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Research ArticleBRAIN

Degree of Hippocampal Atrophy Is Related to Side of Seizure Onset in Temporal Lobe Epilepsy

M. García-Fiñana, C.E. Denby, S.S. Keller, U.C. Wieshmann and N. Roberts
American Journal of Neuroradiology May 2006, 27 (5) 1046-1052;
M. García-Fiñana
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C.E. Denby
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S.S. Keller
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U.C. Wieshmann
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N. Roberts
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  • Fig 1.
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    Fig 1.

    Illustration of the application of the Cavalieri method to estimate hippocampal volume.

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    Fig 2.

    Illustration of the point-counting technique applied to estimate hippocampal volume from MR images of a control (C, top row), patient with left-sided seizure onset (LP, second row), and patient with right-sided seizure onset (RP, bottom row).

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    Fig 3.

    Illustration of the boundaries of the hippocampus. The splitting of the lateral ventricles form the posterior border (108, Split LV), and the alveus forms the anterior border (150).

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    Fig 4.

    Empirical probability distributions and Q-Q plots for the right and left volume and asymmetry index of the hippocampus of the control population.

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    Fig 5.

    Left and right hippocampal volume estimate (left panel) and hippocampal volume asymmetry index (right panel) for controls and patients with TLE. The dashed lines represent the 99% prediction lower bounds for the left and right hippocampal volume estimate (left panel) and the 99% prediction interval for the hippocampal volume asymmetry index (right panel). The proportion of patients showing abnormal hippocampal volume is indicated in parentheses.

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    Fig 6.

    Left hippocampal volume versus right hippocampal volume in R-patients (top left panel), L-patients (top right panel), and controls (bottom panel). The dashed lines represent the 99% lower bounds for the right and left hippocampal volume obtained from the control data.

Tables

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    Table 1:

    Demographic and clinical information for controls and patients

    ControlsLeft-Sided Seizure OnsetRight-Sided Seizure Onset
    Mean age, y (SD)33 (10.4)34 (8.4)34 (9.7)
    Sex (%)
        M25 (50)24 (45.3)20 (42)
        F25 (50)29 (55.7)28 (58)
    Handedness (%)
        Right42 (87.5)40 (80)43 (91.5)
        Left6 (12.5)10 (20)4 (8.5)
        Not established231
    Mean onset, y (SD)10.6 (9)10.4 (8)
    Febrile convulsiosn (%)
        Yes18 (45)15 (36.6)
        No22 (55)26 (63.4)
        Not recorded137
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    Table 2:

    Classification of hippocampal atrophy in 101 patients with temporal lobe epilepsy

    Patients with right-sided seizure onset (n = 48)
        No evidence of HA10 (21%)
        Unilateral HA34 (71%)
            Right HA31 (65%)
            Left HA1 (2%)
            Only asymmetry (right ≪ left)2 (4%)
        Bilateral HA4 (8%)
    Patients with left-sided seizure onset (n = 53)
        No evidence of HA9 (17%)
        Unilateral HA43 (81%)
            Right HA0 (0%)
            Left HA38 (72%)
            Only asymmetry (right ≪ left)5 (9%)
        Bilateral HA1 (2%)
    • Note:—Laterality of seizure onset was established using electroencephalogram recordings or invasive foramen ovale. HA indicates hippocampal atrophy.

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American Journal of Neuroradiology: 27 (5)
American Journal of Neuroradiology
Vol. 27, Issue 5
May 2006
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Cite this article
M. García-Fiñana, C.E. Denby, S.S. Keller, U.C. Wieshmann, N. Roberts
Degree of Hippocampal Atrophy Is Related to Side of Seizure Onset in Temporal Lobe Epilepsy
American Journal of Neuroradiology May 2006, 27 (5) 1046-1052;

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Degree of Hippocampal Atrophy Is Related to Side of Seizure Onset in Temporal Lobe Epilepsy
M. García-Fiñana, C.E. Denby, S.S. Keller, U.C. Wieshmann, N. Roberts
American Journal of Neuroradiology May 2006, 27 (5) 1046-1052;
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