Ictal EEG in sunflower syndrome: Provoked or unprovoked seizures?

Objective. We investigated the longitudinal outcome of resective epilepsy surgery to identify the predictors of seizure recurrence. Materials and Methods. We retrospectively analyzed patients who underwent resections for intractable epilepsy over a period of 7 years. Multiple variables were investigated as potential predictors of seizure recurrence. The time to first postoperative seizure was evaluated using survival analysis and univariate analysis at annual intervals. Results. Among 70 patients, 54 (77%) had temporal and 16 (23%) had extratemporal resections. At last follow-up (mean 48 months; range 24–87 months), the outcome was Engel class I in 84% (n=59) of patients. Seizure recurrence followed two patterns: recurrence was “early” (within 2 years) in 82% of patients, of whom 83% continued to have seizures despite optimum medical therapy; recurrence was “late” (after 2 years) in 18%, of whom 25% continued to have seizures subsequently. Among the variables of interest, only resection site and ictal EEG remained as independent predictors of seizure recurrence over the long term (p<0.05). Extratemporal resection and discordance between ictal EEG and resection area were associated with 4.2-fold and 5.6-fold higher risk of seizure recurrence, respectively. Conclusions. Extratemporal epilepsy and uncertainty in ictal EEG localization are independent predictors of unfavorable outcome. Seizure recurrence within two years of surgery indicates poor long-term outcome.

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Electroencephalographic Features of Temporal Lobe Epilepsy

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100010441 ◽

2010 ◽

Vol 37 (4) ◽

pp. 439-448 ◽

Cited By ~ 19

Author(s):

Mohammed M. Jan ◽

Mark Sadler ◽

Susan R. Rahey

Keyword(s):

Temporal Lobe Epilepsy ◽

Surgical Management ◽

Temporal Lobe ◽

Seizure Onset ◽

Resective Surgery ◽

Accurate Localization ◽

Epileptiform Discharges ◽

Ictal Eeg ◽

Temporal Lobe Seizures ◽

Eeg Recordings

Electroencephalography (EEG) is an important tool for diagnosing, lateralizing and localizing temporal lobe seizures. In this paper, we review the EEG characteristics of temporal lobe epilepsy (TLE). Several “non-standard” electrodes may be needed to further evaluate the EEG localization, Ictal EEG recording is a major component of preoperative protocols for surgical consideration. Various ictal rhythms have been described including background attenuation, start-stop-start phenomenon, irregular 2-5 Hz lateralized activity, and 5-10 Hz sinusoidal waves or repetitive epileptiform discharges. The postictal EEG can also provide valuable lateralizing information. Postictal delta can be lateralized in 60% of patients with TLE and is concordant with the side of seizure onset in most patients. When patients are being considered for resective surgery, invasive EEG recordings may be needed. Accurate localization of the seizure onset in these patients is required for successful surgical management.

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Electroencephalographic Recordings of Focal Seizures in Patients Affected by Periventricular Nodular Heterotopia: Role of the Heterotopic Nodules in the Genesis of Epileptic Discharges

Journal of Child Neurology ◽

10.1177/08830738040190031701 ◽

2004 ◽

Vol 19 (3) ◽

pp. 369-377

Author(s):

Giorgio Battaglia ◽

Silvana Franceschetti ◽

Luisa Chiapparini ◽

Elena Freri ◽

Stefania Bassanini ◽

...

Keyword(s):

Brain Regions ◽

Periventricular Nodular Heterotopia ◽

Focal Seizures ◽

Ictal Eeg ◽

Epileptic Discharges ◽

Nodular Heterotopia ◽

Eeg Recordings ◽

Drug Resistant Epilepsy ◽

Video Eeg

Patients affected by periventricular nodular heterotopia are frequently characterized by focal drug-resistant epilepsy. To investigate the role of periventricular nodules in the genesis of seizures, we analyzed the electroencephalographic (EEG) features of focal seizures recorded by means of video-EEG in 10 patients affected by different types of periventricular nodular heterotopia and followed for prolonged periods of time at the epilepsy center of our institute. The ictal EEG recordings with surface electrodes revealed common features in all patients: all seizures originated from the brain regions where the periventricular nodular heterotopia were located; EEG patterns recorded on the leads exploring the periventricular nodular heterotopia were very similar both at the onset and immediately after the seizure's end in all patients. Our data suggest that seizures are generated by abnormal anatomic circuitries, including the heterotopic nodules and adjacent cortical areas. The major role of heterotopic neurons in the genesis and propagation of epileptic discharges must be taken into account when planning surgery for epilepsy in patients with periventricular nodular heterotopia. ( J Child Neurol 2005;20:369—377).

