Indications and outcome of ictal recording with intracerebral and subdural electrodes in refractory complex partial seizures

Thomas R. Henry, Donald A. Ross, Lori A. Schuh, Ivo Drury

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Intracranial electrophysiologic recording has often been used to localize ictal onset zones in presurgical evaluation of refractory complex partial seizures. Specific indications for intracranial ictal monitoring have not been analyzed in detail, however. The authors designed this study to test the utility of intracranial monitoring in specific indications and considered six specific indications for intracranial monitoring. They compared prospectively determined indications and outcomes of chronic intracerebral and subdural electrophysiologic recording in 50 consecutive patients whose ictal onset zones had been inadequately localized with interictal and ictal EEG using extracranial electrodes, magnetic resonance imaging, interictal[18F]fluorodeoxyglucose positron emission tomography, and neuropsychological testing. In 47 patients ictal onset zones were localized with intracranial recordings, leading to resections in 38 patients. Each indication for intracranial monitoring selected a group in which the majority went on to have efficacious epilepsy surgery (5-year follow-up). Definitive diagnosis of bilateral independent ictal onset zones in temporal lobe epilepsy required intracranial ictal EEG. Intracranial EEG localization supported efficacious resection in most patients, despite contradictory or nonlocalizing extracranial ictal EEG and neuroimaging abnormalities. Critical analysis of these specific indications for intracranial monitoring may be useful in multicenter evaluation of these techniques.

Original languageEnglish (US)
Pages (from-to)426-438
Number of pages13
JournalJournal of Clinical Neurophysiology
Volume16
Issue number5
DOIs
StatePublished - Nov 3 1999

Keywords

  • Complex partial seizures
  • Epilepsy surgery
  • Intracranial EEG
  • Magnetic resonance imaging
  • Positron emission tomography

ASJC Scopus subject areas

  • Physiology
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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