Interictal EEG and Ictal Scalp EEG Propagation Are Highly Predictive of Surgical Outcome in Mesial Temporal Lobe Epilepsy

Schulz, Reinhard; Lüders, Hans; Hoppe, Matthias; Tuxhorn, Ingrid; May, Theodor W.; Ebner, Alois

doi:10.1111/j.1528-1157.2000.tb00210.x

Cited by 175 publications

(132 citation statements)

References 16 publications

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“…In summary, the effects of inter-ictal findings in prognosis are still controversial (20,21). In accordance with the findings of our study, inter-ictal spikes originate from neocortical structures instead of mesial temporal structures and noninvasive EEG does (18).…”

Section: Discussionsupporting

confidence: 90%

Investigation of Patients with Hippocampal Sclerosis Associated with Unusual Epileptic Activities

Yavuz¹,

Yener²,

Özemir³

et al. 2016

tnd

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Objective: Hippocampal sclerosis (HS) is usually associated with typical anterior temporal spikes/sharp waves in the electroencephalography (EEG). We aimed to investigate the clinical, electrophysiologic differences, and prognosis between HS patients with unusual epileptic foci in comparison with patients with typical foci. Materials and Methods:Patients diagnosed who were diagnosed as having mesial temporal lobe epilepsy with HS in our center were included. All magnetic resonance imaging (MRI) results were investigated for the presence of two major criteria of HS diagnosis, namely T1 atrophy and T2 hyperintensity. All EEG and video-EEG investigations (a total of 496) were re-evaluated for unusual epileptic activities except T1/2, F7/8, T3/4 foci. Clinical and other laboratory data were retrospectively reevaluated by two investigators and the groups with usual and unusual epileptic activities for this syndrome were statistically compared.Results: A total of 124 patients including 20 (16.1%) with unusual epileptic activities (group 1) and 104 patients with typical foci (group 2) were evaluated. We observed 11 posterior temporal (T5/T6), four frontal (F3/F4), four frontopolar (Fp1/2), two occipital (O1/O2), three central (CP/FC) unusual foci, and two generalized epileptiform discharges in these 20 patients. Impaired background activity, nonspecific interictal diffuse slowing, and atypical seizure offset patterns were more frequently observed in group 1. Forty-nine patients underwent surgery after appropriate preoperative diagnostics; there was no significant difference in the postoperative outcome between the groups despite a tendency to better prognosis in group 2. Conclusion:Our study showed that unusual epileptic foci could be seen in 16.1% of patients with HS. Although some patients with HS have these atypical interictal EEG findings, they might obtain good post-operative outcomes when preoperative diagnostics are appropriately planned. Keywords: Mesial temporal lobe epilepsy, hippocampal sclerosis, electroencephalography, prognosisAmaç: Hipokampal skleroz (HS) genelde elektroensefalografide (EEG) ön temporal elektrotlarda görülen tipik dikenler/keskin dalgalar ile ilişkilidir. Çalışmada bu odaklardan farklı lokalizasyonlarda epileptik odakların ve aktivitelerin görüldüğü olguların, tipik odakları olanlara kıyasla klinik, elektrofizyolojik özelliklerinin ve prognoz farklarının araştırılması amaçlanmıştır. Gereç ve Yöntem:Merkezimizde mezyal temporal lob epilepsisi ile giden HS tanısıyla takipli olgular çalışmaya dahil edildi. Tüm manyetik rezonans görüntülemeler (MRG) iki ana HS tanı kriterinin (hipokampal yapılarda atrofi ve T2 ya da FLAIR sekanslarında sinyal artışı) varlığı açısından incelendi. Tüm EEG ve video EEG incelemeleri (toplam 496 adet) T1/2, F7/8, T3/4 odakları dışında farklı bir alanda epileptik aktivitesi olan ve olmayan hastalar açısından incelendi. Klinik ve diğer laboratuvar incelemeleri iki araştırmacı tarafından retrospektif olarak değerlendirildi. Olağan dışı odağı olan hastalarla olağan d...

