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Localization value of subclinical seizures on scalp video‐EEG in epilepsy presurgical evaluation
- Source :
- Epilepsia. 60:2477-2485
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- Objective To evaluate the localization value and prognostic significance of subclinical seizures (SCSs) on scalp video-electroencephalography monitoring (VEEG) in comparison to clinical seizures (CSs) in patients who had epilepsy surgery. Methods We included 123 consecutive patients who had SCSs and CSs during scalp-VEEG evaluation. All patients had subsequent epilepsy surgery and at least 1-year follow-up. Concordance between SCSs and CSs was summarized into five categories: complete, partial, overlapping, no concordance, or indeterminate. Using the same scheme, we analyzed the relationship between resection and SCS/CS localizations. The concordance measures, along with demographic, electroclinical, and other presurgical evaluation data, were evaluated for their associations with postoperative seizure outcome. Results Sixty-nine patients (56.1%) had seizure-free outcome at 1-year follow-up. In 68 patients (55.3%), the localizations of SCSs and CSs were completely concordant. Multivariate logistic analysis showed that complete SCS/CS concordance was independently associated with seizure-free outcome at 1-year (P = .020) and 2-year follow-up (P = .040). In the temporal lobe epilepsy (TLE) seizure-free group, SCS localization was completely contained within the resection in 44.4% and CS localization was completely contained within the resection in 41.7%; in the extratemporal lobe epilepsy (ETLE) seizure-free group, SCS localization was completely contained within the resection in 54.5% and CS localization was completely contained within the resection in 57.6%. Significance Complete concordance between CS and SCS localization is a positive prognostic factor for 1-year and 2-year postoperative seizure-free outcome. Localization value of SCSs on scalp VEEG is similar to that of CSs for TLE and ETLE. Although SCSs cannot replace CSs, localization information from SCSs should not be ignored.
- Subjects :
- 0301 basic medicine
Prognostic factor
medicine.medical_specialty
Video eeg
business.industry
Concordance
medicine.disease
Temporal lobe
03 medical and health sciences
Epilepsy
030104 developmental biology
0302 clinical medicine
medicine.anatomical_structure
Neurology
Scalp
medicine
Epilepsy surgery
Neurology (clinical)
Radiology
business
030217 neurology & neurosurgery
Subclinical infection
Subjects
Details
- ISSN :
- 15281167 and 00139580
- Volume :
- 60
- Database :
- OpenAIRE
- Journal :
- Epilepsia
- Accession number :
- edsair.doi...........7b9e7594efecd8939c26b90098a66ad0