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Objectives: To characterize a profile for patients with tumor-related epilepsy presenting olfactory auras., Materials and Methods: We conducted a monocentric, retrospective study on patients who underwent surgery in the Neurosurgery Unit of Udine University Hospital (Udine, Italy), between the 1st of January 2010 and the 1st of January 2019, for primary brain tumors (PBTs) involving the temporal lobe and the insula. All patients were affected by tumor-related epilepsy; the study group presented olfactory auras as well. We collected neuroradiological, neuropsychological and neurophysiological data from patients' medical charts., Results: The subtraction analysis of MRI data shows maximum lesion overlay in left olfactory cortex, left and right hippocampus, left amygdala, right rolandic operculum, right inferior frontal gyrus and right middle temporal gyrus. The presence of olfactory auras did not influence seizure outcome (p = 0.500) or tumor recurrence after surgery (p = 0.185). The type of auras (elementary vs. complex), also, did not influence seizure control (p = 0.222)., Discussion: In presence of olfactory auras, anterior and mesial temporal regions are mainly involved, such as olfactory cortex, amygdala, and anterior hippocampus, together with right rolandic operculum, right inferior frontal gyrus and right middle temporal gyrus, suggesting their possible role in the genesis of olfactory auras. Post-surgical seizure outcome and disease relapse are not influenced by neither the presence nor the type of olfactory auras., Conclusions: Olfactory auras are rare event, however they may be often underestimated by the patients and under-investigated by the clinicians, even when their occurrence can represent a useful localizing tool., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The present multimodal diffusion tensor imaging and neuropsychological study investigated the integrity of the white matter fascicles in a 17 years-old patient diagnosed with subacute sclerosing panencephalitis (SSPE). A brief neuropsychological testing showed that word and pseudoword repetition, naming, semantic and phonological fluency, long-term memory, working memory were impaired. A review of the literature on Diffusion weighted imaging (DWI) and Diffusion Tensor Imaging (DTI) evidenced that, studies investigating the integrity of white matter in this condition being a rare disease, are very few. Significant differences (p < 0.05) were found between the fractional anisotropy (FA) values of the controls and the patient in the Superior Longitudinal fasciculus, the Inferior Longitudinal Fasciculus, the Inferior Fronto-Occipital Fasciculus, the Uncinate Fasciculus, and the Arcuate Fasciculus with lower values in the patient. No differences were found for the corticospinal tract. The number of streamlines was significantly lower in the patient, compared to controls, for the left Superior Longitudinal fasciculus, and for the left Uncinate fasciculus while for all the other fascicles, the number did not significantly differ from controls. DTI results were consistent with the patient's cognitive profile showing impairments at repetition, at tasks tapping lexical-semantics and long-term memory / retrieval. Diffusion tensor imaging results indicate that there were diffuse alterations of the degree of anisotropic diffusion along the white matter tracts distributed in posterior-anterior direction. Differently, a selective sparing of this measure was observed along the white matter tract distributed in inferior-superior direction (the corticospinal fascicle)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

We developed a junior-real-time neuropsychological testing (j-RTNT) and used it during surgery of a right fronto-insular dysembryoplastic neuroepithelial tumor causing seizures in a 16 years old female. The j-RTNT included tasks from the battery NEPSY-II. Pre-surgery evaluation detected a below average performance in visuo-spatial planning, inhibition, visual attention, planning and borderline performance in speeded naming. The j-RTNT allows detecting sudden decreases that could be caused by resection. During surgery, ECoG was characterized by slow sharp activity and spikes on the electrodes exploring the right fronto-polar region. After the resection, spikes were not detected anymore. Immediate post-surgery performance resulted within the normal range, remained below average in visuo-spatial planning, and improved in inhibition, switching and in speeded naming. Follow-up revealed cognitive recovery. Neurological assessment was unremarkable and the patient was seizure free. No epileptic activity could be observed on follow-up EEG. fMRI data showed that in the follow-up vs. pre-surgery there was a higher recruitment of the right superior frontal gyrus, a region involved in the cognitive execution and cognitive control networks. The j-RTNT is feasible with young patients, goes beyond the testing of limited functions, assessing multiple times during resection several different functions to better monitoring the effects of resection., (Copyright © 2020 Elsevier Inc. All rights reserved.)