title: [Refractory temporal epilepsy. An analysis of 33 cases submitted to surgery].
abstract: OBJECTIVE
  To analyze clinical manifestations, ictal, interictal and intraoperative EEG monitoring in patients with medical treatment refractory temporal epilepsy successfully controlled surgically.
  
  
  METHODS
  Retrospective analysis, 33 patients. Mean age: 36 ± 11.40; number of monthly seizures: 9 ± 14.23; mean duration of disease: 22 years; number of anti-epileptic drugs: 3 ± 0.93; average monitoring duration on Intensive Video-EEG Monitoring Unit: 6.42 ± 3.61 days. Scalp EEG was recorded with surface electrodes placed according to the 10-20 international system.
  
  
  RESULTS
  158 seizures were recorded, most of them focal complex. 82% of patients presented aura. Disturbances of consciousness appeared in 94.3%, being more precocious than the automatisms in the majority of the sample. The most frequent and precocious automatisms were oromandibular. Intercritical: epileptiform activity was observed in 87.9% of cases; sharp waves in 93.1%, increasing with sleepiness in 97%. Polyspikes during REM sleep in 21.2%. Bilateral epileptiform activity in 21.1%. Ictal activity: changes on EEG activity was observed previous to clinical manifestation in more than 69%. Type of ictal onset: flattening (46%), rhythmic slow activity (41.7%). Ictal onset was focal in 48.9%.
  
  
  CONCLUSIONS
  Detailed knowledge of clinical and electrical manifestations of temporal lobe epilepsies would allow a precocious diagnosis and a reduction of accessing time of these patients to surgical treatment in case of pharmaco-resistance.
authors.affiliation: Hospital General Universitario Gregorio Maranon, 28007 Madrid, Espana. humanpotencial@yahoo.es
authors.forename: B
authors.initials: B
authors.lastname: Alemany-Rosales
authors.forename: J
authors.initials: J
authors.lastname: Prieto-Montalvo
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D004351:Drug Resistance; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D014741:Video Recording
chemical_list: D000927:Anticonvulsants