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ORIGINAL ARTICLE
Year : 2016  |  Volume : 53  |  Issue : 1  |  Page : 41-47

Long-term scalp video-electroencephalography monitoring in the presurgical evaluation of epilepsy surgery


1 Department of Neurology, Minia University, Minia, Egypt
2 Department of Neurology, Minia University, Minia, Egypt; Department of Neurosurgery, Jichi Medical University, Tochigi, Japan
3 Department of Neurosurgery, Jichi Medical University, Tochigi, Japan

Correspondence Address:
Nermin A Hamdy
MD, Department of Neurology, Minia University, Minia, 61111, Egypt

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1083.176370

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Background Diagnosis of the epileptogenic zone is the main aim of the presurgical evaluation in patients with drug-resistant epilepsy. Different diagnostic tools are being used to identify it. Objective This study aimed at studying the value of long-term scalp video-electroencephalography (video-EEG) monitoring to diagnose laterality and locality of the epileptic focus by comparing its results with other noninvasive methods, including interictal magnetoencephalography (MEG), interictal iodine-123 iomazenil single-photon emission computed tomography ( 123 I-IMZ SPECT), and interictal fluorine-18 fluorodeoxyglucose ( 18 F-FDG) PET. Patients and methods A total of 24 patients with drug-resistant epilepsy were included in this study; 17 had mesial temporal lobe epilepsy, whereas the remaining seven had neocortical epilepsy. All patients were admitted to Jichi University Hospital in Japan for the presurgical evaluation and surgical intervention. All patients were subjected to clinical evaluation, brain MRI, and long-term scalp video-EEG monitoring; a total of 23 patients had interictal 123 I-IMZ SPECT, 19 had interictal MEG recording, and 10 had interictal 18 F-FDG PET. The laterality and locality of the epileptogenic area predicted by these methods were defined in relation to the resected area. Results Long-term scalp video-EEG monitoring was significantly superior to interictal 123 I-IMZ SPECT and interictal 18 F-FDG PET in diagnosing laterality and locality of the epileptogenic zone and superior to interictal MEG in patients with mesial temporal lobe epilepsy and patients with epileptogenic MRI findings. Conclusion Long-term scalp video-EEG monitoring is the cornerstone in the presurgical evaluation of epilepsy surgery.


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