therapy: What’s driving recovery?
Published in Neuropsychological Rehabilitation, 2022
Sophie Roberts, Rachel M. Bruce, Louise Lim, Hayley Woodgate, Kate Ledingham, Storm Anderson, Diego L. Lorca-Puls, Andrea Gajardo-Vidal, Alexander P. Leff, Thomas M. H. Hope, David W. Green, Jennifer T. Crinion, Cathy J. Price
Finally, the lesion analyses show that poorer outcomes in patients who did not receive early therapy could not be explained by (A) larger lesion sites or (B) more damage to regions required for recovery because global and local brain structure did not vary between therapy groups; nor did it depend on the number of hours of early therapy received. The same analyses were, nevertheless, highly sensitive to two other effects. First, in both analyses (with and without covariates), patients who had Severe initial severity had more extensive damage to the left premotor cortex and underlying white matter (see row A of Figure 5). This was significant, after correction for multiple comparisons within the left hemisphere search volume in both height and extent (peak Z score = 4.5 at MNI co-ordinates [−48, −2, +24], with 3679 voxels at p < 0.001 uncorrected). Second, in the analysis with early and later therapy added as covariates, there was a significant effect of later therapy: Patients who received more hours of later therapy had more extensive lesions in the white matter beneath the left superior temporal gyrus. This was significant, after correction for multiple comparisons within the left hemisphere search volume in both height and extent (peak Z score = 4.34 at MNI co-ordinates [−42, −40, +8], with 384 voxels at p < 0.001 uncorrected). The latter result suggests that patients with damage involving this part of the left temporal lobe required, or were offered, more therapy.
Resting state functional brain imaging in obsessive-compulsive disorder across genders
Published in The World Journal of Biological Psychiatry, 2022
Yinzhu Ma, Qing Zhao, Tingting Xu, Pei Wang, Qiumeng Gu, Zhen Wang
The right parahippocampal gyrus was the brain region which differed the most between mOCD and fOCD patients in our present study. This brain region is the part of the limbic system located in the medial side of the occipital and temporal lobes. Since the parahippocampal gyrus is the main cortical input of the hippocampus, structural or functional damage can lead to emotional and cognitive dysfunction (Jung et al. 2017). Functional and structural studies have shown that there may be pathological changes in the right parahippocampal gyrus in OCD. Zhao et al. (2017) explored the differences in ALFF between OCD patients and HCs before and after cognitive-coping therapy (CCT) and pharmacotherapy and CCT, demonstrating that the ALFF value of OCD subjects in the parahippocampal gyrus increased before treatment, and disappeared after treatment. Yang et al.’s (2019) study on abnormal regional homogeneity (REHO) values in OCD patients showed that their REHO values in the right parahippocampal gyrus were decreased compared with those of HCs. Studies on brain structure have also found abnormal changes in this brain region in patients with OCD. Tang et al.’s (2015) voxel-based morphometry study of OCD participants found increased grey matter volume in the right parahippocampal gyrus. Using these studies as a guide, our study further verified the changes in the right parahippocampal gyrus in patients with OCD of different genders, while also demonstrating novel brain regions to investigate functional changes in OCD.