DOI: 10.5402/2012/942849. Scalp and Intracranial EEG in Medically Intractable Extratemporal Epilepsy with Normal MRI

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

10.5402/2012/942849

Crossref journal-article

Hindawi Limited

ISRN Neurology (98)

Abstract

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.

Bibliography

Zakaria, T., Noe, K., So, E., Cascino, G. D., Wetjen, N., Van Gompel, J. J., Marsh, W. R., Meyer, F. B., Giannini, C., Watson, R. E., & Worrell, G. A. (2012). Scalp and Intracranial EEG in Medically Intractable Extratemporal Epilepsy with Normal MRI. ISRN Neurology, 2012, 1â9.

Authors 11

Tarek Zakaria (first)
Katherine Noe (additional)
Elson So (additional)
Gregory D. Cascino (additional)
Nicholas Wetjen (additional)
Jamie J. Van Gompel (additional)
W. Richard Marsh (additional)
Fredric Bruce Meyer (additional)
Caterina Giannini (additional)
Robert E. Watson (additional)
Gregory A. Worrell (additional)

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Dates

Type	When
Created	13 years, 1 month ago (July 29, 2012, 5:33 a.m.)
Deposited	4 years, 8 months ago (Dec. 9, 2020, 10:09 p.m.)
Indexed	4 days, 4 hours ago (Aug. 31, 2025, 6:06 a.m.)
Issued	13 years, 2 months ago (June 25, 2012)
Published	13 years, 2 months ago (June 25, 2012)
Published Print	13 years, 2 months ago (June 25, 2012)

Funders 0

None

BibTeX

@article{Zakaria_2012, title={Scalp and Intracranial EEG in Medically Intractable Extratemporal Epilepsy with Normal MRI}, volume={2012}, ISSN={2090-5513}, url={http://dx.doi.org/10.5402/2012/942849}, DOI={10.5402/2012/942849}, journal={ISRN Neurology}, publisher={Hindawi Limited}, author={Zakaria, Tarek and Noe, Katherine and So, Elson and Cascino, Gregory D. and Wetjen, Nicholas and Van Gompel, Jamie J. and Marsh, W. Richard and Meyer, Fredric Bruce and Giannini, Caterina and Watson, Robert E. and Worrell, Gregory A.}, year={2012}, month=jun, pages={1–9} }

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  "abstract": "<jats:p><jats:italic>Purpose</jats:italic>. To investigate EEG and SPECT in the surgical outcome of patients with normal MRI (nonlesional) and extratemporal lobe epilepsy.  <jats:italic>Methods</jats:italic>. 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. <jats:italic>Results</jats:italic>. 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 (&gt;13\u2013125\u2009Hz) was associated with favorable surgical outcome (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.02</mml:mn></mml:mrow></mml:math>). Similarly, a focal fast-frequency oscillation (&gt;13\u2013125\u2009Hz) on iEEG at ictal onset was associated with favorable outcome (<mml:math xmlns:mml=\"http://www.w3.org/1998/Math/MathML\"><mml:mrow><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.03</mml:mn></mml:mrow></mml:math>). <jats:italic>Discussion</jats:italic>. A focal fast-frequency discharge at ictal onset identifies nonlesional MRI, extratemporal epilepsy patients likely to have a favorable outcome after resective epilepsy surgery.</jats:p>",
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