Simultaneous Treatment of Epilepsy and Secondary Dystonia After Anterior Temporal Lobectomy and Amygdalohippocampectomy

Lily Rasouli, Jonathan J. Rasouli, Fedor Panov, Ji Yeoun Yoo, Patricia E. McGoldrick, Steven Frucht, Steven Wolf, Saadi Ghatan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: The relationship between temporal lobe epilepsy and focal limb dystonia is a well-recognized phenomenon, yet its pathogenesis and anatomic foundation are not well understood. Here, we describe 2 patients with refractory focal epilepsy and contralateral focal limb dystonia whose seizures and dystonic symptoms simultaneously resolved after anterior temporal lobectomy and amygdalohippocampectomy. Case Description: We identified 2 patients within the Mount Sinai Health system with improvement in dystonia after medial temporal lobectomy. Retrospective chart reviews for the clinical history were performed. Patient 1 suffered a traumatic injury of the right temporal lobe, developing left hemidystonia and epilepsy. He received a right amygdala-hippocampectomy, which resolved both. Patient 2 has a history of right temporal glioma resection complicated by an infarct, resulting in left hemidystonia and epilepsy. He received a right medial temporal resection, which nearly resolved both. Conclusion: Our cases demonstrate a medial temporal-basal ganglia network dysfunction in dystonia-epilepsy that was modulated and cured by resective surgery. We hypothesize that the mechanisms behind these observed phenomena were due to a pathologic connectivity of the basal ganglia and amygdala-hippocampus. To our knowledge, these are the first reported cases of dystonia and concomitant epilepsy resolving with temporal lobectomy and provide valuable prognostic information for similarly affected patients.

Original languageEnglish
Pages (from-to)439-442
Number of pages4
JournalWorld Neurosurgery
Volume117
DOIs
StatePublished - Sep 2018

Keywords

  • ATLAH
  • Amygdalohippocampectomy
  • Anterior temporal lobectomy
  • Drug-resistant epilepsy
  • Dystonia
  • Epilepsy

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