Accuracy and interobserver reliability of scalp ictal EEG

Walczak, Thaddeus S.; Radtke, Rodney A.; Lewis, D. V.

doi:10.1212/wnl.42.12.2279

Cited by 93 publications

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“…The percentage of correct lateralization based on initial ictal EEG features and rhythmic theta or alpha waves was similar to other studies 11,14 . There were no differences between the two groups for rhythmic waves presence, as reported by Burgerman et al 12 although O'Brien et al 15 have observed this EEG feature mainly in mesial seizures.…”

Section: Discussionsupporting

confidence: 89%

“…False lateralization occurred in one seizure of group 1 and in three temporal tumor patients of group 2, a phenomenon already described 40 . Postictal EEG lateralizatory findings were observed in 48% of the seizures and they correctly lateralized the EA in almost all of them, as reported by others 14,41 . Although we observed a high percentage of correct lateralization, the presence of postictal features in only about 50% of seizures in our casuistics limited its value, as was also observed in Walczak et al 14 study.…”

Section: Discussionsupporting

confidence: 79%

“…Gibbs et al 10 described an electroencephalographic pattern recorded during TLS characterized by 3-6 Hz rhythmic waves. More recent descriptions have demonstrated the value of scalp EEG for localization and lateralization of the epileptogenic area (EA) [11][12][13][14] .…”

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confidence: 99%

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Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Dantas¹,

Yacubian

Jorge³

et al. 1998

Arq. Neuro-Psiquiatr.

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-The analysis of the temporal lobe seizures through video-EEG systems shows that they often consist of a sequence of clinical and EEG features which may suggest the localization and the lateralization of the epileptogenic lobe. We analyzed clinical and EEG features of 50 temporal lobe seizures which were separated in group 1 with 25 patients (related to mesial temporal sclerosis) and group 2 with 25 patients (other neocortical temporal lesions). Among the auras, the epigastric type was the most frequent and predominated in group 1. There were differences between the two groups, considering dystonic and tonic posturing and versive head and eye movements. Dystonic posturing was always contralateral to the ictal onset and was considered the most useful lateralizing clinical feature. Ictal speech, spitting and blinking automatisms, prolonged disorientation for place and a greatest percentage of postictal language preservation occurred in right temporal seizures. Postictal aphasia and global disorientation predominated in left temporal seizures. EEG was important for lateralizing the epileptogenic lobe, specially considering rhythmic ictal activity and postictal findings.KEY WORDS: temporal lobe epilepsy, complex partial seizures, video-EEG.Análise clínica e eletrencefalográfica de crises epilépticas temporais de origem mesial e lateral RESUMO -As crises epilépticas do lobo temporal tendem a seguir uma sequência previsível de eventos clínicos e eletrencefalográficos, cuja análise, preferencialmente através de sistemas de vídeo-EEG, sugere a localização e a lateralização do lobo epileptogênico. Para este estudo, foram analisadas 50 crises epilépticas do lobo temporal, do ponto de vista clínico e eletrencefalográfico, sendo 25 relacionadas a esclerose mesial (grupo 1) e 25 a patologias neocorticais (grupo 2). Auras abdominais foram as mais frequentes, predominando no grupo 1. Houve diferenças entre os dois grupos, quanto à instalação e duração da postura distônica, à postura tônica e à versão oculocefálica. Postura distônica unilateral foi o mais importante fenômeno clínico lateralizatório, sempre contralateral à área epileptogênica. Verbalização crítica, automatismo de cuspir, piscamento palpebral bilateral, desorientação espacial prolongada e maior percentual de preservação da linguagem no período pós-crítico foram relacionados a crises temporais direitas. Afasia pós-crítica e desorientação global, a crises temporais esquerdas. O EEG teve importante acurácia lateralizatória em ambos os grupos, especialmente quanto à atividade crítica rítmica e achados pós-críticos. PALAVRAS-CHAVE: epilepsia do lobo temporal, crises parciais complexas, vídeo-EEG.According to the International Classification of Epilepsies and Epileptic Syndromes 1 , these can be divided in partial, generalized, epilepsies and syndromes undetermined whether focal or generalized and special syndromes. Temporal lobe epilepsy (TLE) is responsible for 60% of all the partial epileptic seizures 2 and it has been extensively studied clinically, electr...

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 79%

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Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Dantas¹,

Yacubian

Jorge³

et al. 1998

Arq. Neuro-Psiquiatr.

