Prognostic value of ictal onset patterns in postsurgical outcome of temporal lobe epilepsy

• Published in: Iranian journal of neurology 2017-10, Vol.16 (4), p.185-191
• Main Authors: Mehvari-Habibabadi, Jafar, Basiratnia, Reza, Moein, Houshang, Zare, Mohamad, Barakatain, Majid, Aghakhani, Yahya, Tabrizi, Nasim
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2008-384X; 2252-0058

Background: To investigate ictal onset patterns (IOP) in scalp electroencephalography (EEG) of patients with temporal lobe epilepsy (TLE) and their prognostic effect on the postoperative outcome. Methods: We conducted a retrospective cohort study between 2011 and 2015 in our referral Epilepsy Surgery Center enrolling adult patients with refractory TLE and a visible epileptogenic lesion in magnetic resonance imaging (MRI), who underwent epilepsy surgery. Demographic, clinical and MRI findings were collected and ictal findings during video-EEG monitoring were reviewed in detail. The correlation between preoperative findings and the postsurgical outcome was analyzed. Results: We reviewed 303 seizures in 93 patients. Rhythmic theta and rhythmic spike/sharp and wave were respectively the most common initial ictal pattern and late significant discharges. Engel class I outcome was observed in 88.2% of patients. Female sex, aura, the absence of secondary generalization, rhythmic theta as initial ictal pattern and concordance of ictal-interictal EEG findings were correlated with favorable 1-year postsurgical outcome. Conclusion: Preoperative clinical and EEG findings can provide valuable information regarding postsurgical prognosis in TLE patients.