TY - JOUR
T1 - Ictal spiking patterns recorded from temporal depth electrodes predict good outcome after anterior temporal lobectomy
AU - Schuh, Lori A.
AU - Henry, Thomas R.
AU - Ross, Donald A.
AU - Smith, Brien J.
AU - Elisevich, Kost
AU - Drury, Ivo
PY - 2000
Y1 - 2000
N2 - Purpose: Investigators have shown that the presence of ictal spiking (IS) recorded from temporal depth electrodes is associated with mesial temporal sclerosis (MTS). We investigated the relation of IS to seizure control and pathology after anterior temporal lobectomy (ATL). Methods: All patients undergoing intracranial ictal monitoring from a single institution since 1989 were identified. Those who did not undergo ATL or had postoperative follow-up of <1 year were excluded. All received at a minimum bilateral temporal depth electrodes. Ictal recordings were reviewed for the presence of IS, and the proportion of seizures with IS was determined for each patient. Outcome was determined by using Engel's classification. Surgical specimens were reviewed for pathology. Statistics used were χ2, Fisher exact test, and Wilcoxon rank sum. Results: Forty patients with 571 seizures were reviewed. In 292 seizures from 32 patients, IS was seen. Outcomes were 24 class I (22 with IS), five class II (four with IS), three class III (one with IS), seven class IV (four with IS), and one lost to follow-up (with IS). Pathologic review revealed 25 with MTS, 22 of whom had IS. The presence of IS was associated with class I outcomes (p = 0.04), but not MTS (p = 0.06). Patients with class I outcomes had a significantly greater proportion of seizures with IS (mean, 0.58 ± 0.3) compared with other outcomes (mean, 0.30 ± 0.3, p = 0.02). Conclusions: The presence of IS and higher proportion of seizures with IS correlated with good seizure outcome after ATL. This information may be used in preoperative counseling.
AB - Purpose: Investigators have shown that the presence of ictal spiking (IS) recorded from temporal depth electrodes is associated with mesial temporal sclerosis (MTS). We investigated the relation of IS to seizure control and pathology after anterior temporal lobectomy (ATL). Methods: All patients undergoing intracranial ictal monitoring from a single institution since 1989 were identified. Those who did not undergo ATL or had postoperative follow-up of <1 year were excluded. All received at a minimum bilateral temporal depth electrodes. Ictal recordings were reviewed for the presence of IS, and the proportion of seizures with IS was determined for each patient. Outcome was determined by using Engel's classification. Surgical specimens were reviewed for pathology. Statistics used were χ2, Fisher exact test, and Wilcoxon rank sum. Results: Forty patients with 571 seizures were reviewed. In 292 seizures from 32 patients, IS was seen. Outcomes were 24 class I (22 with IS), five class II (four with IS), three class III (one with IS), seven class IV (four with IS), and one lost to follow-up (with IS). Pathologic review revealed 25 with MTS, 22 of whom had IS. The presence of IS was associated with class I outcomes (p = 0.04), but not MTS (p = 0.06). Patients with class I outcomes had a significantly greater proportion of seizures with IS (mean, 0.58 ± 0.3) compared with other outcomes (mean, 0.30 ± 0.3, p = 0.02). Conclusions: The presence of IS and higher proportion of seizures with IS correlated with good seizure outcome after ATL. This information may be used in preoperative counseling.
KW - EEG
KW - Implanted electrodes
KW - Mesial temporal sclerosis
KW - Seizure outcome
KW - Temporal lobe epilepsy
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U2 - 10.1111/j.1528-1157.2000.tb00161.x
DO - 10.1111/j.1528-1157.2000.tb00161.x
M3 - Article
C2 - 10714403
AN - SCOPUS:0034104056
SN - 0013-9580
VL - 41
SP - 316
EP - 319
JO - Epilepsia
JF - Epilepsia
IS - 3
ER -