EPILEPSY DUE TO SMALL FOCAL TEMPORAL LESIONS WITH BILATERAL INDEPENDENT SPIKE-DISCHARGING FOCI: A STUDY OF SEVEN CASES RELIEVED BY OPERATION

Abstract

Seven cases of epilepsy having temporal lobe origin are presented to exemplify the fact that a unilateral temporal lobe lesion can give rise to bilateral temporal lobe discharges. The cases range in age from 2 1/2 to 48 years and the period of epilepsy ranges from 1 to 24 years. The small, neoplastic focal lesions were too small to change the ventricular contours seen on pneumoencephalography but were associated with bilateral, independent temporal lobe discharges seen on the eeg records. The structures chiefly involved were the fusiform gyrus, hippocampal gyrus, the amygdala and uncus. The focal lesions are presumed to be the epileptogenic agents and the bilateral response related to the close electrical connexions which have been experimentally shown to exist between homologous areas of the two temporal lobes. Therefore, unilateral temporal lobectomy may benefit patients with intractable temporal lobe epilepsy and bilateral temporal lobe discharges.