We have located links that may give you full text access.
MRI supersedes ictal EEG when other presurgical data are concordant.
PURPOSE: When ictal EEG is discordant with MRI and other presurgical data, our group has sometimes discounted the ictal findings and proceeded with epilepsy surgical resection based on MRI. We aimed to evaluate the prudence of such practice by comparing the outcome of MRI-lesional epilepsy surgery patients with discordant ictal EEG with those with concordant ictal EEG.
METHOD: We retrospectively studied 115 children with epilepsy who underwent surgical resection of an MRI lesion that was corroborated as the epileptogenic focus by other presurgical findings. Ictal findings on video-EEG were categorized as: "positive ictal EEG" if the ictal onset localization was concordant with MRI and other presurgical data; "negative ictal EEG" if the ictus was discordant with them. Seizure-free outcome at 2 years was compared between the "positive" and the "negative" ictal EEG groups.
RESULTS: Seizure-free outcome did not differ between children with positive ictal EEG (73%) and those with negative ictal EEG (80%). Positive ictal EEG did not result in better outcome regardless of the location of the surgery or the pathology of the lesion. Ictal EEG with 73% positive predictive value provided no added benefit in this cohort whose seizure-free outcome was of 77% irrespective of ictal EEG findings.
CONCLUSIONS: In our selected cohort of pediatric epilepsy surgery patients with an epileptogenic lesion on MRI and concordant other data, ictal EEG had limited predictive value. This calls into question the additive role of ictal recordings in patients with an MRI lesion and concordant other presurgical data.
METHOD: We retrospectively studied 115 children with epilepsy who underwent surgical resection of an MRI lesion that was corroborated as the epileptogenic focus by other presurgical findings. Ictal findings on video-EEG were categorized as: "positive ictal EEG" if the ictal onset localization was concordant with MRI and other presurgical data; "negative ictal EEG" if the ictus was discordant with them. Seizure-free outcome at 2 years was compared between the "positive" and the "negative" ictal EEG groups.
RESULTS: Seizure-free outcome did not differ between children with positive ictal EEG (73%) and those with negative ictal EEG (80%). Positive ictal EEG did not result in better outcome regardless of the location of the surgery or the pathology of the lesion. Ictal EEG with 73% positive predictive value provided no added benefit in this cohort whose seizure-free outcome was of 77% irrespective of ictal EEG findings.
CONCLUSIONS: In our selected cohort of pediatric epilepsy surgery patients with an epileptogenic lesion on MRI and concordant other data, ictal EEG had limited predictive value. This calls into question the additive role of ictal recordings in patients with an MRI lesion and concordant other presurgical data.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app