title: Relationship of number of seizures recorded on video-EEG to surgical outcome in refractory medial temporal lobe epilepsy.
abstract: BACKGROUND
  Surgical planning for refractory medial temporal lobe epilepsy (rMTLE) relies on seizure localization by ictal electroencephalography (EEG). Multiple factors impact the number of seizures recorded. We evaluated whether seizure freedom correlated to the number of seizures recorded, and the related factors.
  
  
  METHODS
  We collected data for 32 patients with rMTLE who underwent anterior temporal lobectomy. Primary analysis evaluated number of seizures captured as a predictor of surgical outcome. Subsequent analyses explored factors that may seizure number.
  
  
  RESULTS
  Number of seizures recorded did not predict seizure freedom. More seizures were recorded with more days of seizure occurrence (p<0.001), seizure clusters (p≤0.011) and poorly localized seizures (PLSz) (p=0.004). Regression modeling showed a trend for subjects with fewer recorded poorly localized seizures to have better surgical outcome (p=0.052).
  
  
  CONCLUSIONS
  Total number of recorded seizures does not predict surgical outcome. Patients with more PLSz may have worse outcome.
authors.affiliation: Division of Neurology, Department of Neurosciences, Medical University of South Carolina (MUSC), Charleston, SC 29425, USA. dr.sainju@gmail.com
authors.forename: Rup Kamal
authors.initials: RK
authors.lastname: Sainju
authors.forename: Bethany Jacobs
authors.initials: BJ
authors.lastname: Wolf
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bonilha
authors.forename: Gabriel
authors.initials: G
authors.lastname: Martz
mesh_terms: D000328:Adult; D000368:Aged; D004569:Electroencephalography / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis*; D016896:Treatment Outcome; D014741:Video Recording; D055815:Young Adult