Subject(s)
Anticonvulsants/therapeutic use , Brain/pathology , Epilepsy/drug therapy , Epilepsy/pathology , Adolescent , Adult , Cadaver , Drug Resistance , Epilepsy/physiopathology , Humans , Middle AgedSubject(s)
Epilepsy, Temporal Lobe/psychology , Epilepsy, Temporal Lobe/surgery , Adolescent , Adult , Epilepsy, Temporal Lobe/physiopathology , Female , Humans , Male , Memory , Middle Aged , Neuropsychological Tests , Neurosurgery/methods , Postoperative Period , Treatment Outcome , Verbal LearningABSTRACT
Two of 4 patients who were re-evaluated by means of foramen-ovale electrodes in the course of presurgical monitoring suffered a brain-stem lesion. Only 1 of these 2 patients already had a temporal resection. None of 55 patients who underwent this procedure for the first time had such a complication. We conclude that this electrode technique is not indicated to evaluate patients a second time, even if no surgical resection has been performed between the 2 recording sessions.
Subject(s)
Brain Diseases/etiology , Brain Stem , Electrodes , Electroencephalography/adverse effects , Epilepsy, Temporal Lobe/surgery , Brain Diseases/diagnosis , Brain Stem/pathology , Epilepsy, Temporal Lobe/physiopathology , Humans , Male , Middle AgedABSTRACT
Ictal single photon emission computed tomography recordings were performed in 9 patients in the course of 11 seizures. Injections of radionuclide were made an average of 72 seconds after the onset of the seizure as indicated by electroencephalography. All patients also underwent interictal recordings. In 6 patients, the localization of the electroencephalographic focus and the morphological lesions corresponded with the ictal hyperperfusion. This could be seen in single photon emission computed tomography. Seizures triggered by hyperventilation, and seizures of patients with anatomical brain lesions (e.g., cysts, surgical defects, and recent injections of technetium-hexamethylene-propylene-amine-oxime) showed an absent or noncorresponding localization of the ictal recording. The ictal and interictal recording seems suitable as a confirmatory noninvasive method for the localization of the epileptogenic focus, particularly in the preoperative evaluation of epilepsy.