Magnetic resonance imaging abnormalities in familial temporal lobe epilepsy with auditory auras.

Abstract

BACKGROUND:

Two forms of familial temporal lobe epilepsy (FTLE) have been described: mesial FTLE and FTLE with auditory auras. The gene responsible for mesial FTLE has not been mapped yet, whereas mutations in the LGI1 (leucine-rich, glioma-inactivated 1) gene, localized on chromosome 10q, have been found in FTLE with auditory auras.

OBJECTIVE:

To describe magnetic resonance imaging (MRI) findings in patients with FTLE with auditory auras.

DESIGN AND METHODS:

We performed detailed clinical and molecular studies as well as MRI evaluation (including volumetry) in all available individuals from one family, segregating FTLE from auditory auras.

RESULTS:

We evaluated 18 of 23 possibly affected individuals, and 13 patients reported auditory auras. In one patient, auditory auras were associated with déjà vu; in one patient, with ictal aphasia; and in 2 patients, with visual misperception. Most patients were not taking medication at the time, although all of them reported sporadic auras. Two-point lod scores were positive for 7 genotyped markers on chromosome 10q, and a Zmax of 6.35 was achieved with marker D10S185 at a recombination fraction of 0.0. Nucleotide sequence analysis of the LGI1 gene showed a point mutation, VIIIS7(-2)A-G, in all affected individuals. Magnetic resonance imaging was performed in 22 individuals (7 asymptomatic, 4 of them carriers of the affected haplotype on chromosome 10q and the VIIIS7[-2]A-G mutation). Lateral temporal lobe malformations were identified by visual analysis in 10 individuals, 2 of them with global enlargement demonstrated by volumetry. Mildly reduced hippocampi were observed in 4 individuals.

CONCLUSIONS:

In this family with FTLE with auditory auras, we found developmental abnormalities in the lateral cortex of the temporal lobes in 53% of the affected individuals. In contrast with mesial FTLE, none of the affected individuals had MRI evidence of hippocampal sclerosis.

• Authors: Eliane Kobayashi, Neide F Santos, Fabio R Torres, Rodrigo Secolin, Luiz A C Sardinha, Iscia Lopez-Cendes, Fernando Cendes
• Journal: Archives of neurology (Arch Neurol) Vol. 60 Issue 11 Pg. 1546-51 (Nov 2003) ISSN: 0003-9942 [Print] United States
• PMID: 14623726 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Child
• Epilepsy, Temporal Lobe (diagnostic imaging, genetics)
• Female
• Haplotypes
• Humans
• Magnetic Resonance Imaging
• Male
• Pedigree
• Radiography
• Sequence Analysis, DNA
• Temporal Lobe (pathology)