Correlation of Icatal Scalp/Sphenoidal EEG Patterns and MRI Findings with Surgical Outcome in Temporal Lobe Epilepsy

ABSTRACT

BACKGROUND & OBJECTIVE: It has not been clear that the correlation between individual ictal scalp/sphenoidal EEG patterns and MRI findings or surgical outcome. So we investigated the correlation between the differences in individual ictal EEG patterns, MRI findings and surgical outcome. METHOD: Twenty nine temporal lobe epilepsy patients undergoing anterior temporal lobectomy with hippocampectomy in AMC since 1993 were evaluated. Ictal EEGs were classified as A(focal ictal onset) and B(lateralizing pattern) MRI findings were grouped as hippocampal atrophy (HA) with or without lateral temporal atrophy (LTA). RESULT: In group A(19), 7(37%) had HA with LTA on MRI and 12(63%) showed HA only. In group B(10), 8(80%) had HA with LTA and 2(20%) showed HA only. Among the 20 patients whose postoperative follow up period were more than 1 year, 11 cases(73%) of group A(IS) had seizure free outcome, whereas all (100%) of group B (5) had seizure free outcome. Eight (72.7%) out of 11 cases with HA only on MRI were seizure free outcome, whereas 8(89%) out of 9 cases with HA with LTA were seizure free after surgery. CONCLUSION: Focal ictal EEG pattern was more commonly noticed in HA only and lateralized Ictal EEG pattern was more commonly noticed in HA with LTA on MRI. Surgical outcome seems not to be directly correlated with the ictal EEG patterns or accompanied LTA on MRI in temporal lobe epilepsy.