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Visual and semiautomated evaluation of epileptogenicity in focal cortical dysplasias - An intracranial EEG study

Gollwitzer, S; Valente, I; Rodionov, R; Scott, C; Ritter, LM; Wehner, T; Hamer, HM; ... Diehl, B; + view all (2016) Visual and semiautomated evaluation of epileptogenicity in focal cortical dysplasias - An intracranial EEG study. Epilepsy & Behaviour , 58 pp. 69-75. 10.1016/j.yebeh.2016.03.009. Green open access

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Abstract

INTRODUCTION: The aim of the study was the evaluation of the added value of depth to subdural electrodes in delineating epileptogenicity of focal cortical dysplasias (FCDs) and to test the Epileptogenicity Index (EI) in this setting. MATERIAL AND METHODS: Fifteen patients with FCD underwent iEEG with subdural and depth electrodes. Visual/EI analysis was performed in up to three habitual seizures per patient. RESULTS: Visual analysis: Grid onset seizures (n=10) started in electrodes overlying the lesion in 7 and remote from it in 3 cases. Depth onset seizures (n=7) affected only intralesional contacts in 4, intra- and extralesional in 2, and exclusively extralesional in 1 patient. Seizures started in depth and grid contacts simultaneously in 2 cases. EI analysis: The EI completely confirmed visual localization of seizure onset in 8 cases and depicted ictal onset-time accurately in 13. Beta/gamma ictal patterns were most reliably captured. Impact on surgical decision: Resection outline differed from MRI lesion in 7 patients based on grid and in three based on depth electrode information. DISCUSSION: In FCD, seizures can be generated within gyral/deep tissue appearing normal on imaging. CONCLUSION: Investigating FCD with subdural and depth electrodes is efficient to outline the seizure onset zone. The EI is a helpful additional tool to quantify epileptogenicity. Specific ictal patterns are prerequisite for reliable results.

Type: Article
Title: Visual and semiautomated evaluation of epileptogenicity in focal cortical dysplasias - An intracranial EEG study
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.yebeh.2016.03.009
Publisher version: http://doi.org/10.1016/j.yebeh.2016.03.009
Language: English
Additional information: Copyright © 2016 Elsevier Ltd. All rights reserved. This is an Open Access article made available under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International license (CC BY-NC-ND 4.0). This license allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licenses are available at http://creativecommons.org/ licenses/by/4.0. Access may be initially restricted by the publisher.
Keywords: Epilepsy surgery, Epileptogenicity Index, Focal epilepsy, SEEG
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/1482474
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