Epileptic Disorders


Temporal encephalocele: a rare but treatable cause of temporal lobe epilepsy Volume 24, numéro 6, December 2022



(1) In a case of typical temporal lobe epilepsy thought to be MRI-negative, what other possibility should you consider before establishing that it is truly MRI-negative?


(2) What is the aetiopathogenesis of temporal encephalocele?


(3) What is the ideal treatment for temporal encephalocele?





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(1) Temporal encephalocele is one of the causes of temporal lobe epilepsy which is commonly missed by radiologists as well as epileptologists. It may present as a very subtle abnormality at the temporal pole. An additional tool for the confirmation of the diagnosis of an encephalocele is CT with coronal reformation images, to look for skull defects.


(2) Encephaloceles are mostly spontaneous but may also be congenital or related to trauma, infection, inflammation or surgery. The exact mechanism of epileptogenesis in TE is not known, but may be due to the dysmorphic tissue in the encephalocele. Another possibility is the stretching of neural tissue in the encephalocele, resulting in gliosis with development of an epileptogenic network.


(3) The ideal treatment for temporal encephalocele remains unclear and a variety of resective surgical strategies have been proposed (i.e., tailored resection of encephalocele, resection of encephalocele with removal of the surrounding temporal pole,standard anterior temporal lobectomy). As per our study, resection of the encephalocele along with the surrounding temporal pole is associated with good surgical outcome.









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