Electrocorticography in temporal lobe epilepsy surgery

Stefan, Hermann; Quesney, L. F.; Abou-Khalil, B.; Olivier, André

doi:10.1111/j.1600-0404.1991.tb04651.x

Cited by 27 publications

(10 citation statements)

References 15 publications

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“…In addition to the complexities already described with regard to individual discharges, most patients show more than one independent discharge pattern with distinct topographies regarding spike incidence, amplitude, sites with leading spikes and propagation patterns. The occurrence of multiple ECoG patterns with respect to amplitude and incidence of spikes has been described repeatedly (Engel et al, 1975;Graf et al, 1984;McBride et al, 1991;Stefan et al, 1991;Tsai et al, 1993a). Furthermore, we have found that most patients show more than one leading region with distinct associated propagation patterns.…”

Section: Neurophysiological Implicationssupporting

confidence: 61%

Origin and propagation of interictal discharges in the acute electrocorticogram. Implications for pathophysiology and surgical treatment of temporal lobe epilepsy

Alarcón

Seoane²,

Binnie³

et al. 1997

Brain

225

158

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Although acute electrocorticography (ECoG) is routinely performed during epilepsy surgery there is little evidence that the extent of the discharging regions is a useful guide to tailoring the resection or that the findings are predictive of outcome or pathology. Patterns of discharge propagation have, however, rarely been considered in assessing the ECoG. We hypothesize that regions where discharges show earliest peaks ('leading regions') are located in the epileptogenic zone, whereas sites in which late, secondary, propagated activity occurs have less epileptogenic potential and do not need to be excised. To allow intraoperative topographic ECoG analysis, a computer program has been developed to identify leading regions and the sites showing greatest rates or amplitudes of spikes. Their topography has been compared retrospectively with pathology and seizure control in 42 consecutive patients following temporal lobe surgery. Leading regions were most often found in the hippocampus, the subtemporal cortex and the superior temporal gyrus. The most common propagation patterns were from hippocampus to subtemporal cortex and vice versa. There was no association between seizure outcome and the location of regions with greatest incidence or amplitude of spikes or location of leading regions. There was, however, a strong and significant association between poor outcome and non-removal of leading regions other than those in the posterior subtemporal cortex. All leading regions (other than posterior subtemporal) were resected in 27 patients of whom 25 had a favourable outcome. Leading regions (other than posterior subtemporal) remained in 14 patients of whom only four had a good outcome. One patient had no epileptiform activity in the ECoG and good outcome. Persistent posterior subtemporal leading regions remained in nine subjects; all had favourable outcome (Grades I or II) but only three were seizure free. These results suggest that: (i) interictal epileptiform discharges may originate from a complex interaction between separate regions, resulting in propagation and recruitment of neuronal activity along specific neural pathways; (ii) removal of all discharging areas appears unnecessary to achieve seizure control provided that leading regions (other than posterior subtemporal) are removed; and (iii) identification of such leading regions could be used to tailor resections in order to improve seizure control and reduce neurological, neuropsychological and psychiatric post-surgical morbidity.

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Section: Neurophysiological Implicationssupporting

confidence: 61%

Origin and propagation of interictal discharges in the acute electrocorticogram. Implications for pathophysiology and surgical treatment of temporal lobe epilepsy

Alarcón

Seoane²,

Binnie³

et al. 1997

Brain

225

158

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“…Eigene Erfahrungen mit einzelnen Patienten während des Wada-Testes, bei denen es zum einen zu Weinausbrüchen und schweren depressiven Verstimmungen, zum anderen aber auch zu abnorm positiven Empfindungen und submanischem Verhalten kam, bestätigen diese Berichte. Ob bei diesen Patienten durch einen epilepsiechirurgischen Eingriff ähnliche dauerhafte Stimmungsänderungen auftreten ist nicht bekannt [13] (Tab. 2).…”

Section: Depression/traurigkeitunclassified

Iktuale emotional-affektive und vegetative Phänomene bei Temporallappenepilepsie

Stefan¹,

Feichtinger²

2001

Akt Neurol

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Zusammenfassung: Emotional affektive und vegetative Anfallssymptome treten isoliert oder kombiniert mit anderen Anfallssymptomen während einfach-und komplex-partieller Anfälle auf. Viszerale Epilepsien können schwer von kardialen, psychiatrischen oder gastrointestinalen nichtepileptischen Störungen zu differenzieren sein. Es wird ein Überblick über emotional-affektive und vegetative Anfallsmanifestationen gegeben.

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“…5 However, many others have failed to establish correlations between spike quantification and seizure outcome. [6][7][8][9][10] Despite its classical use in epilepsy surgery, most centers have abandoned intraoperative ECoG in cases of TLE-HS. However, ECoG analysis nowadays should probably include parameters other than post-resection spike quantification, in order to permit a more complete study of the pathophysiology of TLE, and in the search of patterns of prognostic value that could eventually influence the surgical technique.…”

Section: Introductionmentioning

confidence: 99%

Can intraoperative electrocorticography patterns predict surgical outcome in patients with temporal lobe epilepsy secondary to unilateral mesial temporal sclerosis?

Oliveira

Garzón

Caboclo

et al. 2006

Seizure

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Electrocorticography in temporal lobe epilepsy surgery

Cited by 27 publications

References 15 publications

Origin and propagation of interictal discharges in the acute electrocorticogram. Implications for pathophysiology and surgical treatment of temporal lobe epilepsy

Origin and propagation of interictal discharges in the acute electrocorticogram. Implications for pathophysiology and surgical treatment of temporal lobe epilepsy

Iktuale emotional-affektive und vegetative Phänomene bei Temporallappenepilepsie

Can intraoperative electrocorticography patterns predict surgical outcome in patients with temporal lobe epilepsy secondary to unilateral mesial temporal sclerosis?

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