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Clinical Findings in Temporal Lobe Epilepsy Associated With Isolated Amygdala Enlargement.

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Title: Clinical Findings in Temporal Lobe Epilepsy Associated With Isolated Amygdala Enlargement.
Authors: Kirscht, Annika (AUTHOR), Zöllner, Johann Philipp (AUTHOR), Conradi, Nadine (AUTHOR), Neuhaus, Elisabeth (AUTHOR), Hattingen, Elke (AUTHOR), Belke, Marcus (AUTHOR), Knake, Susanne (AUTHOR), Willems, Laurent (AUTHOR), Wichert, Jennifer (AUTHOR), Jansen, Andreas (AUTHOR), Rosenow, Felix (AUTHOR), Strzelczyk, Adam (AUTHOR)
Source: European Journal of Neurology. Jun2025, Vol. 32 Issue 6, p1-12. 12p.
Subjects: Temporal lobe epilepsy, Amygdaloid body, Volume (Cubic content), Volume measurements, Histopathology, Physical diagnosis, Neuropsychological tests
Abstract: Background: Mesial temporal lobe epilepsy (mTLE) infrequently presents with isolated amygdala enlargement (AE), but its relevance remains ambiguous. We therefore investigated clinical, imaging, and histopathological findings in mTLE‐AE compared to non‐lesional mTLE (mTLE‐NL) patients, and additionally strategies for identifying AE. Methods: We detected AE by automated volumetry of otherwise unremarkable magnetic resonance images of mTLE patients, compared with a healthy comparator. Autoimmune inflammation as an AE cause was excluded using the Graus criteria. We compared clinical and neuropsychological variables between mTLE‐AE and mTLE‐NL. Secondary assessment of AE was by neuroradiologist visual detection. Results: Of 63 mTLE patients, 15 had mTLE‐AE. In these, normalized mean volume was 1857.58 mm3 (SD = 207.38) for the left, 1973.09 mm3 (SD = 214.91) for the right amygdala, 2003.34 mm3 (SD = 218.85) for the larger and 1827.34 mm3 (SD = 179.85) for the smaller amygdala. Mean volume in the healthy control subjects was 1853.4 mm3 for the left (SD = 212.44) and 1895.2 mm3 for the right amygdala (SD = 224.29). Clinical parameters including age, sex, epilepsy duration, history of febrile convulsions, drug resistance, neuropsychological performance, surgical outcome, and medications did not differ significantly between mTLE‐AE and mTLE‐NL. Histopathological findings in mTLE‐AE included dysmorphic neurons, potential tumors, and focal cortical dysplasia. Neuroradiologists independently described AE in 37 of 63 mTLE patients. Conclusions: mTLE‐AE has no specific clinical profile compared to non‐lesional mTLE and features diverse underlying pathologies. Volumetric detection appears more conservative than conventional qualitative visual analysis, but may miss cases of subtle AE. Combining automated volumetry with visual assessment may improve AE detection. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Clinical Findings in Temporal Lobe Epilepsy Associated With Isolated Amygdala Enlargement.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Kirscht%2C+Annika%22">Kirscht, Annika</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zöllner%2C+Johann+Philipp%22">Zöllner, Johann Philipp</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Conradi%2C+Nadine%22">Conradi, Nadine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Neuhaus%2C+Elisabeth%22">Neuhaus, Elisabeth</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hattingen%2C+Elke%22">Hattingen, Elke</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Belke%2C+Marcus%22">Belke, Marcus</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Knake%2C+Susanne%22">Knake, Susanne</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Willems%2C+Laurent%22">Willems, Laurent</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wichert%2C+Jennifer%22">Wichert, Jennifer</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jansen%2C+Andreas%22">Jansen, Andreas</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rosenow%2C+Felix%22">Rosenow, Felix</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Strzelczyk%2C+Adam%22">Strzelczyk, Adam</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Jun2025, Vol. 32 Issue 6, p1-12. 12p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Temporal+lobe+epilepsy%22">Temporal lobe epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Amygdaloid+body%22">Amygdaloid body</searchLink><br /><searchLink fieldCode="DE" term="%22Volume+%28Cubic+content%29%22">Volume (Cubic content)</searchLink><br /><searchLink fieldCode="DE" term="%22Volume+measurements%22">Volume measurements</searchLink><br /><searchLink fieldCode="DE" term="%22Histopathology%22">Histopathology</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+diagnosis%22">Physical diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Neuropsychological+tests%22">Neuropsychological tests</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Mesial temporal lobe epilepsy (mTLE) infrequently presents with isolated amygdala enlargement (AE), but its relevance remains ambiguous. We therefore investigated clinical, imaging, and histopathological findings in mTLE‐AE compared to non‐lesional mTLE (mTLE‐NL) patients, and additionally strategies for identifying AE. Methods: We detected AE by automated volumetry of otherwise unremarkable magnetic resonance images of mTLE patients, compared with a healthy comparator. Autoimmune inflammation as an AE cause was excluded using the Graus criteria. We compared clinical and neuropsychological variables between mTLE‐AE and mTLE‐NL. Secondary assessment of AE was by neuroradiologist visual detection. Results: Of 63 mTLE patients, 15 had mTLE‐AE. In these, normalized mean volume was 1857.58 mm3 (SD = 207.38) for the left, 1973.09 mm3 (SD = 214.91) for the right amygdala, 2003.34 mm3 (SD = 218.85) for the larger and 1827.34 mm3 (SD = 179.85) for the smaller amygdala. Mean volume in the healthy control subjects was 1853.4 mm3 for the left (SD = 212.44) and 1895.2 mm3 for the right amygdala (SD = 224.29). Clinical parameters including age, sex, epilepsy duration, history of febrile convulsions, drug resistance, neuropsychological performance, surgical outcome, and medications did not differ significantly between mTLE‐AE and mTLE‐NL. Histopathological findings in mTLE‐AE included dysmorphic neurons, potential tumors, and focal cortical dysplasia. Neuroradiologists independently described AE in 37 of 63 mTLE patients. Conclusions: mTLE‐AE has no specific clinical profile compared to non‐lesional mTLE and features diverse underlying pathologies. Volumetric detection appears more conservative than conventional qualitative visual analysis, but may miss cases of subtle AE. Combining automated volumetry with visual assessment may improve AE detection. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=186225069
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      – Type: doi
        Value: 10.1111/ene.70225
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 12
        StartPage: 1
    Subjects:
      – SubjectFull: Temporal lobe epilepsy
        Type: general
      – SubjectFull: Amygdaloid body
        Type: general
      – SubjectFull: Volume (Cubic content)
        Type: general
      – SubjectFull: Volume measurements
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      – SubjectFull: Histopathology
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      – SubjectFull: Physical diagnosis
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      – SubjectFull: Neuropsychological tests
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      – TitleFull: Clinical Findings in Temporal Lobe Epilepsy Associated With Isolated Amygdala Enlargement.
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              Text: Jun2025
              Type: published
              Y: 2025
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