Diagnostic Value of Interictal and Ictal Epileptiform Discharges on Scalp EEG in Partial Epilepsy Patients with Good Surgical Outcome.
Abstract number :
1.080
Submission category :
Year :
2001
Submission ID :
945
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
D.W. Seo, M.D., Neurology, Samsung Medical Center, Seoul, Republic of Korea; S.B. Hong, M.D., Neurology, Samsung Medical Center, Seoul, Republic of Korea; S.C. Hong, M.D., Neurosurgery, Samsung Medical Center, Seoul, Republic of Korea; Y.M. Shon, M.D., Ne
RATIONALE: Epileptiform discharges (ED) of partial seizures as recorded from video-scalp EEG monitoring can give initial information of epileptogenic focus in presurgical evaluation of localization-related epilepsies. The accuracy had been reported based on depth or imaging studies. We evaluated diagnostic value of ictal (IC) and interictal (INIC) scalp EEG based on surgical outcome.
METHODS: We included 186 epilepsy patients with good surgical outcome according to modified Engel[ssquote]s classification. Video-scalp EEG monitoring was performed in all the patients. Based on presurgical evaluation and resected region, we determined epilepsy syndrome [frontal lobe epilepsy (FLE) : 16, temporal lobe epilepsy (TLE) : 147, parietal lobe epilepsy (PLE) : 10, occipital lobe epilepsy (OLE) : 5, combined lobe epilepsy (CLE) : 8]. We evaluated the localizaton of interictal epileptiform discharges which were more than 10% in frequency. And lateralization and localization of ictal EEG at ictal onset were analyzed too.
RESULTS: The localization of INIC ED was correct in 31% of FLE, 67% of TLE, 50% of PLE, 40% of OLE, 62.8% of CLE patients but false localization of them was in 3% of TLE, 20% of OLE. No INIC ED were observed in 38% of FLE, 10% of TLE, 40% of PLE, 40% of OLE. The lateralization of INIC ED was right in 31.3% of FLE, in 70.0% of TLE, in 50.0% of PLE, in 60.0% of OLE, in 87.5% of CLE. The localization of IC ED was correct in 56% of FLE, 49% of TLE, 60% of PLE, 60% of OLE, 38% of CLE but false localization of them was 6% of FLE, 15% of TLE, 20% of PLE, 0% of OLE, 13% of CLE. The lateralization of IC ED was correct in 63% of FLE, 74% of TLE, 70% of PLE, 100% of OLE, 62.5% of CLE, while no lateralization of them was in 25% of FLE, in 12% of TLE, 18% of PLE, 0% of OLE, 13% of CLE and bilateral independent lateralization of them was in 10% of TLE.
CONCLUSIONS: The INIC ED is less frequently detected in extra-TLE than in TLE. localization of INIC ED is worse than that of IC ED in extra-TLE while better in TLE and CLE. Compared with lateralizing power of INIC ED, that of IC ED is more enhanced in extra-TLE (especially in OLE) than in TLE. The information of INIC and IC ED should be considered depending on the epilepsy syndrome.