Stereo-EEG and Surgery in Partial Epilepsy with Temporo-Parieto-Occipital Foci

Marossero, F; Cabrini, G; Ettorre, G; Ravagnati, L.; Sironi, V. A.; Miserocchi, Giuseppe; Motti, Enrico

doi:10.1007/978-3-7091-8592-6_13

Cited by 6 publications

(5 citation statements)

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“…The presence of interictal or ictal epileptic abnormalities in TL structures in patients with seizures of confirmed or suspected OL origin and the low yield of localizing information provided by extracranial EEG ictal recordings in such patients (Gastaut, 1958;Bancaud, 1969;Takeda et al, 1969;Ludwig and Ajmone-Marsan, 1975;Marossero et al, 1980;Olivier et al, 1982;Williamson and Spencer, 1986) was confirmed by our study.…”

Section: Discussionsupporting

confidence: 78%

“…Elementary visual hallucinations have been widely recognized as indicative of ictal onset in the calcarine cortex. They were observed in spontaneous seizures (Russell and Whitty, 1955;Ludwig and Ajmone-Marsan, 1975;Marossero et al, 1980;Williamson and Spencer, 1986) as well as with electrical stimulation of the occipital cortex (Penfield and Jasper, 1954;Takeda et al, 1969). They usually take the form of phosphenes, manifested as white, black, or colored spots; may be stationary, moving, or intermittent; and may be present in one or, less commonly, both visual fields.…”

Section: Discussionmentioning

confidence: 99%

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Occipitotemporal Epilepsies: Evaluation of Selected Patients Requiring Depth Electrodes Studies and Rationale for Surgical Approaches

et al. 1993

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In 8 patients in whom it was uncertain whether they had occipital or temporal lobe (TL) epilepsy, clinical, scalp EEG, and radiologic features were correlated with the sites of seizure onset as determined by depth EEG. The 8 patients were selected from > 40 with occipital epilepsy because they had (a) an aura considered to be of occipital lobe (OL) origin, (b) an occipital interictal epileptic focus, (c) an OL lesion, or (d) a combination of all of these. Scalp EEG and clinical patterns suggested temporal involvement in all, however. Extracranial EEG recordings were often misleading, showing multilobar interictal epileptic abnormalities, and seizure onset was of poor localizing value and did not clarify the problem sufficiently. Intracranial EEG recordings showed that seizure onset could be ordered along an occipitotemporal gradient. Consistent OL seizure onset was observed in patients who had only elementary visual auras. Those who had inconsistent aura or no aura, suggesting OL origin, had onset of most attacks in the TL. All patients had a seizure spread pattern suggesting early TL involvement. To prevent visual field defect, surgical approaches included temporal resection when temporal seizure origin or spread was demonstrated; although occasionally this produced excellent results, it was of limited benefit in most patients, even when some seizures were proven to originate in TL structures. In patients with malignant epilepsy and in those with an occipital lesion, occipital resection should be considered.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Occipitotemporal Epilepsies: Evaluation of Selected Patients Requiring Depth Electrodes Studies and Rationale for Surgical Approaches

et al. 1993

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“…Children as weil as adults may benefit from epilepsy surgery (4,7,8,11,12,13,15,16,23,29,34,35,37,46) but in children the presurgical evaluation has less often included invasive electroencephalography (EEG) and functionallocalization studies. In most series, epilepsy surgery in children and adolescents was planned from results of extraoperative scalp EEG (4,7,8,15,16,23,34,35) or intraoperative electrocorticography (13,30,37,46) and few reports of younger patients have emphasized extraoperative invasive EEG and cortical electrical stimulation (11,12).…”

Section: Introductionmentioning

confidence: 99%

“…In most series, epilepsy surgery in children and adolescents was planned from results of extraoperative scalp EEG (4,7,8,15,16,23,34,35) or intraoperative electrocorticography (13,30,37,46) and few reports of younger patients have emphasized extraoperative invasive EEG and cortical electrical stimulation (11,12). This contrasts with the more widespread use of invasive pre-resection EEG techniques in adults (1,3,5,6,9,10,17,21,22,24,29,36,39,41,42,44,45,47). This apparent difference in approach to the presurgical evaluation, based on age, has not been examined.…”

Section: Introductionmentioning

confidence: 99%

Subdural Electrodes in the Evaluation for Epilepsy Surgery in Children and Adults

et al. 1988

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To evaluate the utility and safety of chronic extraoperative subdural EEG and functional localization studies in children compared to adults, we studied 61 patients each of whom had similar evaluations for epilepsy surgery, regardless of age. The 23 children and adolescents (3 to 18 years old) and the 38 adults (20 to 41 years old) each had several days and nights of extraoperative EEG from scalp and chronically-implanted subdural electrodes, and the same percentage of children and adults also had functional localization studies including cortical electrical stimulation. The methods and results of these studies and of the subsequent resections did not differ between the two groups, and they both had similar rate of complications and similar incidence of good outcome. The subdural technique was as effective and well-tolerated in children and adolescents as in adults. Other invasive EEG techniques have not yet been systematically compared between children and adults, but the subdural technique, at least, appears to be suitable for patients over a wide age range.

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“…The concept of T+E is not new and since a number of decades, observations made by means of intracerebral recordings have shown that an epileptogenic zone could be distributed between distinct (but interconnected) regions of different lobes of one hemisphere, thus leading to the concept of frontotemporal [29][30][31][32], temporoperisylvian [5,33,34] and temporo-parieto-occipital epilepsies [35][36][37][38].…”

Section: Temporal Plus Epilepsy: An 'Observational' Conceptmentioning

confidence: 99%