Can intraoperative electrocorticography patterns predict surgical outcome in patients with temporal lobe epilepsy secondary to unilateral mesial temporal sclerosis?

Can intraoperative electrocorticography patterns predict surgical outcome in patients with temporal lobe epilepsy secondary to unilateral mesial temporal sclerosis?

Author Oliveira, Pedro A. L. Google Scholar
Garzon, Eliana Autor UNIFESP Google Scholar
Caboclo, Luís Otávio Sales Ferreira Autor UNIFESP Google Scholar
Sousa, Patricia da Silva Autor UNIFESP Google Scholar
Carrete Junior, Henrique Autor UNIFESP Google Scholar
Centeno, Ricardo Silva Autor UNIFESP Google Scholar
Costa, José Maria P. Google Scholar
Machado, Helio Rubens Google Scholar
Yacubian, Elza Márcia Targas Autor UNIFESP Google Scholar
Bianchin, Marino Muxfeldt Google Scholar
Sakamoto, Américo Ceiki Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Abstract Introduction: Intraoperative electrocorticography (ECoG) can be performed in cases of temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS). However, its significance and correlation with surgical outcome are still controversial.Objectives: To analyze the electrophysiological characteristics of temporal lobe structures during ECoG of patients with TLE-HS, with emphasis on the comparison between pre- and post-resection recordings and surgical outcome.Patients and methods: Seventeen patients with refractory TLE-HS submitted to corticoamigdalohipocampectomy were included in the study. Clinical variables included age at the onset, duration of epilepsy and seizure outcome. the postoperative follow-up ranged from 24 to 36 months. According to outcome subjects were divided in two subgroups: (A) individuals free of seizures (Engel 1A), and (B) individuals not-free of seizures (Engel 1B-IV). Four patterns of ECoG findings were identified: isolated discharges; high frequency spikes (HFS); continuous discharges; combination of isolated discharges and HFS. According to predominant topography ECoG was classified as mediobasal, lateral (or neocortical), mediobasal and lateral.Results: the progressive removal of the temporal pole and the hippocampus was associated with significant decrease of neocortical spikes. No correlation between clinical variables and seizure outcome was observed. Patients who only had isolated spikes on intraoperative ECoG presented a statistical trend for excellent surgical control. Patients who presented temporal pole blurring on MRI also had better post-surgical seizure outcome.Conclusions: This study showed that out of diverse clinical and laboratory variables, only isolated discharges on intraoperative ECoG and temporal pole blurring on MRI predicted excellent post-surgicat seizure outcome. However, other studies with larger number of patients are stilt necessary to confirm these findings. (C) 2006 British Epilepsy Association. Published by Elsevier B.V. All rights reserved.
Keywords electrocorticography
temporal lobe epilepsy
hippocampus sclerosis
Language English
Date 2006-10-01
Published in Seizure-european Journal of Epilepsy. London: W B Saunders Co Ltd, v. 15, n. 7, p. 541-551, 2006.
ISSN 1059-1311 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co Ltd
Extent 541-551
Origin http://dx.doi.org/10.1016/j.seizure.2006.06.009
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000240864700010
URI http://repositorio.unifesp.br/handle/11600/29162

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