Electrocorticography in the management of surgically treated epileptic patients.

OBJECTIVE: To report our experience on 8 patients with mean age of onset of seizures of 8 years, who had intra-operative electrocorticography monitoring during the surgical treatment of their medically intractable partial epilepsy. METHODS: Post-resection electrocorticography grades were according to Jay et al and seizure outcome was a according to Kobayashi et al grades. RESULTS: Five patients had temporal lobe surgery and 3 patients had extra temporal surgery. Four patients had post-resection electrocorticography grade A (no residual epileptic activity), two of them had seizure outcome grade 1 (free of seizures) and the other 2 had grade 11 (free of seizures on medication). The other 4 patients had post-resection electrocorticography grade B (minimal residual epileptic activity) and all had seizure outcome grade 11 except one patient who had grade 111 (more than 50% reduction in seizure frequency). CONCLUSION: Despite the small size of our study, our results suggest that intra-operative electrocorticography may be an important tool in the surgical management of medically intractable epilepsy.

Diagnostic value of short duration outpatient video electroencephalographic monitoring.

There is little published on the diagnostic value of short duration outpatient video electroencephalographic (VEEG) monitoring in children. The authors performed a prospective study on 37 patients (mean age = 10.4 years), with daily paroxysmal events who underwent short duration (mean = 3.2 hours) outpatient VEEG monitoring. Events were detected in 23 patients (62.2%), and a change in management as a result of outpatient VEEG monitoring was documented in 25 patients (67.6%). Despite the short duration of the outpatient VEEG in this study, the detection rate was comparable with the previously reported studies with longer duration monitoring. The authors found it convenient for the patient and less costly. The study demonstrated that short duration outpatient VEEG monitoring was able to differentiate between seizures and nonseizures in 11 patients (78.6%) and resulted in changing seizure classification in five patients (62.5%), and in selecting epilepsy surgery candidates in nine patients (60%). Short duration outpatient VEEG is useful as a diagnostic tool in patients with daily paroxysmal events, particularly in identifying nonepileptic events.

Perspectives on neurosurgical practice: neurosurgery in Jordan.

Neurosurgery as a specialty medical field is new in Jordan. This article documents the history, current status, and projected future of neurosurgery in Jordan. Resident training is also highlighted, and challenges for the future of the profession are presented.