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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

Is inpatient ictal video-electroencephalographic monitoring mandatory in mesial temporal lobe epilepsy with unilateral hippocampal sclerosis? A prospective study

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Autor(es):
Alvim, Marina K. M. [1] ; Morita, Marcia E. [1] ; Yasuda, Clarissa L. [1] ; Damasceno, Benito P. [1] ; Lopes, Tatila M. [1] ; Coan, Ana Carolina [1] ; Ghizoni, Enrico [1] ; Tedeschi, Helder [1] ; Cendes, Fernando [1]
Número total de Autores: 9
Afiliação do(s) autor(es):
[1] Univ Estadual Campinas, Neuroimaging Lab, Dept Neurol, Campinas, SP - Brazil
Número total de Afiliações: 1
Tipo de documento: Artigo Científico
Fonte: Epilepsia; v. 59, n. 2, p. 410-419, FEB 2018.
Citações Web of Science: 4
Resumo

ObjectiveTo compare surgical outcome in mesial temporal lobe epilepsy (MTLE) patients with unilateral hippocampal sclerosis (MTLE-HS) who had or did not have preoperative video-electroencephalographic monitoring (VEEG). MethodsA prospective study was undertaken with 166 consecutive pharmacoresistant unilateral MTLE-HS patients. All patients were investigated with detailed seizure semiology, serial routine outpatient EEG, magnetic resonance imaging, neuropsychological evaluation, and if necessary, other examinations. Postoperative follow-up ranged between 2 and 16years. Patients were divided into: (1) patients operated on based on routine outpatient EEG information, with >80% of EEGs with unilateral interictal epileptiform discharges (IEDs) ipsilateral to HS or ictal events (n=71); and (2) patients submitted to preoperative VEEG (n=95). To avoid the bias generated by ictal recordings, we performed a subanalysis of: (1) patients without preoperatively ictal recordings (n=80) and (2) patients with ictal recordings in VEEG or routine outpatient EEG (n=86). ResultsGroups were similar regarding gender, age at surgery, seizure onset, preoperative seizure frequency, and duration of follow-up. Overall, 136/166 (81.92%) were classified as Engel I seizure outcome, with no difference between groups; 76.84% and 88.73% of patients with and without VEEG, respectively, had Engel I postoperative seizure outcome (P=.77). The time lag until surgery was shorter in the group without VEEG (80 vs 38months; P=.01). Considering ictal recordings, 76.74% of patients with seizures recorded and 87.50% without ictal recordings had Engel I outcome (P=.11). SignificanceWe performed the first prospective study in a tertiary epilepsy center comparing surgical outcomes in unilateral MTLE-HS patients investigated preoperatively with and without VEEG. Based on the surgical outcome, VEEG is not imperative in patients with unilateral MTLE-HS who have compatible semiology and clearly ipsilateralized IEDs evaluated by a multidisciplinary and experienced epilepsy group. (AU)

Processo FAPESP: 15/17066-0 - Avaliação da relação entre marcadores inflamatórios e padrão de atrofia hipocampal e extra-hipocampal em pacientes com epilepsia de lobo temporal
Beneficiário:Marina Koutsodontis Machado Alvim
Linha de fomento: Bolsas no Brasil - Doutorado Direto
Processo FAPESP: 12/05364-8 - Avaliação de linguagem em epilepsia de lobo temporal mesial: correlações com neuroimagem estrutural e funcional
Beneficiário:Tátila Martins Lopes
Linha de fomento: Bolsas no Brasil - Doutorado