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Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography.
King-Stephens, David; Mirro, Emily; Weber, Peter B; Laxer, Kenneth D; Van Ness, Paul C; Salanova, Vicenta; Spencer, David C; Heck, Christianne N; Goldman, Alica; Jobst, Barbara; Shields, Donald C; Bergey, Gregory K; Eisenschenk, Stephan; Worrell, Gregory A; Rossi, Marvin A; Gross, Robert E; Cole, Andrew J; Sperling, Michael R; Nair, Dileep R; Gwinn, Ryder P; Park, Yong D; Rutecki, Paul A; Fountain, Nathan B; Wharen, Robert E; Hirsch, Lawrence J; Miller, Ian O; Barkley, Gregory L; Edwards, Jonathan C; Geller, Eric B; Berg, Michel J; Sadler, Toni L; Sun, Felice T; Morrell, Martha J.
Afiliação
  • King-Stephens D; Pacific Epilepsy Program, Pacific Medical Center, San Francisco, California, 94115, U.S.A.
  • Mirro E; NeuroPace, Inc., Mountain View, California, 94043, U.S.A.
  • Weber PB; Pacific Epilepsy Program, Pacific Medical Center, San Francisco, California, 94115, U.S.A.
  • Laxer KD; Pacific Epilepsy Program, Pacific Medical Center, San Francisco, California, 94115, U.S.A.
  • Van Ness PC; Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, 75390, U.S.A.
  • Salanova V; Department of Neurology, Indiana University, Indianapolis, Indiana, 46202, U.S.A.
  • Spencer DC; Oregon Health and Science University, Portland, Oregon, 97239, U.S.A.
  • Heck CN; USC Comprehensive Epilepsy Program, Los Angeles, California, 90089, U.S.A.
  • Goldman A; Baylor College of Medicine, Houston, Texas, 77030, U.S.A.
  • Jobst B; Dartmouth-Hitchcock Epilepsy Center, Lebanon, New Hampshire, 03756, U.S.A.
  • Shields DC; George Washington University, Washington, District of Columbia, 20052, U.S.A.
  • Bergey GK; Johns Hopkins Epilepsy Center, Baltimore, Maryland, 21287, U.S.A.
  • Eisenschenk S; Department of Neurology, University of Florida, Gainesville, Florida, 32611, U.S.A.
  • Worrell GA; Department of Neurology, Mayo Clinic, Rochester, Minnesota, 55905, U.S.A.
  • Rossi MA; Rush Epilepsy Center, Chicago, Illinois, 60612, U.S.A.
  • Gross RE; Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, U.S.A.
  • Cole AJ; MGH Epilepsy Service, Massachusetts General Hospital, Boston, Massachusetts, 02114, U.S.A.
  • Sperling MR; Jefferson Comprehensive Epilepsy Center, Thomas Jefferson University, Philadelphia, Pennsylvania, 19107, U.S.A.
  • Nair DR; Cleveland Clinic Neurological Institute, Cleveland, Ohio, 44195, U.S.A.
  • Gwinn RP; Swedish Neuroscience Institute, Seattle, Washington, 98052, U.S.A.
  • Park YD; Georgia Regents University, Augusta, Georgia, 30912, U.S.A.
  • Rutecki PA; University of Wisconsin, Madison, Wisconsin, 53792, U.S.A.
  • Fountain NB; Comprehensive Epilepsy Center, University of Virginia, Charlottesville, Virginia, 22908, U.S.A.
  • Wharen RE; Mayo Clinic Jacksonville, Jacksonville, Florida, 32224, U.S.A.
  • Hirsch LJ; Yale University School of Medicine, New Haven, Connecticut, 06510, U.S.A.
  • Miller IO; Comprehensive Epilepsy Center, Miami Children's Hospital, Miami, Florida, 33155, U.S.A.
  • Barkley GL; Henry Ford Hospital, Detroit, Michigan, 48202, U.S.A.
  • Edwards JC; The Medical University of South Carolina, Charleston, South Carolina, 29425, U.S.A.
  • Geller EB; Institute of Neurology and Neurosurgery at Saint Barnabas, Livingston, New Jersey, 07039, U.S.A.
  • Berg MJ; University of Rochester Medical Center, Rochester, New York, 14642, U.S.A.
  • Sadler TL; Via Christi Comprehensive Epilepsy Center, Wichita, Kansas, 67214, U.S.A.
  • Sun FT; NeuroPace, Inc., Mountain View, California, 94043, U.S.A.
  • Morrell MJ; NeuroPace, Inc., Mountain View, California, 94043, U.S.A.
Epilepsia ; 56(6): 959-67, 2015 Jun.
Article em En | MEDLINE | ID: mdl-25988840
ABSTRACT

OBJECTIVE:

Patients with suspected mesial temporal lobe (MTL) epilepsy typically undergo inpatient video-electroencephalography (EEG) monitoring with scalp and/or intracranial electrodes for 1 to 2 weeks to localize and lateralize the seizure focus or foci. Chronic ambulatory electrocorticography (ECoG) in patients with MTL epilepsy may provide additional information about seizure lateralization. This analysis describes data obtained from chronic ambulatory ECoG in patients with suspected bilateral MTL epilepsy in order to assess the time required to determine the seizure lateralization and whether this information could influence treatment decisions.

METHODS:

Ambulatory ECoG was reviewed in patients with suspected bilateral MTL epilepsy who were among a larger cohort with intractable epilepsy participating in a randomized controlled trial of responsive neurostimulation. Subjects were implanted with bilateral MTL leads and a cranially implanted neurostimulator programmed to detect abnormal interictal and ictal ECoG activity. ECoG data stored by the neurostimulator were reviewed to determine the lateralization of electrographic seizures and the interval of time until independent bilateral MTL electrographic seizures were recorded.

RESULTS:

Eighty-two subjects were implanted with bilateral MTL leads and followed for 4.7 years on average (median 4.9 years). Independent bilateral MTL electrographic seizures were recorded in 84%. The average time to record bilateral electrographic seizures in the ambulatory setting was 41.6 days (median 13 days, range 0-376 days). Sixteen percent had only unilateral electrographic seizures after an average of 4.6 years of recording.

SIGNIFICANCE:

About one third of the subjects implanted with bilateral MTL electrodes required >1 month of chronic ambulatory ECoG before the first contralateral MTL electrographic seizure was recorded. Some patients with suspected bilateral MTL seizures had only unilateral electrographic seizures. Chronic ambulatory ECoG in patients with suspected bilateral MTL seizures provides data in a naturalistic setting, may complement data from inpatient video-EEG monitoring, and can contribute to treatment decisions.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Eletrocardiografia Ambulatorial / Epilepsia do Lobo Temporal / Ondas Encefálicas / Lateralidade Funcional Tipo de estudo: Observational_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Eletrocardiografia Ambulatorial / Epilepsia do Lobo Temporal / Ondas Encefálicas / Lateralidade Funcional Tipo de estudo: Observational_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2015 Tipo de documento: Article