The Impact of Ictal EEG Patterns on the Surgical Outcomes of Patients with Drug-resistant Epilepsy
Abstract number :
1.319
Submission category :
9. Surgery / 9A. Adult
Year :
2023
Submission ID :
551
Source :
www.aesnet.org
Presentation date :
12/2/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Albatoul Almulhim, MBBS – King Faisal Specialist Hospital and Research Centre-Jeddah
Fawzi Babtain, MBBS, MHSc, FRCPC, CSCN (EEG, EMG) – Neurologist, Epidemiologist, Neurosciences, King Faisal Specialist Hospital aand Research Center; Youssef Alsaid, MBBS, FRCPC – Neurologist, Neurosciences, King Faisal Specialist hoospital and research centre, Jeddah; Saleh Baeesa, MBBS, FRCS – Neurosurgeon, Neurosciences, King Faisal Specialist Hospital aand Research Center
Rationale: Predicting the surgical outcomes in drug-resistant epilepsy (DRE) is crucial to optimize patients’ selection, yet utilizing ictal EEG patterns as a predictive tool is still unclear.
Methods: We retrospectively evaluated epilepsy surgery outcomes, using the International League Against Epilepsy (ILAE) classification in patients with DRE between 2020 and 2022. The frequency of ictal onset and seizure duration were visually analyzed.
Results: We included 29 patients. There were 20 (69%) men; the mean age was 32 years, and the mean age of epilepsy onset was 13 years. Surgery was performed at a mean age of 31 years, and the mean epilepsy duration was 19 years. The temporal lobectomy was the most frequent surgery performed (79%), while abnormal MRI findings were observed in 83% of patients, with mesial temporal sclerosis being the most prevalent pathology (38%). Seizure outcomes classification revealed that 52% were Class I, 10% were Class II, 3% were Class III,17% were Class IV, and none had class V. We reviewed 235 seizures, a mean of 10 seizures recorded per patient, with a mean seizure duration of 98 seconds. Rhythmic theta (30.2%), rhythmic delta (19.6%), and rhythmic alpha (8.5%) were the most frequent initial ictal discharges, while the patterns were undetermined in 11.1% of cases. On average, seizures associated with class I and II outcomes had a seizure duration of 82 and 100 seconds, which were significantly shorter than seizures associated with class IV outcomes by 46 and 28 seconds, respectively (p-value< 0.05). The ictal onset of seizures with class IV outcomes appeared to have 1 Hz slower than seizures with other outcomes (p-value=0.051)
Surgery