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Section: Discussionsupporting

confidence: 90%

Investigation of Patients with Hippocampal Sclerosis Associated with Unusual Epileptic Activities

Yavuz¹,

Yener²,

Özemir³

et al. 2016

tnd

View full text Add to dashboard Cite

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“…Whether this means they will have a worse prognosis after epilepsy surgery requires further investigations, but seems likely. [11,12,[37][38][39] Prerequisite for such an individualized counselling approach is the definition of reliable markers for early prediction of later pathology spread.…”

Section: Discussionmentioning

confidence: 99%

The long-term course of temporal lobe epilepsy: From unilateral to bilateral interictal epileptiform discharges in repeated video-EEG monitorings

Gollwitzer

Scott

Farrell

et al. 2017

Epilepsy & Behavior

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“…15 In patients with MTS, postsurgical seizure control is worse when MR imaging and EEG findings are discordant. 16 FDG-PET can complement MR imaging (Fig 1). 5,14 FDG-PET detects hypometabolism in approximatley 80% of patients with unilateral MTLE.…”

Section: Mtsmentioning

confidence: 99%

[¹⁸F] Fluorodeoxyglucose–Positron-Emission Tomography and MR Imaging Coregistration for Presurgical Evaluation of Medically Refractory Epilepsy

Lee¹,

Salamon²

2009

AJNR Am J Neuroradiol

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SUMMARY:Epilepsy is a chronic disorder affecting approximately 1% of the population of the world. Approximately one third of patients with epilepsy remain refractory to medical therapy. For these patients, surgery is a curative option. In order for surgery to be considered, precise localization of the structural abnormality is needed. When MR imaging findings are normal, more sensitive techniques such as positron-emission tomography (PET) can help find the abnormality. Combining MR imaging and PET information increases the sensitivity of the presurgical evaluation. In this review, we discuss the clinical applications of coregistration of [18 F] fluorodeoxyglucose (FDG)-PET with MR imaging for medically refractory epilepsy. Because FDG-PET/MR imaging coregistration has been a routine component of the presurgical evaluation for patients with epilepsy at our institution since 2004, we also included cases from our data base that exemplify the utility of this technology to obtain better postsurgical outcomes.

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Interictal EEG and Ictal Scalp EEG Propagation Are Highly Predictive of Surgical Outcome in Mesial Temporal Lobe Epilepsy

Abstract: Switch of lateralization or bitemporal asynchrony in the ictal scalp EEG and bitemporal IED are most probably an index of bitemporal epileptogenicity in MTS and are associated with a worse outcome.

Cited by 175 publications

References 16 publications

Investigation of Patients with Hippocampal Sclerosis Associated with Unusual Epileptic Activities

Investigation of Patients with Hippocampal Sclerosis Associated with Unusual Epileptic Activities

The long-term course of temporal lobe epilepsy: From unilateral to bilateral interictal epileptiform discharges in repeated video-EEG monitorings

[¹⁸F] Fluorodeoxyglucose–Positron-Emission Tomography and MR Imaging Coregistration for Presurgical Evaluation of Medically Refractory Epilepsy

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Interictal EEG and Ictal Scalp EEG Propagation Are Highly Predictive of Surgical Outcome in Mesial Temporal Lobe Epilepsy

Abstract: Switch of lateralization or bitemporal asynchrony in the ictal scalp EEG and bitemporal IED are most probably an index of bitemporal epileptogenicity in MTS and are associated with a worse outcome.

Cited by 175 publications

References 16 publications

Investigation of Patients with Hippocampal Sclerosis Associated with Unusual Epileptic Activities

Investigation of Patients with Hippocampal Sclerosis Associated with Unusual Epileptic Activities

The long-term course of temporal lobe epilepsy: From unilateral to bilateral interictal epileptiform discharges in repeated video-EEG monitorings

[18F] Fluorodeoxyglucose–Positron-Emission Tomography and MR Imaging Coregistration for Presurgical Evaluation of Medically Refractory Epilepsy

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[¹⁸F] Fluorodeoxyglucose–Positron-Emission Tomography and MR Imaging Coregistration for Presurgical Evaluation of Medically Refractory Epilepsy