Document Detail

Interictal rhythmical midline theta differentiates frontal from temporal lobe epilepsies.
MedLine Citation:
PMID:  18801040     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We evaluated the role of interictal rhythmical midline theta (RMT) in the identification of frontal lobe epilepsy (FLE) and its differentiation from temporal lobe epilepsy (TLE) and nonepileptic controls. METHODS: We included 162 individuals in the study: 54 FLE patients, 54 TLE patients, and 54 nonepileptic controls. Continuous electroencephalographic (EEG)-video monitoring was performed in all individuals. Interictal RMT was included only if it occurred during definite awake states. RMT associated with drowsiness or mental activation and ictal RMT was excluded. RESULTS: We identified RMT significantly more frequently in FLE patients (48.1%, 26 of 54) than in TLE patients (3.7%, 2 of 54) (p < 0.01), and not in the control group. The average frequency was 6 Hz (range 5-7 Hz), and the average RMT bursts lasted 8 s (3-12 s). Interestingly, all mesial FLE patients (n = 4) (as established by invasive EEG recordings) showed RMT, whereas this was less frequently the case in the other FLE patients (44%, 22 of 50) (p = 0.03). Thirteen of our 54 patients with FLE (24%) did not have any interictal epileptiform discharges (IEDs), but RMT was observed in the majority of these patients (62%, 8 of 13). CONCLUSION: Interictal RMT is common and has a localizing value in patients with FLE, provided that conditions such as drowsiness and mental activation as confounding factors for RMT are excluded. RMT should be included in the evaluation of patients considered for resective epilepsy surgery.
Pedro Beleza; Ozgür Bilgin; Soheyl Noachtar
Publication Detail:
Type:  Journal Article     Date:  2008-09-17
Journal Detail:
Title:  Epilepsia     Volume:  50     ISSN:  1528-1167     ISO Abbreviation:  Epilepsia     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-25     Completed Date:  2009-04-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  550-5     Citation Subset:  IM    
Epilepsy Center, Department of Neurology, University of Munich, Munich, Germany.
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MeSH Terms
Diagnosis, Differential
Diagnostic Imaging
Dominance, Cerebral / physiology
Epilepsy, Frontal Lobe / diagnosis,  etiology,  physiopathology*,  surgery
Epilepsy, Temporal Lobe / diagnosis,  etiology,  physiopathology*,  surgery
Evoked Potentials / physiology
Frontal Lobe / physiopathology
Hippocampus / physiopathology
Middle Aged
Signal Processing, Computer-Assisted*
Theta Rhythm*
Video Recording*
Young Adult

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

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