Research Of Eeg In Stage Of Attack For The Surgical Localization Of Intractable Temporal Surglcal Localization Of Intractable Temporal Lobe Epilepsy

Background and ObjectiveSurgery is a feasible treatment for localized intractable temporal epilepsy (ITLE). With the development of the technique to localize epileptogenic zone in recent years, the remission rate of epilepsy especially temporal epilepsy (TLE) seemed gradually rising up. Thus presurgical evaluation is important in clinical practice. Using kinds of electrophysiological and morphological technique for presurgical evaluation is a current focus.Although modern medical diagnostic technology advances rapidly, electroencephalogram (EEG) is still the most common assisted approach for epileptic diagnosis, typing and localization.. However, due to the restrictions of time-tracing and the conditions, the positive rates of conventional EEG are not high, while the video-EEG (VEEG) can make a synchronization of EEG and clinical manifestation when seizures onset. During the surgical treatment of ITLE, by analyzing EEG over the stage, particularly initial stage, of attack, VEEG provides the reliable behind for presurgical epileptogenic localization. In this paper, the value of Ictal-EEG for presurgical assessment of temporal lobe epilepsy localization will be further discussed.. MethodsBased on prospective research, totally63patients from Zhe jiang Province people’s hospital neural surgical epilepsy treatment center with diagnosis of ITLE and accepted surgical treatment were collected, All of the patients accepted VE EG and magnetic resonance imaging (MRI) assessment before surgery to localize the epileptogenic focus, as well as electrocorticogram (ECOG) and depth electro coticograhy (DEEG) monitoring during surgery for further localization., After sur gery, a short-term follow-up (6months to1year) were made; x2test was used f or a comparison of EEG localizations between attack and interictal stages. The a ttack type and onset localization of seizures in initial stage in EEG were analyze d. And furthermore, a comparison of accuracy of localization between attack and interictal stages in EEG was made by using of x2test.ResultsAll the patients, with39males and24females and average age23.11±10.77, accepted surgical treatment. Their average courses of disease and treatment were9.47±6.13and7.53±5.89years, respectively. Totally55patients (87.30%) got remission in the period of follow-up.; Compared with interictal stage, the localization rate in attack stage was significantly higher, with x2=10.09, P<0.05; The localization of temporal lobe epilepsy can be correctly localized on89.29%of the patients with hippocampal sclerosis.θ and δ rhythms onsets are the most common onset types of temporal lobe epilepsy; Localization rates of interictal EEG and intrasurgical ECOG overlapped only34.71%, while this index raised to80.62%when turning to.Conclusion1. Ictal-EEG plays an important role in the temporal lobe epilepsy localization, especially for the patients with hippocampal sclerosis.θ and δ rhythms onsets are the most common onset types of temporal lobe epilepsy. By carefully analyzing episodes of electrophysiology semeiology can provide more accurate positioning on the basis of.2. VEEG makes a synchronization between electrophysiological changes and clinical manifestations, so that epileptiform discharges can be recorded during its processes of onset and propagation. Furthermore, VEEG can looking for the most important localizations of onset focus and manifestation region, and it is an essential noninvasive method for presurgical localization.