Lateralized seizure termination: relationship to outcome following anterior temporal lobectomy.

Published

Journal Article

Determination of side of seizure onset is critical for a successful outcome following epilepsy surgery. Little is known about the significance of lateralized seizure termination. Sustained seizure activity contralateral to side of seizure onset, following termination of ictal activity ipsilateral to side of onset, may suggest the presence of an independent focus. Such activity, if present, should predict a poor outcome. We studied side of seizure termination in 13 patients undergoing monitoring with bitemporal depth electrodes and correlated this to outcome following anterior temporal lobectomy (ATL). Side of seizure onset was determined for all seizures during that evaluation. Based on side of final cessation of ictal activity, patients were classified as having ipsilateral final termination or simultaneous termination (Group 1; N=6) or contra-lateral or mixed final termination (Group 2; N=7). The Duke outcome classification system was used. At the end of 2 years follow-up, 6/6 patients in Group 1 and 3/7 patients in Group 2 were seizure free. We conclude that lateralized seizure termination during evaluation with depth electrodes may be useful in predicting outcome following ATL. Continued seizure activity contralateral to side of seizure onset (following termination of ictal activity ipsilateral to side of onset) predicts a poor outcome. This may indicate the presence of an independent seizure focus opposite to the side of surgery.

Full Text

Duke Authors

Cited Authors

  • Verma, A; Lewis, D; VanLandingham, KE; Husain, AM; Friedman, AH; Thompson, E; Radtke, RA

Published Date

  • November 2001

Published In

Volume / Issue

  • 47 / 1-2

Start / End Page

  • 9 - 15

PubMed ID

  • 11673016

Pubmed Central ID

  • 11673016

Electronic International Standard Serial Number (EISSN)

  • 1872-6844

International Standard Serial Number (ISSN)

  • 0920-1211

Digital Object Identifier (DOI)

  • 10.1016/s0920-1211(01)00289-3

Language

  • eng