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Ictal EEG in patients with convulsions with mild gastroenteritis

Brain and Development ◽

10.1016/j.braindev.2006.06.002 ◽

2007 ◽

Vol 29 (1) ◽

pp. 43-46 ◽

Cited By ~ 22

Author(s):

Koichi Maruyama ◽

Akihisa Okumura ◽

Ayako Sofue ◽

Naoko Ishihara ◽

Kazuyoshi Watanabe

Keyword(s):

Ictal Eeg

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Temporal Epileptogenesis: Localizing Value of Scalp and Subdural Interictal and Ictal EEG Data

Epilepsia ◽

10.1046/j.1528-1157.2001.02700.x ◽

2001 ◽

Vol 42 (4) ◽

pp. 508-514 ◽

Cited By ~ 39

Author(s):

Warren T. Blume ◽

Giannina M. Holloway ◽

Samuel Wiebe

Keyword(s):

Ictal Eeg ◽

Eeg Data

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P197 The predictive role of t-histograms of crosscorrelation R-coefficients in the analysis of ictal EEG activity

Electroencephalography and Clinical Neurophysiology ◽

10.1016/0013-4694(96)88323-4 ◽

1996 ◽

Vol 99 (4) ◽

pp. 320 ◽

Cited By ~ 2

Author(s):

S. Suljagic ◽

N. Rajsic ◽

J. Ivanus ◽

Z. Bozovic ◽

A. Kalauzi ◽

...

Keyword(s):

Eeg Activity ◽

Ictal Eeg ◽

Predictive Role

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Reduction of stimulus artifacts in Ictal EEG recordings during electroconvulsive therapy

2015 International Conference on Advances in Biomedical Engineering (ICABME) ◽

10.1109/icabme.2015.7323271 ◽

2015 ◽

Author(s):

Hassan S. Farhat ◽

Fadi N. Karameh ◽

Ziad Nahas

Keyword(s):

Electroconvulsive Therapy ◽

Ictal Eeg ◽

Eeg Recordings

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Invasive EEG in Tuberous Sclerosis

Invasive Studies of the Human Epileptic Brain ◽

10.1093/med/9780198714668.003.0017 ◽

2018 ◽

pp. 213-234 ◽

Cited By ~ 1

Author(s):

A. Simon Harvey

Keyword(s):

Surgical Treatment ◽

Tuberous Sclerosis ◽

Focal Cortical Dysplasia ◽

Cortical Dysplasia ◽

Eeg Monitoring ◽

Intracranial Eeg ◽

Depth Electrodes ◽

Ictal Eeg ◽

Seizure Localization

This chapter reviews the application of intracranial EEG monitoring and cortical stimulation in the surgical treatment of tuberous sclerosis (TS) patients with uncontrolled epilepsy. It begins with a review of issues related to seizure localization and determination of epileptogenic tubers, followed by a review of surgical series in which intraoperative electrocorticography (ECoG) or extraoperative EEG monitoring with subdural or depth electrodes was utilized. Specific interictal and ictal EEG patterns suggesting intrinsic epileptogenicity of tubers are described, and similarities with focal cortical dysplasia are emphasized. The discussion is illustrated with examples of invasive EEG findings in patients with TS, and their relationship to the centre and rims of epileptogenic and non-epileptogenic tubers, and to perituberal and remote cortex. The chapter provides a comprehensive resource that will help epileptologists and neurophysiologists to decide on the need for invasive EEG, and the significance of findings, in TS patients with uncontrolled epilepsy.

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