An "epileptic scent": Olfactory auras in tumor-related epilepsy.
Level 4 - case-series / case-control
Retrospective single-center observational study
PubMed 38242066 · doi:10.1016/j.yebeh.2024.109642
What was done
A monocentric retrospective study was conducted on patients undergoing surgery for temporal lobe and insular primary brain tumors with tumor-related epilepsy between January 2010 and January 2019 at Udine University Hospital. Patients presenting with olfactory auras were evaluated against medical chart data, including neuroradiological, neuropsychological, and neurophysiological records, alongside MRI lesion subtraction overlay analysis.
What was found
MRI subtraction analysis demonstrated maximum lesion overlay in the left olfactory cortex, bilateral hippocampus, left amygdala, right rolandic operculum, right inferior frontal gyrus, and right middle temporal gyrus. The presence of olfactory auras did not significantly influence post-surgical seizure outcome (p = 0.500) or tumor recurrence (p = 0.185). The specific type of aura (elementary vs. complex) also had no significant effect on seizure control (p = 0.222).
Why it matters
This study defines anatomical correlates involving anterior/mesial temporal and opercular regions in tumor-related olfactory seizures and suggests that these auras do not worsen surgical seizure control or oncological prognosis.
Limits
The abstract does not state the sample size (n), patient demographics, tumor histological subtypes, effect estimates, or confidence intervals. The single-center retrospective design carries inherent risk of selection and reporting bias.
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