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Interictal scalp EEG showed paroxysmal abnormalities during prolonged monitoring in 64 patients(96%).These were localized in the anterior temporal,region in 60(94%)of these 64 patients.Bilateral independent paroxysmal activity occurred in 42%of the patients and was preponderant over the side of seizure origin in half.Ictal EEG changes were rarely detected at the time of clinical seizure onset,but lateralized buildup of rhythmic seizure activity during the seizure occurred in 80%of patients.In 13%,the scalp EEG seizure buildup was,however,contralateral to the side of seizure origin as subsequently determined by depth EEG and curative surgery.Lateralized postictal slowing,when present,was a very reliable lateralizing finding.Neuropsychological testing provided lateralizing findings concordant with the side of seizure origin in 73%of patients.When neuropsychological testing produced discordant results or nonlateralizing findings,those patients were usually found to have right temporal seizure origin.Intracarotid amobarbital(Amytal)testing demonstrated absent or marginal memory functions on the side of seizure onset in 63%of patients, but 26 patients(37%)had bilaterally intact memory.In those patients who had magnetic resonance imaging,it was very sensitive in detecting subtle medial temporal abnormalities.These abnormalities were present in 23 of 28 magnetic resonance images,and corresponded with mesial temporal sclerosis on pathological examination in all but 2 patients.Eighty-one percent of the 51 patients who had adequate pathological examination of tissue had mesial temporal sclerosis.Forty-one patients with adequate pathological examination had histories of febrile seizures and of these 38(93%)had mesial temporal sclerosis. |
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electroencephalogram
electroencephalogram,abnormalities of
mesial temporal sclerosis
MRI
MRI,abnormal
neuropathology
psychological testing
review article
seizure,febrile
seizure,psychomotor-temporal lobe
seizure,psychomotor-temporal lobe,interictal behavior
seizure,surgical treatment of
seizure,treatment of
temporal lobectomy
treatment of neurologic disorder
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