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“…Dodrill et al (27), reported that ictal EEG recording was associated with a poorer outcome after ATL, but not all patients in the study received long-term monitoring. Others (8,33) have shown greater accuracy with ictal EEG. We found in this series of 78 patients that lateralization of ictal EEG was not contralateral to MRI and interictal EEG in the 61% of patients with concordant MRI and interictal scalp EEG abnormalities.…”

Section: Discussionmentioning

confidence: 98%

Association of Combined MRI, Interictal EEG, and Ictal EEG Results with Outcome and Pathology After Temporal Lobectomy

et al. 1997

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Summary:Purpose: Magnetic resonance imaging, interictal scalp EEG, and ictal scalp EEG each have been shown to localize the primaly epileptic region in most patients with mesial-basal temporal lobe epilepsy (MBTLE), but the association of surgical outcome and pathology with each combination of these test results is not known.Methods: We reviewed the MRI, interictal scalp EEG, and ictal scalp EEG results of 90 consecutive patients with MBTLE. Twelve patients were excluded from the analysis because inconclusive bitemporal intracranial EEG results precluded anterior temporal lobectomy (ATL); none had concordant MRI and interictal scalp EEG results. We compared all combinations of presurgical MRI, interictal EEG, and ictal EEG results to seizure outcome and tissue pathology in the 78 patients who underwent an ATL.Results: Forty-eight (6 1 %) patients had concordant lateralized MRI and interictal EEG temporal lobe abnormalities, with no discordant ictal EEG results; 77% of these patients were seizure-free after ATL. Concordance of MRI and interictal EEG abnormalities correlated with seizure cessation (p < 0.05), compared to all combinations with discordant or nonlateralizing MRI and interictal EEG results. Mesial temporal sclerosis (MTS) was confirmed pathologically in about 80% of both groups (p = 0.5). Outcome in patients with concordant MRI and ictal EEG with nonlateralizing interictal EEG was significantly worse than combinations with concordant MRI and interictal EEG (p < 0.02). Mesial-basal temporal lobe epilepsy (MBTLE) is a common syndrome that often remains resistant to drug therapy. Anterior temporal lobectomy (ATL), therefore, is the most frequently performed epilepsy surgery worldwide (1). Most epilepsy centers require an intensive presurgical assessment using neuroimaging tests and longterm, inpatient video/EEG monitoring to confirm the brain region of seizure onset (2). Prior investigations have demonstrated that MRI (3-lo), interictal EEG (1 1-19), and ictal EEG (8,9,20) anterior temporal epileptiform EEG abnormalities is associated with successful surgery, but detailed analysis of the pathology and outcome associated with each combination of MRI, interictal EEG, and ictal EEG result has not been reported previously. ConclusionsWe reviewed retrospectively results of the MRI, interictal scalp EEG, and ictal scalp EEG of 90 consecutive patients evaluated for possible ATL to determine the association of all observed combinations of test results with surgical outcome. We also compared each combination of test results to resected tissue pathology to determine the association with mesial temporal sclerosis. METHODS PatientsWe evaluated a cohort of 90 consecutive patients who had historical and routine EEG or MRI evidence of tem- 1315

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“…Among studies that used M 1 , T 1 sphenoidal, or sphenoidal electrodes supplementing the 10-20 system, the site of scalp-recorded seizures in temporal lobe epilepsy correlated with side of invasively recorded seizures or of effective lobectomy in 75-83% of cases (37)(38)(39)(40). Among 67 nonlesional temporal patients rendered SF by surgery, Williamson et al (41) found scalp ictal lateralizing "changes" ultimately appearing in 81% of patients; in 87% of these, the seizures occurred ipsilateral to depth EEG seizures and curative surgery.…”

Section: Scalp Eegmentioning

confidence: 99%

Indices of Resective Surgery Effectiveness for Intractable Nonlesional Focal Epilepsy

et al. 2003

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Summary: Among 70 patients with intractable focal epilepsy and no specific lesion, as determined by both MRI (magnetic resonance imaging) and histopathology, outcome after resective surgery was polarized: 26 (37%) became seizure free (SF), and 27 (39%) were not helped. Eighteen (42%) of 43 standard temporal resections rendered patients SF, somewhat more than eight (30%) of 27 other procedures. To seek reliable prognostic factors, the subsequent correlative data compared features of the 26 SF patients with those of the 27 not helped. Although ictal semiology guided the site of surgical resection, it and other aspects of seizure and neurologic history failed to predict surgical outcome. However, two aspects of preoperative scalp EEGs correlated with SF outcomes: (a) among 25 patients in whom >50% of clinical seizures arose from the later resected lobe and no other origins, 18 (72%) became SF compared with seven (28%) of 25 with other ictal profiles; (b) 13 (93%) of 14 temporal lobe patients whose interictal and ictal EEGs lacked features indicative of multifocal epileptogenesis became SF compared with five (33%) of 15 with such components. The considered need for subdural (SD) EEG reduced SF outcome from 18 (90%) of 20 patients without SD to eight (24%) of 33 with SD; this likely reflected an insufficient congruity of ictal semiology and interictal and ictal scalp EEG for localizing epileptogenesis. Within this SD group, >50% of clinical seizure origins from a later resected lobe increased SF outcome somewhat: from two (14%) of 14 without this attribute to six (40%) of 15 with it; 100% of such origins increased SF outcome from two (12%) of 16 to six (46%) of 13.

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Accuracy and interobserver reliability of scalp ictal EEG

Cited by 93 publications

References 0 publications

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Clinical and eeg analysis of mesial and lateral temporal lobe seizures

Association of Combined MRI, Interictal EEG, and Ictal EEG Results with Outcome and Pathology After Temporal Lobectomy

Indices of Resective Surgery Effectiveness for Intractable Nonlesional Focal Epilepsy

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