Michael P Malter1, Christina Bahrenberg2, Pitt Niehusmann3, Christian E Elger2, Rainer Surges4. 1. Department of Epileptology, University Hospital of Bonn, Germany; Department of Neurology, University Hospital Cologne, Germany. 2. Department of Epileptology, University Hospital of Bonn, Germany. 3. Department of Neuropathology, University Hospital of Bonn, Germany. 4. Department of Epileptology, University Hospital of Bonn, Germany. Electronic address: rainer.surges@ukb.uni-bonn.de.
Abstract
OBJECTIVE: To investigate determining factors of the ictal scalp EEG pattern at seizure onset and its predictive value for postsurgical outcome in people with unilateral MTLE due to hippocampal sclerosis (MTLE-HS). METHODS: Review of consecutive people with chronic MTLE-HS undergoing presurgical video-EEG telemetry. Exclusion criteria were additional epileptogenic lesions or seizure generators or compromised EEG traces at seizure-onset. Mixed linear or logistic regression models were used. RESULTS: Inclusion of 63 patients with 219 seizures with a favorable outcome (no seizures or auras only) in 43 patients at last follow-up. Rhythmic activity at seizure-onset (RA) had a frequency of 4.7±1.5/s (range 1-8/s), mostly localized in the anterior temporal region. Postsurgical seizure outcome was not associated with any clinical or electrophysiological feature. RA in the delta-band was more often observed with shorter epilepsy duration (p=0.002). CONCLUSIONS: RA on scalp EEG gets faster with increasing epilepsy duration, possibly via time-dependent alterations of epileptogenic networks. Neither the frequency of RA nor other EEG-features appeared to predict postsurgical seizure outcome. SIGNIFICANCE: The results challenge the view that if patients with apparent MTLE display RA in the delta-band, seizure-onset in neocortical structures rather than in temporo-mesial tissue should be considered and further investigations should be prompted.
OBJECTIVE: To investigate determining factors of the ictal scalp EEG pattern at seizure onset and its predictive value for postsurgical outcome in people with unilateral MTLE due to hippocampal sclerosis (MTLE-HS). METHODS: Review of consecutive people with chronic MTLE-HS undergoing presurgical video-EEG telemetry. Exclusion criteria were additional epileptogenic lesions or seizure generators or compromised EEG traces at seizure-onset. Mixed linear or logistic regression models were used. RESULTS: Inclusion of 63 patients with 219 seizures with a favorable outcome (no seizures or auras only) in 43 patients at last follow-up. Rhythmic activity at seizure-onset (RA) had a frequency of 4.7±1.5/s (range 1-8/s), mostly localized in the anterior temporal region. Postsurgical seizure outcome was not associated with any clinical or electrophysiological feature. RA in the delta-band was more often observed with shorter epilepsy duration (p=0.002). CONCLUSIONS:RA on scalp EEG gets faster with increasing epilepsy duration, possibly via time-dependent alterations of epileptogenic networks. Neither the frequency of RA nor other EEG-features appeared to predict postsurgical seizure outcome. SIGNIFICANCE: The results challenge the view that if patients with apparent MTLE display RA in the delta-band, seizure-onset in neocortical structures rather than in temporo-mesial tissue should be considered and further investigations should be prompted.
Authors: Raquel A Do Val-da Silva; Jose E Peixoto-Santos; Ludmyla Kandratavicius; Jana B De Ross; Ingrid Esteves; Bruno S De Martinis; Marcela N R Alves; Renata C Scandiuzzi; Jaime E C Hallak; Antonio W Zuardi; Jose A Crippa; Joao P Leite Journal: Front Pharmacol Date: 2017-03-17 Impact factor: 5.810
Authors: Shasha Wu; Naoum P Issa; Maureen Lacy; David Satzer; Sandra L Rose; Carina W Yang; John M Collins; Xi Liu; Taixin Sun; Vernon L Towle; Douglas R Nordli; Peter C Warnke; James X Tao Journal: Front Neurol Date: 2021-05-17 Impact factor: 4.003