title: Evaluation of partial epilepsy in Iran: role of video-EEG, EEG, and MRI with epilepsy protocol.
abstract: BACKGROUND
  We evaluated the diagnostic value of Electroencephalography (EEG), video-EEG monitoring (VEM) and Magnetic resonance imaging (MRI) of the brain with epilepsy protocol in patients with complex partial epilepsy.
  
  
  METHODS
  Forty-two consecutive patients underwent complete neurological examination, EEG, and MRI with a modified epilepsy protocol. A subset of these patients (n = 29) also underwent VEM. Data were presented using descriptive statistics and were analyzed using Chi square and McNemar tests.
  
  
  RESULTS
  Twenty-four women and eighteen men entered the study. The mean (±SD) age for patients, was 25.2(±10.1) and mean (±SD) age at onset was 10.9(±8.1). All patients had abnormal ictal or interictal EEG. Fifteen patients had normal MRI. Temporal lobe involvement was the most common involvement in both EEG (27 patients) and MRI (14 patients). Interictal EEG was abnormal in 81% of patients which showed epileptiform discharges in about half of the cases. In half of patients who had lateralized finding on MRI, site of the lesion was congruent between MRI and interictal EEG. Thirty-six patients had symptoms suggesting a specific lobe, of which interictal EEG was able to show the concordant lobe in 22 (61%) patients. McNemar test showed superiority of EEG over MRI in correct diagnosis of the involved lobe based on the clinical manifestations (P < 0.01).
  
  
  CONCLUSIONS
  In our setting, both ictal and interictal EEG perform better than MRI in evaluating complex partial epilepsy. In addition, combination of these tools may increase the yield of showing abnormality to near 100% in patients with complex partial epilepsy.
authors.affiliation: Iranian Center of Neurological Research, Tehran University of Medical Sciences, Neurology Department, Imam Khomeini Hospital, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Tafakhori
authors.forename: Vajiheh
authors.initials: V
authors.lastname: Aghamollaii
authors.forename: Amir Hossein
authors.initials: AH
authors.lastname: Modabbernia
authors.forename: Majid
authors.initials: M
authors.lastname: Ghaffarpour
authors.forename: Hossein Ali Ghelichnia
authors.initials: HA
authors.lastname: Omrani
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Harirchian
authors.forename: Mahsa
authors.initials: M
authors.lastname: Mousavi
authors.forename: Parastoo
authors.initials: P
authors.lastname: Faraji
keywords: Electroencephalography; Iran; MRI; Partial Epilepsy; Video EEG Monitoring