title: Safety of video-EEG monitoring and surgical outcome in patients with mesial temporal sclerosis and psychosis of epilepsy.
abstract: OBJECTIVE
  Cortico-amygdalohippocampectomy (CAH) has become an important treatment option for patients with refractory temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS); it has resulted in a 60-70% seizure remission rate and significant quality of life (QOL) improvements. Video-electroencephalography (VEEG) monitoring has been widely used in epilepsy centers for pre-surgical evaluation. A major concern in epilepsy surgery is whether to consider CAH treatment in patients with psychosis of epilepsy (POE). This study analyzed the safety and adverse events (AEs) of VEEG monitoring and the post-surgical outcomes of patients with refractory TLE-MTS and POE who underwent CAH.
  
  
  METHODS
  Clinical, sociodemographic and VEEG data from 18 patients with TLE-MTS and POE were analyzed. Psychiatric evaluations were performed using DSM-IV and ILAE criteria. The seizure outcome was evaluated using Engel's criteria.
  
  
  RESULTS
  Two patients (11.2%) presented AEs that did not result in increased lengths of hospitalization. Of the 10 patients (55.5%) who underwent CAH, 6 (60%) became free of disabling seizures (Engel I). The psychiatric and QOL evaluations revealed improvements of psychotic symptoms (p=0.01) and in Physical Health (p=0.01) following surgery.
  
  
  CONCLUSIONS
  These data reinforce that VEEG monitoring is a safe method to evaluate patients with refractory TLE-MTS and POE in epilepsy centers.
authors: Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
authors: Priscila Oliveira
authors: PO
authors: da Conceição
authors: Gerardo Maria
authors: GM
authors: de Araujo Filho
authors: Lenon
authors: L
authors: Mazetto
authors: Neide Barreira
authors: NB
authors: Alonso
authors: Elza Márcia Targas
authors: EM
authors: Yacubian
mesh_terms: D000328:Adult; D000368:Aged; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects / Q000379:methods; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011300:Preoperative Care / Q000379:methods*; D011618:Psychotic Disorders / Q000209:etiology* / Q000601:surgery; D012598:Sclerosis; D013702:Temporal Lobe / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014741:Video Recording