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Ictal electrocorticographic findings related with surgical outcomes in nonlesional neocortical epilepsy

 S.A. Park  ;  S.R. Lim  ;  G.S. Kim  ;  K. Heo  ;  S.C. Park  ;  J.W. Chang  ;  S.S. Chung  ;  J.U. Choi  ;  T.S. Kim  ;  Byung In Lee 
 EPILEPSY RESEARCH, Vol.48(3) : 199-206, 2002 
Journal Title
Issue Date
Adolescent ; Adult ; Child ; Electroencephalography/statistics & numerical data* ; Epilepsy/diagnosis ; Epilepsy/physiopathology ; Epilepsy/surgery* ; Female ; Follow-Up Studies ; Humans ; Male ; Neocortex/physiopathology ; Neocortex/surgery* ; Treatment Outcome
Ictal EEG ; Electrocorticogram ; Epilepsy surgery ; OutcomeNeocortical epilepsy
Purpose: To characterize ictal electrocorticographic features related to surgical outcomes in nonlesional neocortical epilepsy (NE). Methods: We analyzed 187 ictal electrocorticograms (ECoG) obtained from 18 patients who had undergone presurgical evaluation and subsequent neocortical resections (frontal: seven, parietal: one, occipital: four, multilobar: six). None of them had any MRI-detectable lesions. Various ECoG data sets recorded from eight patients who achieved a favorable surgical outcome (either seizure free or more than 90% reduction of seizure frequencies) were compared with that from ten patients with unfavorable outcome (less than 90% reduction of seizure frequencies) (follow up duration: 47±11 months). Results: Reproducible ictal onset zone (IOZ) in recurrent seizures (P=0.013) and persistent ictal discharges in IOZ from the onset to the end of seizure (P=0.004) were found more frequently in the patients with good outcome. Ictal onset patterns consisting of low voltage fast or high amplitude beta spikes predicted a good surgical outcome while rhythmic sinusoidal activity or rhythmic spike/sharp waves of slow frequency were predictive of poor outcome (P=0.01). The ictal onset rhythm consisting of gamma or beta frequencies was more prevalent in the favorable group (P=0.015). Conclusions: The presence of stable ictal circuit suggested by the consistent earliest activation of specific electrodes in the repetitive seizures (reproducible IOZ) and the active participation of IOZ throughout the attack were valuable prognostic factors in addition to the morphology and frequency of ictal onset rhythm.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Byung In(이병인)
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Heo, Kyoung(허경)
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