Time from ictal subdural EEG seizure onset to clinical seizure onset: prognostic value for selecting temporal lobectomy candidates.
Long-term subdural EEG recording was performed to test the hypothesis that the duration from ictal subdural EEG seizure onset (ECOT) is prognostic for seizure-free outcome following temporal lobectomy. In 48 patients with complex partial seizures, temporal lobectomy was based on invasive localization of the ictal seizure focus. Subdural EEG data were analyzed for association with seizure-free outcome (seizure-free: yes or no) at a minimum of one year following temporal lobectomy. As the duration from ictal subdural EEG seizure onset to clinical seizure onset increased, the odds of being seizure-free postoperatively increased. The best fitting statistical model for predicting seizure-free outcome included seizure onset (unilateral vs. bilateral) and duration from ictal subdural EEG seizure onset to clinical seizure onset. While selection of temporal lobectomy candidates has increasingly emphasized noninvasive recording, some scalp-EEG monitored patients cannot be offered surgery for various reasons, one of which may include ictal EEG seizure onset following clinical seizure onset. When subdural EEG monitoring is performed for selection of temporal lobectomy candidates, analysis of the duration from subdural EEG seizure onset to clinical seizure onset should improve the prognostic value of the subdural EEG data for seizure-free outcome following temporal lobectomy.
Weinand
M E
ME
Department of Surgery, University of Arizona College of Medicine, Tucson 85724-5070, USA. ndw@u.arizona.edu
Kester
M M
MM
Labiner
D M
DM
Ahern
G L
GL
D000293:Adolescent; D000328:Adult; D002648:Child; D004569:Electroencephalography / Q000379:methods*; D017029:Epilepsy, Complex Partial / Q000503:physiopathology / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D011612:Psychosurgery / Q000009:adverse effects*; D011930:Reaction Time / Q000502:physiology*; D013355:Subdural Space / Q000502:physiology / Q000601:surgery; D013702:Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome