Temporal lobe "plus" epilepsy associated with oligodendroglial hyperplasia (MOGHE)

Acta Neurol Scand. 2019 Oct;140(4):296-300. doi: 10.1111/ane.13142. Epub 2019 Jul 8.

Abstract

Background: Mild malformation of cortical dysplasia (mMCD) with oligodendroglial hyperplasia (MOGHE) is an epilepsy-related pathologic entity highlighted in post-surgical specimens of frontal lobe epilepsy (FLE) patients.

Aims of the study: We present two temporal lobe epilepsy (TLE) cases with MOGHE and discuss clinical, neurophysiological, and neuroimaging features that may be indicative of surgical outcome.

Methods: We identified two cases with MOGHE out of 30 temporal lobe epilepsy (TLE) surgical patient cohort, whose pathological distribution spared the hippocampal structures.

Results: The TLE cases shared common features with the FLE series in terms of patient profiles, MRI findings and post-surgical outcome. TLE plus seizure semiology combined with extratemporal scalp electroencephalographic (EEG) and electrocorticographic (ECoG) epileptiform elements at a distance from the imaging lesion were suggestive of an underlying multifocal pathology.

Conclusions: MOGHE pathology has to be considered in the decision-making process for TLE epilepsy surgery when this constellation of features is met.

Keywords: MRI; epilepsy surgery; histopathology; mild malformation of cortical development with oligodendroglial hyperplasia; temporal lobe plus epilepsy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Electroencephalography / methods
  • Epilepsy, Temporal Lobe / complications
  • Epilepsy, Temporal Lobe / diagnostic imaging*
  • Epilepsy, Temporal Lobe / surgery
  • Female
  • Humans
  • Hyperplasia / complications
  • Hyperplasia / diagnostic imaging
  • Hyperplasia / surgery
  • Magnetic Resonance Imaging / methods
  • Malformations of Cortical Development / complications
  • Malformations of Cortical Development / diagnostic imaging*
  • Malformations of Cortical Development / surgery
  • Oligodendroglia / pathology*
  • Temporal Lobe / diagnostic imaging*
  • Temporal Lobe / surgery