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Acta Neurológica Colombiana

Print version ISSN 0120-8748On-line version ISSN 2422-4022

Abstract

ESPINOSA-JOVEL, Camilo  and  JIMENEZ-ORTIZ, Daniela. Epileptogenesis and the piriform cortex: understanding temporal lobe epilepsy beyond the hippocampus. Acta Neurol Colomb. [online]. 2023, vol.39, n.3, e5.  Epub Nov 03, 2023. ISSN 0120-8748.  https://doi.org/10.22379/anc.v39i3.727.

Introduction:

With the experience of invasive EEG recordings and surgical failure after surgery, it has become clear that temporal lobe epilepsy is much more complex than previously thought, and currently, is conceptualized as a disease of anatomical networks instead of structural lesions.

Content:

The current neurophysiological and imaging information allows us to conclude that several temporal and extratemporal anatomical networks are involved in this type of epilepsy. One way of understanding the concept of the epileptic network in temporal lobe epilepsy is from the knowledge of the piriform cortex. Several clinical studies have shown that in patients with temporal lobe epilepsy associated with hippocampal sclerosis exists an interictal dysfunction of olfactory processing that is more significant compared to patients with focal extra-hippocampal epilepsy and healthy controls. This alteration is probably the consequence of a dysfunctional neural network that extends beyond the hippocampus and affects other nearby structures, including the piriform cortex.

Conclusion:

In this article, we carry out a narrative review of the literature with the aim of establishing a link between the piriform cortex and temporal lobe epileptogenesis, demonstrating that this disease is the consequence of a dysfunctional network that does not depend exclusively of a hippocampal structural abnormality.

Keywords : Rolandic Epilepsy; Piriform Cortex; Temporal Lobe; Hippocampus; Epileptogenic Zone; Smell.

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