title: Epilepsy surgery in patients with unilateral mesial temporal sclerosis and contralateral scalp ictal onset.
abstract: OBJECTIVE
  Concordance of EEG findings and MRI is best correlated with favored     surgical outcome in patients with unilateral mesial temporal sclerosis (MTS). If     there is no evidence for unilateral focus with scalp EEG, invasive recordings     are undertaken. In this report we describe the investigation process for     epilepsy surgery in patients with unilateral MTS and contralateral ictal scalp     EEG findings.
  
  
  METHODS
  The data of all adult patients who had     undergone videoEEG recording with subdural and/or depth electrodes at our center     in almost 7.5 years, were reviewed. Four patients with unilateral MTS and     contralateral ictal onset on scalp EEG were included. Their invasive EEG     recordings and surgical outcomes were examined.
  
  
  RESULTS
  Four patients met the     inclusion criteria. Invasive recordings demonstrated ictal onset in the mesial     temporal lobe ipsilateral to MRI findings. In one patient we have also proven     the false lateralization of scalp EEG simultaneously during the recordings with     depth electrodes. All operated cases are seizure free during follow-up.
  
  
  CONCLUSIONS
  Before the decision of epilepsy surgery we have to identify the     semiology and ictal EEG findings in patients with unilateral MTS and concordant     IEDs. Bilateral depth recordings must be considered to show the ipsilateral     hippocampal epileptogenic focus.
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Neurology, Ankara, Turkey. irseltezer@yahoo.com.tr
authors.forename: F Irsel
authors.initials: FI
authors.lastname: Tezer
authors.forename: Nese
authors.initials: N
authors.lastname: Dericioglu
authors.forename: Gokhan
authors.initials: G
authors.lastname: Bozkurt
authors.forename: Burcak
authors.initials: B
authors.lastname: Bilginer
authors.forename: Nejat
authors.initials: N
authors.lastname: Akalan
authors.forename: Serap
authors.initials: S
authors.lastname: Saygi
mesh_terms: D000328:Adult; D000679:Amygdala / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D038481:Anterior Temporal Lobectomy / Q000379:methods / Q000592:standards; D058256:Brain Waves / Q000502:physiology; D004567:Electrodes, Implanted / Q000592:standards; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D005071:Evoked Potentials / Q000502:physiology; D007839:Functional Laterality / Q000502:physiology; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D018579:Patient Selection; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012535:Scalp / Q000033:anatomy & histology / Q000502:physiology*; D012598:Sclerosis / Q000473:pathology / Q000503:physiopathology; D012680:Sensitivity and Specificity; D013826:Theta Rhythm / Q000502:physiology