Postoperative interictal spikes during sleep contralateral to the operated side is associated with unfavourable surgical outcome in patients with preoperative bitemporal spikes

被引：8

作者：

Halász, P ^{[1
]}

Janszky, J ^{[1
]}

Rásonyi, GY ^{[1
]}

Barcs, G ^{[1
]}

Szúcs, A ^{[1
]}

Holló, A ^{[1
]}

Kelemen, A ^{[1
]}

Clemens, Z ^{[1
]}

Csepella, Z ^{[1
]}

机构：

[1] Natl Inst Psychiat & Neurol, Epilespy Ctr, H-1021 Budapest, Hungary

来源：

SEIZURE-EUROPEAN JOURNAL OF EPILEPSY | 2004年 / 13卷 / 07期

关键词：

postoperative outcome; bitemporat spikes; postoperative contralateral spiking; secondary epileptogenesis;

D O I：

10.1016/j.seizure.2003.10.007

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Purpose: To correlate the persistence of contralateral spikes during steep after unilateral surgery with seizure outcome in a temporal lobe epilepsy (TLE) population and to test the existing hypotheses about the origin of the contralateral spikes in temporal lobe epilepsy. Methods: In the 19 patients selected for this study unilateral temporal lobe surgery was performed. To investigate the course of bilateral interictal epileptiform discharges observed before surgery in awake or steep over the temporal lobe contralateral to surgery, 24 h mobile 12 channel EEG recording was performed at minimum two, in average 4.6 (2-10) years after the surgery. Results: The association of postoperative contralateral spikes and non-seizure free outcome was highly significant. The existence of unilateral pathology before surgery was highly predictive for good outcome and disappearance of contralateral spikes. The association between good seizure outcome, disappearance of contralateral spikes and the existence of unilateral pathology before surgery was also significant. Our data partially satisfies the expectations of both the "seizure induced" and mirror type secondary epilepto-genesis hypotheses concerning origin of contralateral spikes, but were not completely congruent with either of them. Conclusions: Unfavourable surgical outcome in a temporal lobe epilepsy group with preoperative independent bilateral interictal spikes was associated with the persistence of postoperative contralateral spikes and lack of unilateral pathology. Compared with seizure outcome the presence/absence and distribution of postoperative interictal spikes in NREM steep not entirely fit to the predictions of existing secondary epileptogenesis hypotheses. (C) 2004 BEA Trading Ltd. Published by Elsevier Ltd. All rights reserved.

引用

页码：460 / 466

页数：7

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