Occurrence predictors of the temporal interictal epileptic discharges in epilepsy patients with extratemporal lesions: A prospective cohort study

Int J Surg. 2016 Jul:31:52-7. doi: 10.1016/j.ijsu.2016.05.040. Epub 2016 May 20.

Abstract

Objective: Electrical kindling models of epilepsy suggest that medial temporal structures are more prone to be irritated. The aim of this study is to investigate the occurrence rate of temporal interictal epileptic discharges (TIEDs) in the epilepsy patients with extratemporal lesions (ETLs), and to determine the predictive factors for TIEDs in this cohort.

Methods: Totally 221 patients were admitted for presurgical evaluation, and focal ETL were found in all of them by MRI examination. The occurrence rates of TIEDs in several groups with different brain lobe locations, durations; of epilepsy, seizure frequencies, and onset ages stages were assessed. We also evaluated the surgical outcome of; resection in this cohort.

Results: The total occurrence rate of TIEDs in this cohort was 29.9%. The occurrence rate of TIEDs in the patients with longer durations (>5 or 10 years) was significantly higher than those with shorter duration (<1 year). These; patients with lower seizure frequency (<1 seizure/month) had a significantly decreased incidence of TIEDs; compared with those with higher frequency (>1 seizure/month or week). In the terms of the brain lobe locations; and age at onset, there were no differences between the groups. Furthermore, there were no differences in terms of the surgical outcomes between the patients with TIEDs and other patients in this series.

Conclusions: TIEDs were frequently recorded in these patients with ETLs, and the predictive factors for TIEDs included the epilepsy duration and seizure frequency.

Significance: This study is instrumental for the presurgical EEG interpretationand the counseling of these ETLs patients considered for epilepsy surgery.

Keywords: Duration of epilepsy; Extratemporal lesions; Interical epileptic discharges; Seizure frequency; Temporal lobe epilepsy.

MeSH terms

  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiopathology
  • Cerebral Cortex / surgery
  • Electroencephalography
  • Epilepsy / diagnostic imaging
  • Epilepsy / pathology
  • Epilepsy / physiopathology
  • Epilepsy / surgery
  • Epilepsy, Temporal Lobe / diagnostic imaging*
  • Epilepsy, Temporal Lobe / pathology
  • Epilepsy, Temporal Lobe / physiopathology
  • Epilepsy, Temporal Lobe / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Prospective Studies*
  • Temporal Lobe / diagnostic imaging*
  • Temporal Lobe / pathology
  • Temporal Lobe / physiopathology
  • Temporal Lobe / surgery*
  • Time Factors
  • Treatment Outcome