Presurgical evaluation of temporal lobe epilepsy: Is an outpatient prolonged ambulatory EEG study sufficient to recommend a surgical resection?
Purpose: Inpatient Video EEG Monitoring (VEM) is the typical study performed in presurgical evaluations. It is expensive and not widely available in developing countries. Recent studies suggested that in selected patients with mesial temporal lobe epilepsy secondary to unilateral mesial temporal scl...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | Epilepsy & Behavior Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S258998642030040X |
| _version_ | 1818601736429895680 |
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| author | Ada Chicharro Alejandro de Marinis Anna Milán Daniel Mansilla Alberto Prat Alvaro Velásquez Mónica González Hernán Acevedo Andrés M. Kanner |
| author_facet | Ada Chicharro Alejandro de Marinis Anna Milán Daniel Mansilla Alberto Prat Alvaro Velásquez Mónica González Hernán Acevedo Andrés M. Kanner |
| author_sort | Ada Chicharro |
| collection | DOAJ |
| description | Purpose: Inpatient Video EEG Monitoring (VEM) is the typical study performed in presurgical evaluations. It is expensive and not widely available in developing countries. Recent studies suggested that in selected patients with mesial temporal lobe epilepsy secondary to unilateral mesial temporal sclerosis (MTS), the recording of unilateral interictal epileptiform activity ipsilateral to the MTS may yield sufficient presurgical EEG data. Outpatient prolonged ambulatory EEG (AEEG) could be an alternative in these cases. The purpose of this study was to compare the post-surgical seizure outcome and costs between patients evaluated with AEEG versus VEM. Methods: Thirty patients with TLE were included: 21 evaluated with VEM and 9 with AmbEEG and underwent surgery between 2011 and 2017. The minimum, post-surgical follow-up period was 1 year. Results: Seven of nine patients who underwent AEEG had seizures ipsilateral to MTS. In two patients only unilateral interictal activity ipsilateral to the lesion was recorded. All patients were free of disabling seizures (Engel Class I) at last follow-up. The mean cost per patient of AEEG was $980 and was $4680 for VEM. Conclusion: AEEG may be used to identify candidates for temporal lobectomy in selected patients with unilateral lesional mesial TLE. This approach to EEG monitoring could make epilpesy surgery more affordable to some patients in developing countries. |
| first_indexed | 2024-12-16T12:56:07Z |
| format | Article |
| id | doaj.art-ae575cdf9198456990400f369744e75c |
| institution | Directory Open Access Journal |
| issn | 2589-9864 |
| language | English |
| last_indexed | 2024-12-16T12:56:07Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj.art-ae575cdf9198456990400f369744e75c2022-12-21T22:31:02ZengElsevierEpilepsy & Behavior Reports2589-98642020-01-0114100392Presurgical evaluation of temporal lobe epilepsy: Is an outpatient prolonged ambulatory EEG study sufficient to recommend a surgical resection?Ada Chicharro0Alejandro de Marinis1Anna Milán2Daniel Mansilla3Alberto Prat4Alvaro Velásquez5Mónica González6Hernán Acevedo7Andrés M. Kanner8Clinica Alemana de Santiago, Santiago, Chile; Facultad de Medicina Clínica Alemana-Universidad del Desarrollo, Santiago, Chile; Liga Chilena contra la Epilepsia, Santiago, Chile; Corresponding author at: Vitacura 5951, Laboratorio neurofisiología piso 10, Santiago de Chile, Chile.Clinica Alemana de Santiago, Santiago, Chile; Facultad de Medicina Clínica Alemana-Universidad del Desarrollo, Santiago, Chile; Liga Chilena contra la Epilepsia, Santiago, ChileLiga Chilena contra la Epilepsia, Santiago, ChileLiga Chilena contra la Epilepsia, Santiago, ChileFacultad de Medicina Clínica Alemana-Universidad del Desarrollo, Santiago, ChileClinica Alemana de Santiago, Santiago, ChileClinica Alemana de Santiago, Santiago, Chile; Facultad de Medicina Clínica Alemana-Universidad del Desarrollo, Santiago, ChileClínica Davila, Santiago, ChileUniversity of Miami, Miller School of Medicine, Epilepsy Center, 1120 NW 14th Street, Room 1324, Miami, FL 33136, USAPurpose: Inpatient Video EEG Monitoring (VEM) is the typical study performed in presurgical evaluations. It is expensive and not widely available in developing countries. Recent studies suggested that in selected patients with mesial temporal lobe epilepsy secondary to unilateral mesial temporal sclerosis (MTS), the recording of unilateral interictal epileptiform activity ipsilateral to the MTS may yield sufficient presurgical EEG data. Outpatient prolonged ambulatory EEG (AEEG) could be an alternative in these cases. The purpose of this study was to compare the post-surgical seizure outcome and costs between patients evaluated with AEEG versus VEM. Methods: Thirty patients with TLE were included: 21 evaluated with VEM and 9 with AmbEEG and underwent surgery between 2011 and 2017. The minimum, post-surgical follow-up period was 1 year. Results: Seven of nine patients who underwent AEEG had seizures ipsilateral to MTS. In two patients only unilateral interictal activity ipsilateral to the lesion was recorded. All patients were free of disabling seizures (Engel Class I) at last follow-up. The mean cost per patient of AEEG was $980 and was $4680 for VEM. Conclusion: AEEG may be used to identify candidates for temporal lobectomy in selected patients with unilateral lesional mesial TLE. This approach to EEG monitoring could make epilpesy surgery more affordable to some patients in developing countries.http://www.sciencedirect.com/science/article/pii/S258998642030040XEpilepsy surgeryRefractory temporal lobe epilepsy |
| spellingShingle | Ada Chicharro Alejandro de Marinis Anna Milán Daniel Mansilla Alberto Prat Alvaro Velásquez Mónica González Hernán Acevedo Andrés M. Kanner Presurgical evaluation of temporal lobe epilepsy: Is an outpatient prolonged ambulatory EEG study sufficient to recommend a surgical resection? Epilepsy & Behavior Reports Epilepsy surgery Refractory temporal lobe epilepsy |
| title | Presurgical evaluation of temporal lobe epilepsy: Is an outpatient prolonged ambulatory EEG study sufficient to recommend a surgical resection? |
| title_full | Presurgical evaluation of temporal lobe epilepsy: Is an outpatient prolonged ambulatory EEG study sufficient to recommend a surgical resection? |
| title_fullStr | Presurgical evaluation of temporal lobe epilepsy: Is an outpatient prolonged ambulatory EEG study sufficient to recommend a surgical resection? |
| title_full_unstemmed | Presurgical evaluation of temporal lobe epilepsy: Is an outpatient prolonged ambulatory EEG study sufficient to recommend a surgical resection? |
| title_short | Presurgical evaluation of temporal lobe epilepsy: Is an outpatient prolonged ambulatory EEG study sufficient to recommend a surgical resection? |
| title_sort | presurgical evaluation of temporal lobe epilepsy is an outpatient prolonged ambulatory eeg study sufficient to recommend a surgical resection |
| topic | Epilepsy surgery Refractory temporal lobe epilepsy |
| url | http://www.sciencedirect.com/science/article/pii/S258998642030040X |
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