Document Detail


Lateralising value of neuropsychological protocols for presurgical assessment of temporal lobe epilepsy.
MedLine Citation:
PMID:  12614397     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To estimate the value of neuropsychological measurements in determining the side of seizure onset for presurgical assessment in patients with temporal lobe epilepsy. The lateralising value of neuropsychological protocols was evaluated for all patients and in subpopulations depending on surgical outcome with regard to seizure control, speech dominance, neuropathology, and need for intracranial EEG recordings. METHODS: A battery of neuropsychological procedures was carried out preoperatively in 125 patients who underwent left (n = 66) or right (n = 59) temporal lobectomies. Binary logistic regression analysis was performed to find sets of variables that allowed the best prediction of the side of seizure onset (assumed to be the operated-on side). RESULTS: Combinations of noninvasive neuropsychological tests and Wada subscores showed the highest lateralising values: 80.8% for all patients, 79.4% in seizure-free patients, 86.0% in patients not rendered seizure free, 85.7% in left speech patients, 77.8% in non-left speech patients, 89.3% in patients with mesial temporal sclerosis (MTS), 78.1% in non-MTS patients, 80.3% in patients who underwent intracranial EEG recordings, and 77.3% in those who did not. CONCLUSIONS: The lateralising value (80-90%) of neuropsychological protocols appears similar to that of other tests widely accepted for lateralisation (ictal and interictal scalp EEG and neuroimaging). Attention should be paid to neuropsychological results, particularly from the Wada test, during presurgical assessment of temporal lobe epilepsy, as they can provide strong support for findings from other lateralising tests, particularly in patients with presumed MTS or in left-speech patients.
Authors:
Nozomi Akanuma; Gonzalo Alarcón; Francis Lum; Najib Kissani; Michael Koutroumanidis; Naoto Adachi; Colin D Binnie; Charles E Polkey; Robin G Morris
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Epilepsia     Volume:  44     ISSN:  0013-9580     ISO Abbreviation:  Epilepsia     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-04     Completed Date:  2003-06-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  United States    
Other Details:
Languages:  eng     Pagination:  408-18     Citation Subset:  IM    
Affiliation:
Division of Neuroscience, Guy's, King's, and St Thomas' School of Medicine, King's College London, London, England.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amobarbital / diagnostic use
Brain Mapping / methods
Cognition Disorders / diagnosis
Electrodes, Implanted
Electroencephalography / methods
Epilepsy, Temporal Lobe / diagnosis*,  surgery*
Female
Functional Laterality* / drug effects,  physiology
Humans
Logistic Models
Magnetic Resonance Imaging
Male
Neuropsychological Tests* / statistics & numerical data
Preoperative Care / methods*
Speech / physiology
Tomography, X-Ray Computed
Treatment Outcome
Videotape Recording
Chemical
Reg. No./Substance:
57-43-2/Amobarbital
Comments/Corrections
Erratum In:
Epilepsia. 2003 Jul;44(7):990

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


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