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Temporal lobectomy and independent bitemporal interictal activity: what degree of lateralization is sufficient?

Publication ,  Journal Article
Chung, MY; Walczak, TS; Lewis, DV; Dawson, DV; Radtke, R
Published in: Epilepsia
1991

We attempted to determine whether the degree of lateralization of independent bitemporal interictal spikes and sharp waves (ISSW) is correlated with good results after temporal lobectomy. Three observers independently counted ISSW in the scalp EEGs of 59 candidates for temporal lobectomy to determine the degree of lateralization of ISSW. Interobserver correlation in percentage of lateralization was excellent (r = 0.92). Thirty-one candidates were also evaluated with depth EEG (DEEG). Operative success was graded by the number of seizures reported in the second postoperative year. There was a significant progressive decrease in the number of good operative results as the degree of lateralization of ISSW lessened (p = 0.0142). Ninety-two percent of patients with greater than 90% lateralization had a good surgical outcome, whereas only 50% with less than 90% lateralization had a good outcome. Even when all DEEG-recorded seizures emerged from the side of the lobectomy, patients with greater than 90% lateralization appeared to have better outcomes than patients with less than 90% lateralization. We conclude that greater than 90% lateralization of temporal ISSW is associated with good surgical outcome, and DEEG may not be necessary in these patients. Less than 90% lateralization is associated with poor surgical outcome and the additional information provided by DEEG may be especially useful in such patients.

Duke Scholars

Published In

Epilepsia

DOI

ISSN

0013-9580

Publication Date

1991

Volume

32

Issue

2

Start / End Page

195 / 201

Location

United States

Related Subject Headings

  • Temporal Lobe
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Functional Laterality
  • Follow-Up Studies
  • Female
  • Epilepsy, Temporal Lobe
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chung, M. Y., Walczak, T. S., Lewis, D. V., Dawson, D. V., & Radtke, R. (1991). Temporal lobectomy and independent bitemporal interictal activity: what degree of lateralization is sufficient? Epilepsia, 32(2), 195–201. https://doi.org/10.1111/j.1528-1157.1991.tb05244.x
Chung, M. Y., T. S. Walczak, D. V. Lewis, D. V. Dawson, and R. Radtke. “Temporal lobectomy and independent bitemporal interictal activity: what degree of lateralization is sufficient?Epilepsia 32, no. 2 (1991): 195–201. https://doi.org/10.1111/j.1528-1157.1991.tb05244.x.
Chung MY, Walczak TS, Lewis DV, Dawson DV, Radtke R. Temporal lobectomy and independent bitemporal interictal activity: what degree of lateralization is sufficient? Epilepsia. 1991;32(2):195–201.
Chung, M. Y., et al. “Temporal lobectomy and independent bitemporal interictal activity: what degree of lateralization is sufficient?Epilepsia, vol. 32, no. 2, 1991, pp. 195–201. Pubmed, doi:10.1111/j.1528-1157.1991.tb05244.x.
Chung MY, Walczak TS, Lewis DV, Dawson DV, Radtke R. Temporal lobectomy and independent bitemporal interictal activity: what degree of lateralization is sufficient? Epilepsia. 1991;32(2):195–201.
Journal cover image

Published In

Epilepsia

DOI

ISSN

0013-9580

Publication Date

1991

Volume

32

Issue

2

Start / End Page

195 / 201

Location

United States

Related Subject Headings

  • Temporal Lobe
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Functional Laterality
  • Follow-Up Studies
  • Female
  • Epilepsy, Temporal Lobe