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P.089 Multiscale analysis of mesial temporal lobe epilepsy: Anatomo-Electrophysio-pathologic differentiation

Published online by Cambridge University Press:  10 July 2025

P Narayanan Nambiar
Affiliation:
(London)
HG Gray
Affiliation:
(London)*
K Alorabi
Affiliation:
(London)
J Lau
Affiliation:
(London)
A Thurairajah
Affiliation:
(London)
A Khan
Affiliation:
(London)
A SullerMarti
Affiliation:
(London)
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Abstract

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Background: Mesial temporal lobe epilepsy (mTLE) is a heterogenous condition with variable post-surgical outcomes. Combining high resolution magnetic resonance imaging (MRI), stereoelectroencephalography (SEEG) and histology may establish different subtypes of mTLE. Methods: Retrospective analysis of patients with mTLE with 1) SEEG Patterns 2) MRI 3) Post temporal lobectomy tissue analysis 4) Engel Classification. HippUnfold method was used to segment hippocampus on MRI. Results: Of 109 patients investigated with SEEG, 11 patients were analyzed so far. Low voltage fast activity was seen in 215 seizures, low-frequency periodic spikes in 21, sharp activity at <13 Hz in 58, rhythmic spike sharp wave activity in 86, and other types were less frequent. MRI revealed unilateral mesial temporal sclerosis (MTS) in 6 (54.55%), bilateral MTS in 2 (18.18%), and was normal in 3 (27.27%) patients. Histopathology showed ILAE grade I in 3 (37.5 %), II in 4 (50 %), IV in 1 (12.5%) patient. 63.63% had Engel Class I at 6 months. HippUnfold analysis and SEEG electrode coregistration was done in one patient and will be attempted in the rest. Conclusions: Our study highlights a strong correlation between SEEG findings and histological analysis in mTLE. A multidimensional classification will help predict long term outcomes.

Information

Type
Abstracts
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

Footnotes

*

This abstract has been updated with the correct author order.