ХУЛІГАНСТВО ТА ЙОГО ХАРАКТЕРИСТИКА

Abstract BACKGROUND: Temporal lobe gray-white matter abnormalities (GWMA) are frequent morphological aberrances observed on MRI in patients with temporal lobe epilepsy (TLE) in addition to hippocampal sclerosis (HS). OBJECTIVE: To study the influence of temporal pole GWMA on clinical characteristics and seizure outcome in patients with HS operated on for TLE. METHODS: A cohort of 370 patients undergoing surgery for intractable TLE was prospectively collected in an epilepsy surgery data base. Clinical characteristics and seizure outcome of all 58 TLE patients with identified HS and GWMA (group 1) were compared with those of a matched control group of 58 HS patients without GWMA (group 2). Both groups were further subdivided into patients undergoing transsylvian selective amygdalohippocampectomy (sAH) and anterior temporal lobectomy with amygdalohippocampectomy (ATL). RESULTS: The HS plus GWMA patients were significantly younger at epilepsy onset than those without GWMA. In the HS plus GWMA group, 41% of patients were younger than 2 years when they experienced their first seizure in contrast to only 17% of patients with pure HS (P = .004). Seizure outcome was not statistically different between the 2 groups: 75.9% of the patients in group 1 were seizure free (Engel class I) compared with 81% of patients in group 2. Seizure outcome in both groups was about equally successful with selective amygdalohippocampectomy and anterior temporal lobectomy (ns). CONCLUSION: Limited and standard resections in TLE patients with HS are equally successful regardless of the presence of GWMA

Client and therapist initial experience of using mindfulness in therapy

Literature has demonstrated the influence of mindfulness practice on both clients and therapists; however, no literature has considered the experience of mindfulness in therapy from both members of the therapeutic dyad. The present study interviewed five separate therapy dyads (n=10) regarding their experience of first using mindfulness in session. Participants, both clients and therapists, had little-to-no experience with mindfulness prior to the study. Interview transcripts were analyzed and common themes were derived. Results indicated that both clients and therapist felt that the practice of mindfulness had an impact on the therapeutic relationship. Furthermore, participants also suggested ways in which therapists may better utilize mindfulness in therapy

Correlation of MRI and histopathology in epileptogenic parietal and occipital lobe lesions

SummaryIntroductionTo analyze the diagnostic accuracy of MRI in patients undergoing parietal and occipital lobe epilepsy surgery.MethodsIn a retrospective study, we analyzed MRI scans and neuropathology reports of 42 patients who had undergone resective epilepsy surgery in the parietal and occipital lobe between 1998 and 2003. We evaluated, whether lesions were precisely characterized by MRI and whether lesion characterization allowed to estimate postsurgical seizure outcome.ResultsWithin the categories epilepsy associated tumors, focal cortical dysplasias, vascular malformations, scarring, and others, MRI was concordant with histopathology in 36 of 42 (86%) lesions. Among the discordant lesions, one lesion was re-classified following MRI–histopathology synopsis, another two lesions represented new tumor entities (angiocentric neuroepithelial tumor, isomorphic astrocytoma) which have been described recently. Seizure freedom (Engel class I) one year following surgery was achieved in 25 patients (60%). Seizure outcome was different for lesion categories (Engel class I: epilepsy associated tumors, 62%; focal cortical dysplasias, 71%; vascular malformations, 75%; scarring, 40%), and was unchanged if no lesion was found on preoperative MRI.ConclusionIf MRI and histopathology are discordant, not only the MRI findings may be debatable. MRI lesion detection is important, since chance of seizure freedom is low if no lesion is detected