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• W2509630406 abstract "Objective: Inpatient Video EEG Monitoring (VMEEG) is the gold standard in patients with temporal lobe epilepsy who are under epilepsy surgery evaluation. VMEEG is expensive and not available for a significant proportion of patients in low and medium income countries. The purpose of this study is to assess the usefulness of prolonged outpatient ambulatory EEG (AmbEEG) in presurgical evaluation in patients with refractory temporal lobe epilepsy.Methods: We analized 30 refractory patients referred for AmbEEG as part of presurgical evaluation. The prolonged AmbEEG lasted 1-5 days (average 1.5 days). The study was done without medication withdrawal. EEG data and clinical records were reviewed. Patients were followed by prospective clinical interviews.Results: Among the 30 patients, 5 had complex partial seizures during the study, all had mesial temporal sclerosis on the same side of seizure onset. They also had congruent epileptiform interictal activity and underwent surgery with good outcome.Surgery was not recommended in 7 patients due to normal MRI associated with one of the following: 1) Presence of bilateral independent and extended foci, 2) Independent multifocal interictal epileptiform activity, 3) Generalized interictal epileptiform activity.In six patients AmbEEG showed unilateral anterior temporal epileptiform interictal activity ipsilateral to mesial temporal sclerosis, but no seizures were recorded. These patients were later studied with VMEEG; all had seizures with congruent lateralization. They underwent temporal lobe surgery and had a good outcome.No epileptiform abnormalities were observed in the remaining 12 patients.Conclusions: AmbEEG may be used instead of VMEEG in confirming or ruling out epilepsy surgery in patients with refractory temporal lobe epilepsy. Alternatively, AmbEEG can be used to select patients for inpatient VMEEG in a context of limited resources. Objective: Inpatient Video EEG Monitoring (VMEEG) is the gold standard in patients with temporal lobe epilepsy who are under epilepsy surgery evaluation. VMEEG is expensive and not available for a significant proportion of patients in low and medium income countries. The purpose of this study is to assess the usefulness of prolonged outpatient ambulatory EEG (AmbEEG) in presurgical evaluation in patients with refractory temporal lobe epilepsy. Methods: We analized 30 refractory patients referred for AmbEEG as part of presurgical evaluation. The prolonged AmbEEG lasted 1-5 days (average 1.5 days). The study was done without medication withdrawal. EEG data and clinical records were reviewed. Patients were followed by prospective clinical interviews. Results: Among the 30 patients, 5 had complex partial seizures during the study, all had mesial temporal sclerosis on the same side of seizure onset. They also had congruent epileptiform interictal activity and underwent surgery with good outcome. Surgery was not recommended in 7 patients due to normal MRI associated with one of the following: 1) Presence of bilateral independent and extended foci, 2) Independent multifocal interictal epileptiform activity, 3) Generalized interictal epileptiform activity. In six patients AmbEEG showed unilateral anterior temporal epileptiform interictal activity ipsilateral to mesial temporal sclerosis, but no seizures were recorded. These patients were later studied with VMEEG; all had seizures with congruent lateralization. They underwent temporal lobe surgery and had a good outcome. No epileptiform abnormalities were observed in the remaining 12 patients. Conclusions: AmbEEG may be used instead of VMEEG in confirming or ruling out epilepsy surgery in patients with refractory temporal lobe epilepsy. Alternatively, AmbEEG can be used to select patients for inpatient VMEEG in a context of limited resources." @default.
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• W2509630406 date "2015-10-01" @default.
• W2509630406 modified "2023-10-16" @default.
• W2509630406 title "Temporal lobe epilepsy surgery: is prolonged outpatient ambulatory eeg enough? Yes, when everything concurs" @default.
• W2509630406 doi "https://doi.org/10.1016/j.jns.2015.08.497" @default.
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