Abstracts

Rationale: In patients with temporal lobe epilepsy (TLE) who are candidates for surgery, ictal video-EEG may not be necessary if the interictal video-EEG demonstrates consistent unilateral findings and another results of the preoperative assessment studies are concordant (1, 2). Compare the seizure freedom (measured by Engel(3) scale) in patients with TLE who were evaluated with ictal video-EEG versus non-ictal video-EEG undergoing surgery. Methods: Observational, analytical, longitudinal, retrospective study of patients with TLE of the National Institute of Neurology and Neurosurgery undergoing epilepsy surgery from January 2006 to October 2014 and follow-up ≥ 2 years. Results: 162 patients, 86 (53.1%) were women; mean age 40.48 ± 11.04 years, age of epilepsy 11.42 ± 8.71 years. Follow-up 5.64 ± 2.31 (range 2 to 10) years. 45 (68.2%) patients with non-ictal video-EEG and 58 (60.4%) with ictal video-EEG seizure-free ≥2 years Engel I; OR of 1.83 (CI 95%= 0.69-2.7). There were no significant differences in pre- and postoperative clinical variables between patients with ictal versus non-ictal video-EEG. Conclusions: There were no differences in seizure freedom in patients with an ictal video-EEG versus non-ictal video-EEG. The majority of patients that were operated on with TLE have concordance between ictal video-EEG, interictal EEG and MRI.The findings suggest that in patients well selected for TLE surgery, the surgical procedure could be performed without the ictal video-EEG. The surgical results obtained were good and similar with the seizure freedom reported in the world literature.Cascino GD et al. Epilepsia. 1996 Jul;37(7):651-6.2.      Cendes F et al. Arch Neurol. 2000 Apr;57(4):497-500. 3.      Engel JJ et al en: Engel JJ et al. Outcome with respect to epileptic seizures. In Engel J Jr, ed Surgical Treatment of the Epilepsies. Raven Press, 1993; 609-21 Funding: No