PMID- 24112043
OWN - NLM
STAT- MEDLINE
DCOM- 20131231
LR  - 20131108
IS  - 1528-1167 (Electronic)
IS  - 0013-9580 (Linking)
VI  - 54
IP  - 11
DP  - 2013 Nov
TI  - The cortical excitability profile of temporal lobe epilepsy.
PG  - 1942-9
LID - 10.1111/epi.12374 [doi]
AB  - PURPOSE: Transcranial magnetic stimulation (TMS) was used to characterize 
      measurable changes of cortical excitability in patients who were undergoing 
      medical and surgical management of temporal lobe epilepsy (TLE) to investigate 
      whether these alterations depended on timing of achieving seizure control 
      throughout the course of illness and method of management. METHODS: Eighty-five 
      patients with TLE divided into (1) drug naive-new onset, (2) early medically 
      refractor, and (3) late medically refractory, (4) early seizure-free on 
      antiepileptic drugs, and (5) late seizure-free on antiepileptic drugs, (6) 
      postoperative refractory, and (7) postoperative seizure-free groups were studied. 
      Motor threshold (MT) and paired-pulse TMS at short (2, 5, 10, and 15 msec) and 
      long (100-300 msec) interstimulus intervals (ISIs) were measured. Results were 
      compared to those of 20 controls. KEY FINDINGS: A significant interhemispheric 
      difference was observed early at onset prior to starting medication, with higher 
      cortical excitability in the hemisphere ipsilateral to the seizure focus, whereas 
      the unaffected hemisphere was normal. After that, cortical excitability was 
      higher in both hemispheres in the refractory groups (medical and postoperative) 
      compared to the seizure-free and drug-naive groups (p < 0.05). This effect was 
      most prominent at the long ISIs. SIGNIFICANCE: Changes in cortical excitability 
      seen in patients with TLE are influenced by the course of the disease. The 
      alterations that occur due to epilepsy are closely related to course of illness 
      and degree/timing of seizure control. Successful management leads to resolution 
      of this cortical hyperexcitability in a similar fashion regardless of method: 
      medication (intact generator, but modulated by drugs) or surgery (generator 
      removed).
CI  - Wiley Periodicals, Inc. (c) 2013 International League Against Epilepsy.
FAU - Badawy, Radwa A B
AU  - Badawy RA
AD  - Department of Clinical Neurosciences, St Vincent's Hospital, Fitzroy, Victoria, 
      Australia; Department of Medicine, The University of Melbourne, Parkville, 
      Victoria, Australia; Department of Electrical and Electronic Engineering, The 
      University of Melbourne, Parkville, Victoria, Australia.
FAU - Vogrin, Simon J
AU  - Vogrin SJ
FAU - Lai, Alan
AU  - Lai A
FAU - Cook, Mark J
AU  - Cook MJ
LA  - eng
PT  - Journal Article
DEP - 20130920
PL  - United States
TA  - Epilepsia
JT  - Epilepsia
JID - 2983306R
RN  - 0 (Anticonvulsants)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Anticonvulsants/*therapeutic use
MH  - *Cerebral Cortex/drug effects/surgery
MH  - Electroencephalography/methods
MH  - Epilepsy, Temporal Lobe/*drug therapy/*surgery
MH  - Evoked Potentials, Motor/drug effects/physiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Transcranial Magnetic Stimulation/methods
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Cortical excitability
OT  - Refractory seizures
OT  - Seizure freedom
OT  - Temporal lobe epilepsy
OT  - Transcranial magnetic stimulation
EDAT- 2013/10/12 06:00
MHDA- 2014/01/01 06:00
CRDT- 2013/10/12 06:00
PHST- 2013/08/12 00:00 [accepted]
PHST- 2013/10/12 06:00 [entrez]
PHST- 2013/10/12 06:00 [pubmed]
PHST- 2014/01/01 06:00 [medline]
AID - 10.1111/epi.12374 [doi]
PST - ppublish
SO  - Epilepsia. 2013 Nov;54(11):1942-9. doi: 10.1111/epi.12374. Epub 2013 Sep 20.