Predictive value of electroencephalography for seizure outcome following corpus callosotomy in children

脑电图对儿童胼胝体切开术后癫痫发作预后的预测价值

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Abstract

BACKGROUND AND PURPOSE: This study aimed to determine whether preoperative or postoperative electroencephalography (EEG) can predict surgical outcome for corpus callosotomy. METHODS: We retrospectively reviewed the medical records of 16 patients enrolled. We compared postoperative seizure outcome according to seizure type, preoperative interictal EEG, preoperative ictal EEG, and postoperative interictal EEG. Seizure outcome was classified according to postoperative seizure reduction, i.e., seizure free, >90%, 50-90%, <50%, and no change or worsened. A seizure reduction of 50% or more was judged as a "favorable outcome". RESULTS: Most patients showed a favorable outcome (12 patients, 75%) and two patients became seizure free (13%). Atonic seizure was most responsive to corpus callosotomy. Preoperative interictal epileptiform discharge had 3 patterns; bilateral independent, generalized, and combination of independent and generalized. None of the preoperative interictal epileptiform discharge (EDs) had significant correlation with seizure outcome. The preoperative ictal rhythm did not predict seizure outcome. However disappearance of generalized EDs on postoperative EEG was correlated with favorable seizure outcome. CONCLUSIONS: The presence of generalized EDs on postoperative interictal EEG predicted seizure outcome, whereas preoperative EEG did not.

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