Espinosa-Jovel Camilo, Toledano Rafael, Jiménez-Huete Adolfo, Aledo-Serrano Ángel, García-Morales Irene, Campo Pablo, Gil-Nagel Antonio
Epilepsy Unit, Department of Neurology Hospital Occidente de Kennedy Bogotá Colombia.
Epilepsy Unit, Department of Neurology Hospital Ruber Internacional Madrid Spain.
Epilepsia Open. 2019 Jun 6;4(3):487-492. doi: 10.1002/epi4.12343. eCollection 2019 Sep.
Several lines of research have linked olfactory regions with the pathophysiology of focal epilepsies. Among those regions, the piriform cortex represents the major part of the primary olfactory cortex. According to these data, we raised the hypothesis that in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis exists an interictal dysfunction of olfactory processing that could be more significant compared to patients with extra-hippocampal focal epilepsy and healthy controls. This could be the consequence of a dysfunctional epileptogenic network that extends beyond the hippocampus and affects other structures, including the piriform cortex. To test this hypothesis, we evaluated the olfactory function with the Sniffin' Sticks test in 32 patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis, 30 patients with extra-hippocampal focal epilepsy, and 22 healthy controls. Compared to the other study groups, patients with temporal lobe epilepsy due to hippocampal sclerosis showed a basal olfactory dysfunction characterized by an impairment in odor discrimination and odor identification. We also found that high seizure frequency had a strong correlation with the evaluated olfactory tasks. Our results are consistent with neuroimaging and neuropathological data that establish a link between olfactory regions and the pathophysiology of temporal lobe epilepsy.
多项研究表明嗅觉区域与局灶性癫痫的病理生理学相关。在这些区域中，梨状皮质是初级嗅觉皮质的主要部分。基于这些数据，我们提出了一个假设，即对于伴有海马硬化的内侧颞叶癫痫患者，在发作间期存在嗅觉处理功能障碍，相较于海马外局灶性癫痫患者和健康对照，这种功能障碍可能更为显著。这可能是癫痫发作网络功能失调的结果，该网络超出海马范围并影响其他结构，包括梨状皮质。为了验证这一假设，我们使用嗅觉棒测试对32例伴有海马硬化的内侧颞叶癫痫患者、30例海马外局灶性癫痫患者和22名健康对照者的嗅觉功能进行了评估。与其他研究组相比，因海马硬化导致颞叶癫痫的患者表现出基础嗅觉功能障碍，其特征为气味辨别和气味识别受损。我们还发现高癫痫发作频率与所评估的嗅觉任务密切相关。我们的结果与神经影像学和神经病理学数据一致，这些数据证实了嗅觉区域与颞叶癫痫病理生理学之间的联系。
