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Academia Mexicana de Neurología, A.C.

2007, Number 2

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Rev Mex Neuroci 2007; 8 (2)

Relationship between the epileptogenic area lateralization using Video-EEG and the functional neuroimaging evaluation: A study in pharmaco-resistant Medial Temporal Lobe Epilepsy patients submitted to surgery

Morales CLM, Sánchez CC, García ME, Bender J, García I, Lorigados L, Estupiñán DB

Language: Spanish
References: 30
Page: 127-134
PDF size: 94.42 Kb.


ABSTRACT

Objective: To evaluate the relationship between the epileptogenic area lateralization using Video-Electroencephalogram (V-EEG) with additional extracraneal electrodes, and functional neuroimaging studies (Magnetic Resonance Espectroscopy (MRE) and Simple Photon Emission Tomography (SPECT cerebral ) during interictal and ictal states in pharmacoresistant Medial Temporal Lobe Epilepsy patients submitted to surgery. Material and methods: The V-EEG results supplemented with sprectal EEG analysis, as well as the interictal and ictal cerebral SPECT and the metabolic ratios evidenced by MRE were evaluated in 12 pharmacoresistant Medial Temporal Lobe Epilepsy patients submitted to surgery, with normal Magnetic Resonance Imaging (MRI) or with bilateral mesial temporal sclerosis. All patients were considered in Engel class 1 (seizure free) to the year of surgery. Results: The biggest percent of correct lateralization were showed by the ictal V-EEG (100%), continued by the ictal SPECT. During the interictal SPECT semiquantitative analysis, the perfution changes in the lateral temporal region were those of more lateralization value. They were ipsilateral to the surgery side in 92.3% of the patients χ2 (2) = 8, p < 0.0001. On the other hand, the MRE data using discriminant analysis with agrupating variable, the surgery side allowed to be statistically significant model Wilks Lambda 0.224 F (3, 8) = 9.21 p ‹ 0.0056 whose influence variables were Cho/Cr p ‹ 0.003, NAA/Cr p ‹ 0.001 and NAA/ Cho+Cr p ‹ 0.03 indexes. The epileptogenic area was appropriately lateralized in 53.8% of the patients using MRE. Conclusions: The localizate/lateralize information provided by the V-EEG supplemented with the neurofunctional imaging (SPECT and MRE) allows to carry out successful Temporal Lobe Lobectomy in TLE patients with normal MRI or bilateral morphological alterations.


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