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Title: The role of scalp EEG in the presurgical evaluation of patients with medically refractory temporal lobe epilepsy
Authors: Sylaja, PN
Radhakrishnan, K
Keywords: Medical Laboratory Technology; Neurosciences & Neurology
Issue Date: 2001
Citation: 41 ,2;116-135
Abstract: Although the scalp EEG findings in medically refractory temporal lobe epilepsy (TLE) have been known for more than half a century, recent development shave helped us to utilize these data more effectively in selecting ideal candidates for epilepsy surgery and thereby improving the postoperative seizure outcome. We have summarized the currently available information about the value and limitations of interictal and ictal scalp EEG data in the localization of the epileptogenic focus. A majority of patients with medically refractory TLE cart be recruited for surgery based an concordant scalp EEG and magnetic resonance imaging findings. There are distinctive characteristics in the interictal and ictal scalp EEG that, when correlated with clinical, neuropsychological, and imaging data, are helpful in differentiating between mesiobasal and lateral (neocortical) TLE syndromes. Future research on the role of scalp EEG in the presurgical evaluation of patients with medically refractory TLE should concentrate on the following areas: influence of sleep on temporal interictal epileptiform discharges (IEDs) and its implications frequency, pathogenesis, and significance of bilateral independent temporal IEDs; anatomopathological correlates of scalp-recorded interictal and ictal EEG patterns; cast-effective utilization of long-term EEG-video monitoring by selecting the subjects who require this investigation; the role of sphenoidal electrodes in ascertaining interictal and ictal EEG data, the significance of scalprecorded interhemispheric propagation of ictal rhythms and its prognostic implications; and the correlation of scalp-recorded EEG data with magnetoencephalography, and functional neuroimaging findings.
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