![]() ![]() Sixty-five of these patients reported multiple types of auras. To test associations between outcomes and pre-operative auras, the researchers examined data on 174 patients who underwent an ATL: 147 with auras and 27 without. Yet seizures also travel along an extensive network, a fact that can confound these clues. ![]() For example, an olfactory aura indicates that the seizure may be originating in the piriformis and hippocampus, while a gustatory aura may implicate the insular lobe and the frontal operculum. ![]() The individual aura types may provide clues to the site of the seizure’s origin in the brain. Such auras are experienced by 60 to 80 percent of patients with TLE who proceed with the lobectomy. Patients frequently experience more than one type. They are categorized as epigastric, somatosensory, affective, mnemonic (e.g., déjà vu), auditory, visual, gustatory, cephalic (sensations within the head), or tonic-clonic (generalized shaking). Auras, DefinedĪn aura is a subjective sensation or emotion – like colors, smells, sounds, nausea, or sadness – near the onset of a seizure. “Studies like this may encourage greater use of the procedure in appropriate patients by refining the populations most likely to benefit,” she said. The study authors suggest that aura type is therefore a useful metric to consider in optimizing a patient workup and candidate selection for anterior temporal lobectomy (ATL). However, when they examined type of aura among the majority who had pre-seizure auras, they found mild to strong associations with outcomes. When the researchers compared patients with and without auras, they found no significant differences in surgical outcomes. The results add a valuable component to an epilepsy team’s decision matrix as they consider surgery. She and her co-authors on a new multicenter study, published in World Neurosurgery in May, examined pre-seizure auras by type to see if they are predictive of outcomes. Sarah Bick, M.D., a functional neurosurgeon and an assistant professor in the Department of Neurosurgery at Vanderbilt University Medical Center, is examining the complex elements that lead to successful treatment. In temporal lobe epilepsy (TLE), the most common form of epilepsy, up to 40 percent of patients fail to achieve seizure control with antiepileptic medications alone, yet many never receive the gold-standard treatment for medication-refractory seizures: anterior temporal lobectomy.ĭespite the known benefits of the procedure – with half to two-thirds of patients free of disabling seizures one year after surgery – surgical treatment for epilepsy remains an underutilized option. ![]()
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