Abstract Details

Title Observational Analysis of EEG in Patients with Intractable Seizures before and after Lobectomies

Topic Epilepsy

Presentation(s) P06 - (-)

Poster/Presentation
Number 167

Objective

Background BACKGROUND: Epilepsy affects millions of Americans of all ages, and the annual burden costs billions of dollars Begley). Up to 35 percent (Kwan and Brodie) of new patients fail to gain control of seizures despite optimal medical management . Epilepsy surgeries, especially temporal lobectomies are considered as a potential curative intervention for intractable seizures.

Design/Methods DESIGN/METHODS: We performed a retrospective analysis of EEGs before and after lobectomies of 143 consecutive patients who presented to our institution (2000-2012).

Results RESULTS: Thirty four(11M, 23F)(24recurrent seizures, 7medication discontinuation, 4altered mentation) (age 37.9±25.8)of the 143 patients were evaluated post-operatively (28temporal lobectomy with amygdalohippocampectomy. Seizure activity was seen in 30 patients(10R,14L and 6bihemispheric). Epileptiform activity, spike and sharp waves(9R, 9L, 11bihemispheric) were the next common finding followed by slowing(4R, 4L, 5bihemispheric). Interestingly 10 patients had non-epileptic events in addition to their electrographic seizures and there were 7 additional cases of non-epileptic events following surgery. After the surgery EEGs revealed seizure activity(3R, 3L, 3bihemispheric), spike and wave(4R, 12L, 5bihemispheric) and slowing(7R, 9L, 5bihemispheric). Amongst the 6 patients with focal seizure activity, prior seizure activity was seen in;(3ipsilaterally, 2contralaterally, 1bihemsipheric). Amongst the 3 patients with bihemispheric seizure activity, only 1 had prior bihemispheric seizure activity. It is interesting to note that focal slowing was seen in 4 patients contralateral to their surgical side and there were 4 new cases of bihemispheric slowing without any correlation with continued seizures.

Conclusions CONCLUSIONS: There were no statistical correlations between EEGs to help us better understand patients with continued seizures. We propose that laterality of seizure focus or bihemispheric seizure focus does not predict the focality of continued seizures.

Authors/Disclosures
Kogul Arumaithurai, MD (Mayo Clinic) PRESENTER	Dr. Arumaithurai has nothing to disclose.
Akshay M. Shah, MD (San Jose Pacific Neurology)	No disclosure on file
Kendra Drake, MD, FAAN (Western Neuro)	Dr. Drake has nothing to disclose.
David M. Labiner, MD (University of Arizona Health Sciences)	The institution of Dr. Labiner has received research support from CDC.
	No disclosure on file
Gavin Giovannoni, MD (QMUL)	Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck KGaA. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche-Genentech. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Moderna. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Astoria Biologica. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zenas. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medscape.

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