Routine EEG and Temporal Lobe Epilepsy: Relation to Long‐Term EEG Monitoring, Quantitative MRI, and Operative Outcome

Cascino, Gregory D.; Trenerry, Max R.; So, Elson L.; Sharbrough, Frank W.; Shin, Cheolsu; Lagerlund, Terrence D.; Zupanc, Mary L.; Jack, Clifford R.

doi:10.1111/j.1528-1157.1996.tb00629.x

Cited by 162 publications

(137 citation statements)

References 22 publications

(24 reference statements)

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“…However, routine EEGs and long-term EEG monitoring can be discordant, and in some patients, interictal epileptiform discharges can be seen only during long-term EEG monitoring. 24 Among the 4 groups, men with left HS had the least amount of AI for both FA and MD. The presence of the most extensive FA, but not MD, alteration of WM in men with left HS fails to explain a probable relationship between AI and extension of pathologic abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Effect of Patient Sex on White Matter Alterations in Unilateral Medial Temporal Lobe Epilepsy with Hippocampal Sclerosis Assessed by Diffusion Tensor Imaging

Oğuz

Tezer²,

Sanverdi³

et al. 2012

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Effect of Patient Sex on White Matter Alterations in Unilateral Medial Temporal Lobe Epilepsy with Hippocampal Sclerosis Assessed by Diffusion Tensor Imaging

Oğuz

Tezer²,

Sanverdi³

et al. 2012

AJNR Am J Neuroradiol

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“…Studies identified clinical and neuroimaging findings that predict good outcome (7)(8)(9)(10)(11)(12) or increased likelihood for surgical failure (7,8,13); however, few observations of the predictive value of preoperative scalp EEG to outcome after temporal lobectomy have been reported ( I 3,14). Bilateral synchronous spikes or sharp waves and extratemporal or bilateral independent temporal interictal epileptiform activities were reported to be highly associated with surgical failure (1 3 ) .…”

mentioning

confidence: 99%

Visual and Quantitative Ictal EEG Predictors of Outcome After Temporal Lobectomy

Assaf

Ebersole

1999

Epilepsia

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Summary: Purpose; We investigated whether visual and quantitative ictal EEG analysis could predict surgical outcome after anteromesial temporal lobectomy (AMTL) in which mesial structures, basal, and temporal tip cortex were resected.Methods: We retrospectively reviewed 282 presurgical scalprecorded ictal EEGs (21-to 27-channel) from 75 patients who underwent AMTL. We examined the pattern of seizure onset (frequency, distribution, and evolution) and estimated the principal underlying cerebral generators by using a multiple fixed dipole model that decomposes temporal lobe activity into four sublobar sources (Focus 1.1). We correlated findings with a 2-year postoperative outcome.Results: Sixteen patients had seizures with a well-lateralized, regular 5 to 9-Hz rhythm at onset, that most often had a temporal or subtemporal distribution. All patients became seizure free after surgery. In 5 I patients, seizure onset was remarkable for lateralized slow rhythms (<5 Hz), which sometimes appeared as periodic discharges, were often irregular and stable only for short periods (<5 s), and had a widespread lateral temporal distribution. Among these a favorable surgical outcome was encountered in patients with seizures having prominent anterior-tip sources (16 of 17 seizure free), whereas those with dominant lateral or oblique sources had a less favorable outcome (three of 14 and 13 of 18, respectively). Irregular, nonlateralized slowing characterized seizure onsets in eight patients. Three patients became seizure free after surgery.Conclusions: Both visual and quantitative sublobar source analysis of scalp ictal EEG can predict surgical outcome in most cases after AMTL and complement non-invasive presurgical evaluation.

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“…A patient with lateralizing ictal and interictal (i.e., concordant) EEG findings was classified as an optimal surgery candidate, whereas the patient with a nonlateralizing or contralatera1 ictal or interictal finding (i.e., discordant) was classified as a suboptimal candidate. Previous studies have suggested that these two groups may have differing base rates of surgery outcome (1 [8][9][10][11][12][13][14][15][16][17][18][19][20]. We recognize that this distinction is crude, and use it only to illustrate the interaction between base rate and predictive utility.…”

Section: Discussionmentioning

confidence: 99%

Contribution of Neuropsychological Data to the Prediction of Temporal Lobe Epilepsy Surgery Outcome

et al. 1998

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Summary: Purpose:We empirically examined the contribution of' neuropsychological data to the prediction of postoperative seizure control relative to base rate information in an existing series of patients undergoing anterior temporal lobectomy (ATL).Methods: A discriminant function predicting surgery outcome (seizure-free vs. non-seizure-free) was computed separately for samples of patients with left (n = 79) and right (n = 62) temporal lobectomy (LATL, RATL). Predictor variables included 14 measures tapping five neurocognitive domains. The predicted base rates were compared with the actual base rates in the two samples. Finally, overall predictive accuracy was examined in optimal versus suboptimal ATL patients.Results: The base rate of seizure freedom in the LATL group was 74.70%; that in the RATL group was 66.10%. The predictive function for the LATL group achieved a hit rate of 80.00% and a positive predictive power of 92.1 1%. The function for the RATL group achieved a hit rate of 83.33% and a positive predictive power (PPP) of 89.66%. The overall predictive accuracy for the optimal group was only 55%, but that in the suboptimal group was 72%.Conclusions: Neuropsychological data used in a multivariate statistical fashion may be able to offer an incremental increase in the prediction of postoperative seizure freedom relative to existing base rates of surgery success in patients with ATL epilepsy. The use of neuropsychological data may be of greatest predictive value in a population of ATL candidates with suboptimal findings with a lower base rate of postoperative seizure freedom, but may actually reduce predictive accuracy in a group of ATL candidates from an optimal population with an already high base rate of surgical success.

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Routine EEG and Temporal Lobe Epilepsy: Relation to Long‐Term EEG Monitoring, Quantitative MRI, and Operative Outcome

Cited by 162 publications

References 22 publications

Effect of Patient Sex on White Matter Alterations in Unilateral Medial Temporal Lobe Epilepsy with Hippocampal Sclerosis Assessed by Diffusion Tensor Imaging

Effect of Patient Sex on White Matter Alterations in Unilateral Medial Temporal Lobe Epilepsy with Hippocampal Sclerosis Assessed by Diffusion Tensor Imaging

Visual and Quantitative Ictal EEG Predictors of Outcome After Temporal Lobectomy

Contribution of Neuropsychological Data to the Prediction of Temporal Lobe Epilepsy Surgery Outcome

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