Can the interictal EEG predict successful temporal lobectomy for epilepsy?
Scalp and sphenoidal electroencephalograms (EEGs) were examined retrospectively from 45 patients who had temporal lobe surgery for epilepsy in a Comprehensive Epilepsy Programme. Interictal EEG patterns were divided into 4 groups: group 1 (18 patients) showed phase reversal of sharp (8) or spike (10) waves about one sphenoidal electrode, group 2 (11 patients) showed unilateral sharp, spike or wave activity in scalp leads only; group 3 (8 patients) showed bilateral abnormalities which were 60%; lateralized and group 4 (8 patients) showed non-lateralized changes. Lateralized EEG patterns predicted the side of subsequent surgery in all 37 cases. All 18 patients in group 1 benefited from surgery (10 seizure free at 1 year) while 20 of 27 patients in the other 3 groups benefited (13 seizure free). These results favour group 1 (P < 0.05). By comparison, the magnetic resonance image scan predicted the side of surgery in 23 of 36 (64%) patients and single photon emission tomograph scans predicted the side of surgery in 11 of 24 (46%) patients who had ictal and interictal isotope injections. Focal sphenoidal electrode discharges predict successful temporal lobectomy for surgery.
Roubina
S
S
Neuropsychiatric Institute, Prince Henry Hospital, Sydney, NSW, Australia.
Mackenzie
R A
RA
Haindl
W
W
Rossleigh
M
M
Klamus
J
J
Ellis
M
M