Revisiting emotion recognition in different types of temporal lobe epilepsy: The influence of facial expression intensity.

Temporal lobe epilepsy (TLE) can induce various difficulties in recognizing emotional facial expressions (EFE), particularly for negative valence emotions. However, these difficulties have not been systematically examined according to the localization of the epileptic focus. For this purpose, we used a forced-choice recognition task in which faces expressing fear, sadness, anger, disgust, surprise, or happiness were presented in different intensity levels from moderate to high intensity. The first objective of our study was to evaluate the impact of emotional intensity on the recognition of different categories of EFE in TLE patients compared to control participants. The second objective was to assess the effect of localizationof epileptic focus on the recognition of EFE in patients with medial temporal lobe epilepsy (MTLE) associated or not with hippocampal sclerosis (HS), or lateral temporal lobe epilepsy (LTLE). The results showed that the 272 TLE patients and the 68 control participants were not differently affected by the intensity of EFE. However, we obtained group differences within the clinical population when we took into account the localization of the temporal lobe epileptic focus. As predicted, TLE patients were impaired in recognizing fear and disgust relative to controls. Moreover, the scores of these patients varied according to the localization of the epileptic focus, but not according to the cerebral lateralization of TLE. The facial expression of fear was less well recognized by MTLE patients, with or without HS, and the expression of disgust was less well recognized by LTLE as well as MTLE without HS patients. Moreover, emotional intensity modulated differently the recognition of disgust and surprise of the three patient groups underlying the relevance of using moderate emotional intensity to distinguish the effect of epileptic focus localization. These findings should be taken into account for interpreting the emotional behaviors and deserve to befurther investigated before considering TLE surgical treatment or social cognition interventions in TLE patients.

Getting older with chronic temporal lobe epilepsy: What memory profile?

Older adults with epilepsy frequently report changes in memory function, with a concern about degenerative disease. However, the precise limit between memory changes related to the effects of longstanding chronic epilepsy and physiological aging on memory abilities is very difficult to specify. Knowledge about characteristics of physiological cognitive aging, its influence on memory test results, and its interactions with clinical variables related to epileptic disease are therefore essential to interpret memory scores. This paper aims at presenting an overview of the different factors that might modulate the developmental trajectory of episodic memory in chronic temporal lobe epilepsy. For this purpose, the effects of age on memory in healthy and epileptic persons will be first reviewed with a special focus on episodic memory functions in chronic temporal lobe epilepsy. Finally, scientific evidence supporting or not the presence of an accelerated memory decline in patients with longstanding epilepsy will be presented by discussing the interests and the limits of the existing literature. Identifying the best outcome measures to assess episodic memory and understanding the risk factors that might precipitate memory decline are key knowledge to improve the clinical care and quality of life of persons with chronic temporal lobe epilepsy.

Duplicacion del tubo digestivo en ninos. / Duplication of the digestive tract in infants

Se comunican ocho casos de duplicacion del tubo digestivo en ninos, que se presentaron para su atencion en los Hospitales de Especialidades numeros 21 y 25 del Centro Medico del Noreste del Instituto Mexicano del Seguro Social en Monterrey. N. L., en el periodo compreendido entre el mes de noviembre de 1969 y octubre de 1981. En la serie analizada, la edad promedio fue de 62 dias. Cuatro casos correspondieron al sexo femenino y cuatro al masculino. Los signos y sintomas predominantes fueron: masa abdominal palpable, distension abdominal, constipacion y vomito. La localizacion mas frecuentemente encontrada fue en ileon (5 casos). La variedad mas comun fue la quistica (6 casos); le siguio en frecuencia la intramural (2 casos) y no se registraron duplicaciones tubulares. Histopatologicamente, en todos los casos se demostro la presencia de una pared comun de musculo liso, con revestimiento de mucosa intestinal tanto en la duplicacion como en el intestino normal adyacente. Se describe un caso en donde se encontro tejido gastrico y hepatico dentro de la duplicacion