Document Detail


Prognostic significance of interictal epileptiform discharges after epilepsy surgery.
MedLine Citation:
PMID:  20634715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prognostic significance of interictal epileptiform discharges (IED) after epilepsy surgery is uncertain. We reviewed 20 studies (including 2 unpublished data sets) to assess the usefulness of postoperative EEG findings in predicting seizure outcome after resective epilepsy surgery. Patient selection and methodology varied widely among the studies. The published studies included 1,345 patients (temporal resection, n = 751; extratemporal resection, n = 373; unspecified site, n = 221). We defined a favorable outcome as a postoperative seizure status of Engel class I or equivalent. The frequency of postoperative IED ranged from 13% to 68% (mean, 31.5%). Postoperative IED were strongly associated with an unfavorable seizure outcome for the whole cohort (odds ratio, 3.3; 95% confidence interval, 2.5-4.5), for the subgroup of patients who underwent temporal resection (odds ratio, 2.5; 95% confidence interval, 1.6-4.0), and for the extratemporal resection subgroup (odds ratio, 5.6; 95% confidence interval, 3.9-9.3). Postoperative IED had a modest positive predictive value (52%) but an excellent negative predictive value (71%) for unfavorable seizure outcome. Most IED (>90%) were localized to the site of resection and were also influenced by preoperative spike frequency and completeness of resection. Insufficient data preclude any firm conclusions about the value of postoperative IED in predicting seizure outcomes after hemispherotomy or corpus callosotomy.
Authors:
Chaturbhuj Rathore; Kurupath Radhakrishnan
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society     Volume:  27     ISSN:  1537-1603     ISO Abbreviation:  J Clin Neurophysiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-04     Completed Date:  2010-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506708     Medline TA:  J Clin Neurophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  255-62     Citation Subset:  IM    
Affiliation:
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Brain / physiopathology,  surgery*
Brain Waves*
Child
Corpus Callosum / surgery
Electroencephalography
Epilepsy / diagnosis*,  physiopathology,  surgery*
Hemispherectomy
Humans
Neurosurgical Procedures* / adverse effects
Odds Ratio
Predictive Value of Tests
Prognosis
Recurrence
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Young Adult

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


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