J Korean Neurol Assoc > Volume 20(5); 2002 > Article

Journal of the Korean Neurological Association 2002;20(5): 497-503.

"측두엽간질에서 경막하 선형전극술: 반구간 전파 시간과 수술 예후와의 연관성"

김광덕 , 조용원 ·강봉구 ·최종환 ·손성일 ·정두교 ·이이형 ·임정근 ·이상도

계명대학교 의과대학교 신경과학교실

"Subdural Strip Electrode Studies in Temporal Lobe Epilepsy: Relation between Interhemispheric Propagation Time and Surgical Outcome"

Kwang-Duk Kim, M.D.

Department of Neurology, Keimyung University, School of Medicine

Abstract

"Background : We evaluated whether the time required for a seizure to spread contralaterally, interhemispheric propa-gation time (IHSPT) could be related to post-surgical outcome in temporal lobectomy. Methods : We performed a ret-rospective study of 28 patients. All patients had previously undergone a phase I presurgical evaluation including MRI and video-EEG monitoring with scalp and sphenoidal electrodes, which strongly suggested the diagnosis of mesial tem-poral lobe epilepsy, but proved inadequate to lateralize the epileptogenic zone. All patients performed the video-EEG monitoring with bilateral subdural strip electrodes on their basal and mesial temporal area and unilateral temporal lobectomy with a minimum of 1-year follow up postoperatively. IHSPT was divided into two categories, 0~5.0 seconds, 5.1 seconds or longer. Results : Sixteen patients (57.1%) were seizure free and 12 suffered persistent seizures. A pro-longed IHSPT (> 5.0sec) significantly correlated with a favorable surgical outcome (P = 0.05). Hippocampal atrophy on MRI significantly correlated with prolonged IHSPT (P < 0.05). Conclusions : Our result suggests that hippocampal atrophy on MRI and IHSPT can predict the surgical outcome and may be used as the selection criteria of temporal lobectomy for patients with intractable temporal lobe epilepsy.Key Words : IHSPT, Surgical outcome, Temporal lobe epilepsy"