Document Detail

Ictal scalp EEG findings in patients with mesial temporal lobe epilepsy.
MedLine Citation:
PMID:  18318415     Owner:  NLM     Status:  MEDLINE    
The syndrome of mesial temporal lobe epilepsy (MTLE) is a well-defined clinical entity that responds to surgical treatment in a considerable number of patients. Although it has been subjected to intensive clinical research, few investigators have published the ictal scalp EEG findings and looked for specific features that might predict postoperative outcome. This study was designed to examine ictal scalp EEG characteristics in detail, in a group of patients with pathologically confirmed hippocampal sclerosis (HS). Patients who underwent long-term video-EEG monitoring at our center during a 3-year period and were diagnosed to have MTLE and pathologically proven HS were included in this retrospective study. All ictal scalp EEGs were investigated in a common reference montage, paying attention to the localization, morphology and frequency of ictal discharges that were accepted to represent a specific phase if the findings were sustained for at least 3 seconds. Any significant change in localization, morphology or frequency of discharges was said to represent a different phase. The ictal EEG patterns in different phases were later compared among seizures of different patients. In addition, the ictal EEG characteristics of the patients in Group I (Engel's classification) were compared with the ictal EEG findings in patients who were included in another group. All the patients have been followed for more than 5 years. Seventy-one ictal EEGs were investigated in 25 adult patients (11 M, 14 F). Onset patterns were lateralized in 81.7% and localized in 76% of the seizures. Thirteen different patterns of onset were detected, the most common of which was the cessation of interictal discharges (35.2%). The most common ictal pattern following the initial changes was ipsilateral temporal rhythmic theta-delta activity (85.2%) that occurred on the average 13.4 seconds after onset. Nonlocalized/lateralized seizure onset of all the seizures or bilateral independent onset was present in 75% of the patients in Groups II-III, whereas this ratio was 14.3% in the patients in Group I (p=0.031). In conclusion, ictal scalp EEG in MTLE allows correct lateralization and localization in most of the seizures. Onset patterns may vary considerably; however, a later significant pattern consisting of rhythmic ipsilateral temporal build-up develops in the majority of seizures. Some ictal EEG characteristics may be related to post-operative outcome.
Nese Dericioglu; Serap Saygi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical EEG and neuroscience     Volume:  39     ISSN:  1550-0594     ISO Abbreviation:  Clin EEG Neurosci     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-03-05     Completed Date:  2008-04-10     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  101213033     Medline TA:  Clin EEG Neurosci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  20-7     Citation Subset:  IM    
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MeSH Terms
Epilepsy, Temporal Lobe / physiopathology*,  surgery
Magnetic Resonance Imaging
Video Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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