Significance of simple partial seizures in temporal lobe epilepsy.
We determined how localization of simple partial seizures (SPS) correlated with localization of complex partial seizure (CPS) in scalp/sphenoidal EEG and assessed prognosis after temporal lobe resective surgery in patients with an ictal correlate of SPS in scalp/sphenoidal EEG recordings. EEGs were recorded with the 10-20 system of electrode placement and supplemented with sphenoidal electrodes. Between 1985 and 1992, 183 patients with temporal lobe epilepsy (TLE) reported an aura (SPS) during inpatient monitoring; all were eligible for inclusion in our study. The EEGs during SPS showed ictal changes in 51 patients (28%, 117 SPS). Forty-four patients had unilateral temporal interictal spikes (IIS), and SPS and CPS always arose from the same region. Seven patients had bitemporal interictal spikes; SPS colocalized with CPS in 4 patients (57%), SPS were contralateral to CPS in 2 patients, and 1 patient had bilateral independent CPS but unilateral SPS. SPS accompanied by EEG ictal changes conveyed a favorable prognosis in patients who underwent epilepsy surgery. Scalp/sphenoidal recorded IIS but were less reliable in identifying the location of CPS onset in patients with bitemporal spikes.
Sirven
J I
JI
Comprehensive Epilepsy Center, Graduate Hospital, Philadelphia, PA 19146, USA.
Sperling
M R
MR
French
J A
JA
O'Connor
M J
MJ
D000328:Adult; D004569:Electroencephalography / Q000379:methods; D004828:Epilepsies, Partial / Q000175:diagnosis*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000601:surgery; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D008297:Male; D011379:Prognosis; D013702:Temporal Lobe / Q000601:surgery; D016896:Treatment Outcome