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We aimed to investigate the role of interleukin-1 beta (IL-1β) in the mechanisms underlying mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE+HS). We assessed a cohort of 194 patients with MTLE+HS and 199 healthy controls. Patients were divided into those with positive and negative antecedent febrile seizures (FS). We used a multidimensional approach, including (i) genetic association with single nucleotide polymorphisms (SNPs) in the IL1B gene; (ii) quantification of the IL1B transcript in the hippocampal tissue of patients with refractory seizures; and (iii) quantification of the IL-1β protein in the plasma. We found a genetic association signal for two SNPs, rs2708928 and rs3730364*C in the IL1B gene, regardless of the presence of FS (adjusted p = 9.62e–11 and 5.14e–07, respectively). We found no difference between IL1B transcript levels when comparing sclerotic hippocampal tissue from patients with MTLE+HS, without FS, and hippocampi from autopsy controls (p > 0.05). Nevertheless, we found increased IL-1β in the plasma of patients with MTLE+HS with FS compared with controls (p = 0.0195). Our results support the hypothesis of a genetic association between MTLE+HS and the IL1B gene [ABSTRACT FROM AUTHOR]

The absence of the adhesio interthalamica (AI; also called interthalamic adhesion or massa intermedia) and the presence of a large cavum septum pellucidum (CSP) later in life have been related to neurodevelopmental alterations and have not been systematically investigated in epilepsy to date. This study carried out a MRI evaluation of the AI and CSP in a large sample with mesial temporal lobe epilepsy (MTLE). A total of 179 patients, classified according to the side of the epileptogenic focus, and 156 age- and sex-balanced healthy controls were assessed. Between-group comparisons of the prevalence and length of both AI and CSP were conducted. Neuropsychological assessments were also performed in 160 MTLE patients. The patients exhibited reduction in the AI prevalence (P < 0.05; FDR-uncorrected) and length (P < 0.05; FDR-corrected) when compared to controls. Patients without AI showed lower scores in a proportion of neuropsychological tests than patients with AI. No CSP differences were found between MTLE patients and controls. These results support that AI anomalies have clinical significance in MTLE, as well as indicate that neurodevelopmental alterations may be implicated in this disorder. [ABSTRACT FROM AUTHOR]

Cerebral cavernous malformations ( CCMs) are well-defined, mostly singular lesions present in 0.4-0.9% of the population. Epileptic seizures are the most frequent symptom in patients with CCMs and have a great impact on social function and quality of life. However, patients with CCM-related epilepsy ( CRE) who undergo surgical resection achieve postoperative seizure freedom in only about 75% of cases. This is frequently because insufficient efforts are made to adequately define and resect the epileptogenic zone. The Surgical Task Force of the Commission on Therapeutics of the International League Against Epilepsy ( ILAE) and invited experts reviewed the pertinent literature on CRE. Definitions of definitive and probable CRE are suggested, and recommendations regarding the diagnostic evaluation and etiology-specific management of patients with CRE are made. Prospective trials are needed to determine when and how surgery should be done and to define the relations of the hemosiderin rim to the epileptogenic zone. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the patterns of brain activation in polymicrogyric cortex in epilepsy patients by blood oxygenation level–dependent (BOLD) functional MRI ( fMRI), during language and motor activation tasks. Methods: Five patients with extratemporal epilepsy associated with polymicrogyria were scanned in a 1.5-T Siemens scanner with BOLD fMRI sequences, by following language and motor paradigms. Functional images were processed by using Brain Voyager software. Results: Activation of polymicrogyric cortex in the brain area that corresponds to the motor strip was present in all patients. Language studies revealed activation of polymicrogyric cortex over Broca's area in three cases. Conclusions: Functionality was shown in polymicrogyric areas. Therefore if surgical resection is indicated, a careful functional planning is necessary because of functionality of the polymicrogyric cortex. [ABSTRACT FROM AUTHOR]

A response from the authors of the article "Cavernoma-related epilepsy: Review and recommendations for management-Report of the surgical task force of the ILAE commission on therapeutic strategies" in a 2014 issue is presented.

We report the case of a patient with epilepsy who had interictal severe affective aggression, and whose epilepsy significantly improved (but not aggression) after successful temporal lobectomy. Olanzapine significantly improved these aggressive episodes refractory to neurosurgery and previous pharmacological treatments including antipsychotics, anticonvulsants/mood stabilizers and benzodiazepines. [ABSTRACT FROM AUTHOR]