The role of the interictal EEG in selecting candidates for resective epilepsy surgery

Dworetzky, Barbara A.; Reinsberger, Claus

doi:10.1016/j.yebeh.2010.08.025

Cited by 30 publications

(15 citation statements)

References 83 publications

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“…Notably, an increase in IEDs rate can occur after seizures but with a more extensive spatial distribution (Gotman & Koffler 1989;. Moreover, IEDs can be falsely localized in some patients and have often a wider projection on scalp than the epileptogenic zone (Dworetzky and Reinsberger, 2011).…”

Section: Interictal Recording In Focal Epilepsiesmentioning

confidence: 99%

Focal epilepsies and focal disorders

Lagarde¹,

Bartolomei²

2019

Handbook of Clinical Neurology

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Electroencephalographic (EEG) investigations are crucial in the diagnosis and management of patients with focal epilepsies. EEG may reveal different interictal epileptiform discharges (IED: spikes, sharp waves). The EEG visibility of spike depends on the surface area of cortex involved (>10cm 2) and the brain localisation of cortical generators. Regions generating IED (defining the "irritative zone") are not necessarily equivalent to the seizure onset zone. Focal seizures are dynamic processes originating from one or several brain regions (generating fast oscillations and called "epileptogenic zone") before to spread to other structures (generating lower frequency oscillations and called "propagation zone"). Several factors limit the expression of seizures on scalp EEG, such as area involved, degree of synchronization and depth of the cortical generators. Different scalp EEG seizure onset patterns may be observed: fast discharge, background flattening, rhythmic spikes, sinusoidal discharge, or sharp activity but to a large extent EEG changes are linked to seizure propagation. Finally, in the context of presurgical evaluation, the combination of interictal and ictal EEG features is crucial to provide optimal hypothesis about the epileptogenic zone.

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Section: Interictal Recording In Focal Epilepsiesmentioning

confidence: 99%

Focal epilepsies and focal disorders

Lagarde¹,

Bartolomei²

2019

Handbook of Clinical Neurology

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“…In such cases, presurgical identification of unilateral hippocampal atrophy together with the appropriate interictal epileptiform discharges on EEG yields 94 % positive outcome after epilepsy surgery [27]. The predictive value of the standard EEG alone on surgery outcomes is hard to establish, however, lateralized IEDs on standard EEG have a high predictive value for the correct identification of epileptogenic sites and is associated with 1-year seizure freedom after surgery [11,12]. Persistent focal slowing in TLEs has a very high sensitivity to correct identification of the temporal origin of seizures [8].…”

Section: Discussionmentioning

confidence: 99%

Perspectives of epilepsy surgery in resource-poor countries: a study in Georgia

Kasradze¹,

Alkhidze

Lomidze³

et al. 2015

Acta Neurochir

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“…[9] Epilepsi cerrahisinin başarı oranları epileptojenik odağı be- Literatürde de epilepsi cerrahisi adayı olan hastalarda benzer bir araştırma şeması önerilmektedir. [10,11] İnteriktal EEG epileptojenik odağı %80.9 oranında lokalize edebilirken, VEM'de en az üç özgün nöbet gözlenmesi son- [12] Bunun nedeninin de VEM sonuçları ile epileptojenik odağı tespit edilemeyen hasta sayısının az olmasına bağlı olduğu değerlendirilmiştir.…”

Section: Discussionunclassified

Clinical Spectrum, Seizure Outcomes, Correlation of Neuroradiology and Neuropathology, in Surgically Treated Epileptic Patients

Uysal¹,

Eroğlu²,

Erdoğan³

et al. 2013

Epilepsi

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SummaryObjectives: We aimed to investigate seizure outcomes, factors affecting these outcomes and predictive value of presurgical tests for surgical decision-making and postoperative seizure counts in patients with temporal lobe seizures. Methods: In the study, data from 47 patients (25 female, 22 male), operated for temporal lobe epilepsy between the years 1999-2010 and with at least 2 years of regular follow-were evaluated retrospectively. Patients demographic information, preoperative tests for suitability for surgery and seizure outcomes were evaluated. Results: The percentage of success in localization and lateralization of the epileptic focus was 88.6% for video EEG monitoring (VEM), 85.1% for magnetic resonance imaging (MRI) and 63.3% for positron emission tomography (PET). The rates of being seizure free for 2 years after surgery was 85.7% for patients with presurgical compatible VEM, MRI and PET results for epileptic focus, 72.7% for patients with only two of presurgical compatible results and 50% for patients with only 1 compatible result (p=0.314). 75.8% Engel Class 1 outcomes in mesial temporal sclerosis group, 92.3% in mass group were observed in second year outcomes after surgery. Conclusion:Epilepsy surgery provides high rates of probability of being seizure-free and an increase in quality of life in selected patients.Key words: Epilepsy surgery; MRI; PET; VEM. ÖzetAmaç: Temporal lob cerrahisi uygulanmış olan hastalarda nöbet sonuçlarını, cerrahi öncesi uygulanan testlerin cerrahi kararı vermede ve cerrahi sonrası nöbet sayılarını öngörmede değerleri olup olmadığı araştırıldı. Gereç ve Yöntem:1999-2010 yılları arasında epilepsi cerrahisi grubu tarafından cerrahi kararı verilen, cerrahi sonrasında da kliniğimizde en az iki yıl düzenli takipleri yapılmış 47 hasta (25 kadın, 22 erkek) geriye dönük olarak incelendi. Hastaların demografik bilgileri, cerrahi öncesi yapılan testler ve cerrahi sonrası nöbet sonuçları değerlendirildi. Bulgular: Epileptik odağı lateralize ve lokalize edebilme oranları video EEG monitörizasyon (VEM) ile %88.6, manyetik rezonans görüntüleme (MRG) ile %85.1, pozitron emisyon tomografi (PET) ile %63.3 olarak saptandı. Cerrahi öncesi her üç incelemenin epileptik odak ile uyumlu olduğu olgularda cerrahi sonrası ikinci yıl nöbetsizlik oranı %85.7 Engel 1 iken, iki incelemenin uyumlu olduğu olgularda %72.7, bir incelemenin uyumlu olduğu olgularda %50'dir (p=0.314). Cerrahi sonrası meziyal temporal skleroz grubunda %75.8, kitle grubunda ise %92.3 oranında Engel 1 ikinci yıl nöbet sonuçları tespit edildi. Sonuç:Epilepsi cerrahisi iyi seçilmiş hastalarda yüksek oranlarda nöbetsizlik, yaşam kalitesinde artma sağlamaktadır.

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The role of the interictal EEG in selecting candidates for resective epilepsy surgery

Cited by 30 publications

References 83 publications

Focal epilepsies and focal disorders

Focal epilepsies and focal disorders

Perspectives of epilepsy surgery in resource-poor countries: a study in Georgia

Clinical Spectrum, Seizure Outcomes, Correlation of Neuroradiology and Neuropathology, in Surgically Treated Epileptic Patients

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