Ictal EEG wave forms from epidural electrodes predictive of seizure control after temporal lobectomy

Faught, Edward; Kuzniecky, Ruben; Hurst, David C.

doi:10.1016/0013-4694(92)90116-y

Cited by 59 publications

(42 citation statements)

References 13 publications

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“…Two studies with mesial TLE patients and one study on patients with mixed topographies found that focal onsets were associated with LFRS and regional onsets with LVFA. Although one study found that an ED pattern was associated with regional or hemispheric onsets (75%), Faught et al . found this pattern in a localized or regional distribution in a patients with mTLE.…”

Section: Resultsmentioning

confidence: 95%

“…also showed that if an ED was part of the IOP in conjunction with LVFA, the seizure freedom rate was 45% as compared to 70% with LVFA alone. However, two other studies reported better outcomes with ED . Although these authors did not include ED in formal analyses of surgical outcomes, 57% of all their patients became seizure‐free .…”

Section: Resultsmentioning

confidence: 99%

“…LVFA was most frequently reported in neocortical epilepsy, both temporal and extratemporal (n = 9) . One study demonstrated that LVFA in the beta frequency range was associated with neocortical temporal epilepsy, whereas LVFA within the gamma frequency range was associated with extratemporal epilepsy …”

Section: Resultsmentioning

confidence: 99%

“…Of interest, all studies evaluating mesial temporal epilepsy that used depth electrodes found LFRS as a prominent IOP, except one that used epidural electrodes . This may suggest that LFRS is an IOP better detected by depth electrodes.…”

Section: Discussionmentioning

confidence: 99%

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Ictal onset on intracranial EEG: Do we know it when we see it? State of the evidence

2015

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SUMMARYObjective: A major limitation of intracranial electroencephalography (iEEG) is recording from a confined region. This may falsely localize seizure onset if the distinction between ictal onset zone, proximity, and spread is unclear, or if the ictal rhythm is not clearly identified. Delineation of the ictal onset zone is crucial for surgical success. We appraised the evidence to determine whether specific iEEG ictal patterns are associated with the ictal onset zone. Methods: We searched Embase for articles in English until September 30, 2014, with MeSH keywords related to intracranially implanted electrodes and seizures. Two authors independently screened abstracts, reviewed full text articles, and abstracted data. The association between seizure outcome and type of ictal onset pattern (IOP), and its extent, location, and spread were explored visually or by univariate analysis when sufficient data were provided. Methodologic quality of each study was assessed. Results: We reviewed 1,987 abstracts from which 21 articles were analyzed. Fifteen IOPs were reported. Low frequency high amplitude repetitive spiking (LFRS) was the most frequently reported IOP by studies that dealt with mesial temporal lobe epilepsy (mTLE) and investigated with depth electrodes. In neocortical epilepsy, low voltage fast activity (LVFA) was the most commonly described IOP. Delta activity was an infrequently reported IOP and was described mostly as a spread pattern. Significance: LFRS is associated with good surgical outcome in mTLE and has a strong relation with mesial temporal pathology and its severity. LVFA is associated with neocortical temporal epilepsy and focal LVFA is associated with better surgical outcome. Electrodecrement may be associated with regional or widespread onsets. Rhythmic delta is a propagation rhythm rather than an IOP. Focal IOPs and slower propagation times are associated with better outcomes. The quality of the studies is suboptimal and there are methodological problems. Interobserver agreement is poorly documented.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ictal onset on intracranial EEG: Do we know it when we see it? State of the evidence

2015

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“…Indirect support for this hypothesis comes from several studies of mainly temporal lobe epilepsy surgery indicating that low-voltage fast activity at seizure onset was associated with good surgical outcome [31, 52–55]. In contrast, slower-frequency diffuse activity at ictal onset may suggest a propagated electrographic pattern [52, 56]. …”

Section: Discussionmentioning

confidence: 99%

Scalp and Intracranial EEG in Medically Intractable Extratemporal Epilepsy with Normal MRI

Zakaria

Noe

et al. 2012

ISRN Neurology

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.Purpose. To investigate EEG and SPECT in the surgical outcome of patients with normal MRI (nonlesional) and extratemporal lobe epilepsy. Methods. We retrospectively identified 41 consecutive patients with nonlesional extratemporal epilepsy who underwent epilepsy surgery between 1997 and 2007. The history, noninvasive diagnostic studies (scalp EEG, MRI, and SPECT) and intracranial EEG (iEEG) monitoring was reviewed. Scalp and iEEG ictal onset patterns were defined. The association of preoperative studies and postoperative seizure freedom was analyzed using Kaplan-Meier analysis, log-rank test, and Cox proportional hazard. Results. Thirty-six of 41 patients had adequate information with a minimum of 1-year followup. Favorable surgical outcome was identified in 49% of patients at 1 year, and 35% at 4-year. On scalp EEG, an ictal onset pattern consisting of focal beta-frequency discharge (>13-125 Hz) was associated with favorable surgical outcome (P = 0.02). Similarly, a focal fast-frequency oscillation (>13-125 Hz) on iEEG at ictal onset was associated with favorable outcome (P = 0.03). Discussion. A focal fast-frequency discharge at ictal onset identifies nonlesional MRI, extratemporal epilepsy patients likely to have a favorable outcome after resective epilepsy surgery.

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Surgical outcome and prognostic factors of cryptogenic neocortical epilepsy

Lee

Kim

et al. 2005

Annals of Neurology

273

203

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Surgical treatment of cryptogenic neocortical epilepsy is challenging. The aim of this study was to evaluate surgical outcomes and to identify possible prognostic factors including the results of various diagnostic tools. Eighty-nine patients with neocortical epilepsy with normal magnetic resonance imaging (35 patients with frontal lobe epilepsy, 31 with neocortical temporal lobe epilepsy, 11 with occipital lobe epilepsy, 11 with parietal lobe epilepsy, and 1 with multifocal epilepsy) underwent invasive study and focal surgical resection. Patients were observed for at least 2 years after surgery. The localizing values of interictal electroencephalogram (EEG), ictal scalp EEG, interictal 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and subtraction ictal single-photon emission computed tomography were evaluated. Seventy-one patients (80.0%) had a good surgical outcome (Engel class 1-3); 42 patients were seizure free. Diagnostic sensitivities of interictal EEG, ictal scalp EEG, FDG-PET, and subtraction ictal single-photon emission computed tomography were 37.1%, 70.8%, 44.3%, and 41.1%, respectively. Localization by FDG-PET and interictal EEG was correlated with a seizure-free outcome. The localizing value of FDG-PET was greatest in neocortical temporal lobe epilepsy. The focalization of ictal onset and also ictal onset frequency in invasive studies were not related to surgical outcome. Concordance with two or more presurgical evaluations was significantly related to a seizure-free outcome.

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Ictal EEG wave forms from epidural electrodes predictive of seizure control after temporal lobectomy

Cited by 59 publications

References 13 publications

Ictal onset on intracranial EEG: Do we know it when we see it? State of the evidence

Ictal onset on intracranial EEG: Do we know it when we see it? State of the evidence

Scalp and Intracranial EEG in Medically Intractable Extratemporal Epilepsy with Normal MRI

Surgical outcome and prognostic factors of cryptogenic neocortical epilepsy

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