| The value of intraoperative electrocorticography in surgical decision making for temporal lobe epilepsy with normal MRI. | |
| | |
MedLine Citation:
|
PMID: 21480886 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: We hypothesized that acute intraoperative electrocorticography (ECoG) might identify a subset of patients with magnetic resonance imaging (MRI)-negative temporal lobe epilepsy (TLE) who could proceed directly to standard anteromesial resection (SAMR), obviating the need for chronic electrode implantation to guide resection. METHODS: Patients with TLE and a normal MRI who underwent acute ECoG prior to chronic electrode recording of ictal onsets were evaluated. Intraoperative interictal spikes were classified as mesial (M), lateral (L), or mesial/lateral (ML). Results of the acute ECoG were correlated with the ictal-onset zone following chronic ECoG. Onsets were also classified as "M,""L," or "ML." Positron emission tomography (PET), scalp-EEG (electroencephalography), and Wada were evaluated as adjuncts. KEY FINDINGS: Sixteen patients fit criteria for inclusion. Outcomes were Engel class I in nine patients, Engel II in two, Engel III in four, and Engel IV in one. Mean postoperative follow-up was 45.2 months. Scalp EEG and PET correlated with ictal onsets in 69% and 64% of patients, respectively. Wada correlated with onsets in 47% of patients. Acute intraoperative ECoG correlated with seizure onsets on chronic ECoG in all 16 patients. All eight patients with "M" pattern ECoG underwent SAMR, and six (75%) experienced Engel class I outcomes. Three of eight patients with "L" or "ML" onsets (38%) had Engel class I outcomes. SIGNIFICANCE: Intraoperative ECoG may be useful in identifying a subset of patients with MRI-negative TLE who will benefit from SAMR without chronic implantation of electrodes. These patients have uniquely mesial interictal spikes and can go on to have improved postoperative seizure-free outcomes. |
| | |
Authors:
|
Neal Luther; Elayna Rubens; Nitin Sethi; Padmaja Kandula; Douglas R Labar; Cynthia Harden; Kenneth Perrine; Paul J Christos; J Bryan Iorgulescu; Guido Lancman; Neil S Schaul; Dmitriy V Kolesnik; Shahin Nouri; Andrew Dawson; Apostolos J Tsiouris; Theodore H Schwartz |
Related Documents
:
|
21474386 - Drug-resistant temporal lobe epilepsy is associated with postural control abnormalities. 3746306 - Optic neuropathy in sarcoidosis. 21456916 - Diffuse hemispheric dysembryoplastic neuroepithelial tumor: a new radiological variant ... 12592046 - Results of anterior chamber clearance via the pars plana in pseudophakic endophthalmitis. 6227856 - Monoclonal antibody-defined peripheral blood t lymphocyte subpopulations in patients wi... 23640556 - Cytogenetic profile of aplastic anaemia in indian children. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural Date: 2011-04-11 |
Journal Detail:
|
Title: Epilepsia Volume: 52 ISSN: 1528-1167 ISO Abbreviation: Epilepsia Publication Date: 2011 May |
Date Detail:
|
Created Date: 2011-05-12 Completed Date: 2011-07-14 Revised Date: 2013-04-15 |
Medline Journal Info:
|
Nlm Unique ID: 2983306R Medline TA: Epilepsia Country: United States |
Other Details:
|
Languages: eng Pagination: 941-8 Citation Subset: IM |
Copyright Information:
|
Wiley Periodicals, Inc. © 2011 International League Against Epilepsy. |
Affiliation:
|
Department of Neurological Surgery, Weill Cornell Medical College, New York, New York 10065, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Decision Making* Electrodes, Implanted Electroencephalography / methods*, statistics & numerical data Epilepsy, Temporal Lobe / diagnosis*, psychology, surgery* Female Humans Magnetic Resonance Imaging / statistics & numerical data* Male Middle Aged Monitoring, Intraoperative / methods* Neurosurgical Procedures / methods*, standards Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
|
UL1 RR024996/RR/NCRR NIH HHS; UL1-RR024996/RR/NCRR NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Cingulate epileptogenesis in hypothalamic hamartoma.
Next Document: Spectrum of phenotypes in female patients with epilepsy due to protocadherin 19 mutations.