발작 두피뇌파 형태에 따른 측두엽간질의 감별과 수술예후와의 연관성
Differentiation of Temporal Lobe Epilepsy by Scalp Ictal EEG and Its Correlation with Surgical Outcome
이상암, 강중구, 곽규환, 이순금,
소속 상세정보
이상암 ( Lee Sang-Ahm )
울산대학교 의과대학 서울중앙병원 신경과학교실
강중구 ( Kang Joong-Koo )
울산대학교 의과대학 서울중앙병원 신경과학교실
곽규환 ( Kwak Kyu-Hwan )
울산대학교 의과대학 서울중앙병원 신경과학교실
이순금 ( Lee Soon-Keum )
울산대학교 의과대학 서울중앙병원 신경과학교실
KMID : 0877220000040010030
Abstract
Purpose: Ebersole and Pacia recently introduced a classification of scalp ictal EEG in temporal lobe epilepsy (TLE). So we investigated whether scalp ictal EEG without sphenoidal electrode can differentiate mesial TLE from neocortical TLE and can be predictive of surgical outcome after temporal lobectomy.
Methods: A consecutive 77 patients (male 43, female 34) with TLE were included who had temporal lobectomy after the comprehensive presurgical evaluation. The patients with mesial TLE were 59 and those with neocortical TLE 18. The total 358 seizures were analyzed using bipolar and monopolar montage without sphenoidal electrodes. Scalp ictal EEGs were categorized into 3 types based on Ebersole and Pacia’s classification and then were evaluated with regard to the differentiation of TLE and its correlation with surgical outcome.
Results: 1) Out of the total 77 patients, type 1 pattern was observed in 23 (30%), type 2 in 51 (65%), and type 3 in 3 (5%). The number of patients with mesial TLE were 17 (74%) out of 23 with type 1, 41 (80%) out of 51 with type 2, 1 out of 3 with type 3. Type 1 pattern was relatively specific (74%) but not sensitive (30%) for mesial TLE. Also the lesion location of neocortical TLE with type 1 onset was not limited to medial temporal area. 2) Scalp ictal EEG patterns were significantly correlated with surgical outcome only in the subgroup of mesial TLE (p=0.006) but not in neocortical TLE. Type 1 onset pattern in mesial TLE was associated with favorable outcome comparing to type 2 onset.
Conclusions: Scalp ictal EEG onset pattern cannot accurately differentiate mesial TLE from neocortical TLE. However, its onset pattern can be predictive of surgical outcome.
키워드
두피발작뇌파; 발작시작; 측두엽절제술; 수술성적
Scalp Ictal EEG; Seizure onset; Temporal lobectomy; Outcome
원문 및 링크아웃 정보
등재저널 정보