Authors :
Presenting Author: Daniela Dominguez-Peralta, MD – University Hospitals Cleveland Medical Center
Claudia Mayela Torres Romero, MD – University Hospitals Cleveland Medical Center
Akshaya Rathin Sivaji, MD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Mohamed Ahmed Abdelsabour Hasan, MD – University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Chehek Jamwal, MD – University Hospitals Cleveland Medical Center
Michael D Staudt, MD – Department of Neurological Surgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
Neel Fotedar, MD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Rationale:
Careful analysis of the interictal spikes on scalp-EEG is a critical part of presurgical evaluation to delineate the irritative zone. The topographical distribution of the isopotential lines on scalp-EEG can help localize the generator to mesial, lateral or a basal source (anterior or posterior). In this study, we aim to correlate the scalp-EEG distribution of interictal spikes with their corresponding stereo-EEG localization in mesial temporal lobe epilepsy (MTLE).
Methods:
We retrospectively analyzed 10 consecutive MTLE patients (6F/4M; 8 left-sided) with hippocampal sclerosis who achieved Engel I outcome one year after either multiple hippocampal transections (n=7) or anterior temporal lobectomy (n=3). Three hours each of wakefulness and sleep (implant day≥4) were scored for interictal spikes. Twenty-three discrete SEEG spike populations were identified; each was quantified as spikes/hour and examined for a strictly time-locked (< 100ms) simultaneous scalp correlate, its topography and propagation path. We also compared these spikes with the scalp-EEG spikes recorded from phase I evaluation