Usefulness of intracranial EEG in the decision process for epilepsy surgery
- 1 May 2007
- journal article
- Published by Elsevier BV in Epilepsy Research
- Vol. 74 (2-3), 176-182
- https://doi.org/10.1016/j.eplepsyres.2007.03.011
Abstract
In patients with discordant results, non-localizing EEG, or bitemporal seizure onset, intracranial monitoring is done to confirm the seizure onset. Our aim was to assess the yield of intracranial recordings in patients with different clinical scenarios. The records of all patients who underwent prolonged intracranial EEG monitoring (IEM) at the London Health Sciences Centre, University of Western Ontario, Canada, between 1993 and 1999, identified using our EEG patient database in continuous use since December 1972, were reviewed. Patients were analyzed in the following groups according to perceived increasing degrees of uncertainty of epileptic zone localization-group 1: lesion on MRI congruent with focal ictal and interictal scalp EEG, but findings are subtle and of low level of certainty (n=13), group 2: focal MRI, focal ictal and multifocal interictal scalp EEG (n=11), group 3: focal MRI, non-localizing or incongruent scalp EEG (n=73), group 4: normal of multifocal MRI, focal ictal scalp EEG (n=11), group 5: multifocal MRI, non-localizing scalp EEG (n=18), and group 6: normal MRI, multifocal scalp EEG (n=36). One hundred and seventy one patients underwent IEM at the London Health Sciences Centre between 1993 and 1999. All patients had localization-related epilepsy, plus or minus secondary generalization. IEM was helpful overall in 86% of patients, in 69% of group 1, 36% of group 2, 90% of group 3, 81% of group 4, 100 of group 5 and 92% of group 6. Our study shows that the yield of the IEM was higher in the groups of patients with lack of congruence between the MRI and the scalp EEG. The yield was lower in patients with congruent but subtle or uncertain scalp EEG and MRI findings.Keywords
This publication has 35 references indexed in Scilit:
- Morbidity Associated With the Use of Intracranial Electrodes for Epilepsy SurgeryCanadian Journal of Neurological Sciences, 2006
- Lateralization of temporal lobe foci: depth versus subdural electrodesClinical Neurophysiology, 2001
- Surgical technique for the insertion of grids and strips for invasive monitoring in children with intractable epilepsyChild's Nervous System, 2000
- Invasive Electrographic Recording Techniques in Temporal Lobe EpilepsyCanadian Journal of Neurological Sciences, 2000
- Comparison of Combined Versus Subdural or Intracerebral Electrodes Alone in Presurgical Focus LocalizationEpilepsia, 1998
- Invasive monitoring of limbic epilepsy using stereotactic depth and subdural strip electrodes: Surgical techniqueSurgical Neurology, 1997
- Utility of stereoelectroencephalography in preoperative assessment of temporal lobe epilepsy.Journal of Neurology, Neurosurgery & Psychiatry, 1994
- Subdural Recording and Electrical Stimulation for Cortical Mapping and Induction of Usual SeizuresStereotactic and Functional Neurosurgery, 1994
- Invasive Intracranial Monitoring, Cortical Resection and Multiple Subpial Transection for the Control of Intractable Complex Partial Seizure of Cortical OnsetStereotactic and Functional Neurosurgery, 1994
- Principles of Clinical Investigation of Surgical PatientsInternational Anesthesiology Clinics, 1986