Shuang Wang1, Norman K So2, Bo Jin3, Irene Z Wang4, Juan C Bulacio4, Rei Enatsu4, Shenyi Dai5, Zhong Chen3, Jorge Gonzalez-Martinez4, Imad M Najm4. 1. Department of Neurology, Epilepsy Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, China; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: Shuangwang1977@gmail.com. 2. Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Neurology, University of Washington Medical Center, Seattle, WA, USA. 3. Department of Neurology, Epilepsy Center, Second Affiliated Hospital, Zhejiang University, Hangzhou, China. 4. Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA. 5. College of Economics and Management, China Jiliang University, China.
Abstract
OBJECTIVE: This study aimed to identify the subtype of interictal ripples that help delineate the epileptogenic zone in neocortical epilepsy. METHODS: Totally 25 patients with focal neocortical epilepsy who had invasive electroencephalography (EEG) evaluation and subsequent surgery were included. They were followed up for at least 2years. Interictal ripples (80-250Hz) and fast ripples (250-500Hz) during slow-wave sleep were identified. Neocortical ripples were defined as type I ripples when they were superimposed on epileptiform discharges, and as type II ripples when they occurred independently. Resection ratio was calculated to present the extent to which the cortical area showing an interictal event or the seizure onset zone (SOZ) was completely removed. RESULTS: Fast ripples and types I and II ripples were found in 8, 19, and 21 patients, respectively. Only the higher resection ratio of interictal fast or type I ripples was correlated to the Engel 1a surgical outcome. CONCLUSIONS: Type I ripples could assist in localizing the epileptogenic zone in neocortical epilepsy. SIGNIFICANCE: Type I and fast ripples both may be pathological high-frequency oscillations.
OBJECTIVE: This study aimed to identify the subtype of interictal ripples that help delineate the epileptogenic zone in neocortical epilepsy. METHODS: Totally 25 patients with focal neocortical epilepsy who had invasive electroencephalography (EEG) evaluation and subsequent surgery were included. They were followed up for at least 2years. Interictal ripples (80-250Hz) and fast ripples (250-500Hz) during slow-wave sleep were identified. Neocortical ripples were defined as type I ripples when they were superimposed on epileptiform discharges, and as type II ripples when they occurred independently. Resection ratio was calculated to present the extent to which the cortical area showing an interictal event or the seizure onset zone (SOZ) was completely removed. RESULTS: Fast ripples and types I and II ripples were found in 8, 19, and 21 patients, respectively. Only the higher resection ratio of interictal fast or type I ripples was correlated to the Engel 1a surgical outcome. CONCLUSIONS: Type I ripples could assist in localizing the epileptogenic zone in neocortical epilepsy. SIGNIFICANCE: Type I and fast ripples both may be pathological high-frequency oscillations.
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