Electroencephalographic characteristics of patients with temporal lobe epilepsy with bitemporal interictal epilepti-form discharges and their association with surgical outcome
Objective To investigate the electroencephalographic characteristics of patients with temporal lobe epilepsy(TLE)with bitemporal interictal epileptiform discharges(IEDs)and their association with surgical outcome.Methods We retrospectively collected the clinical data of patients with TLE with IEDs who underwent surgical treatment at our epilepsy center from January 2013 to December 2019.The surgical outcomes of patients with different interictal and ictal electroen-cephalographic characteristics were compared.Results A total of 159 patients with TLE were included in this study.The frequency of IEDs showed no laterality in 42.1%(67/159)of the patients,dominance on the surgical side in 48.4%(77/159),and dominance on the contralateral side in 9.4%(15/159).Seizures were recorded in 73.0%(116/159)dur-ing preoperative electroencephalogram monitoring,which originated from the temporal lobe on the surgical side in 56.0%(65/116),the ipsilateral hemisphere in 5.2%(6/116),the contralateral temporal lobe in 5.2%(6/116),and on an unde-termined side in 33.6%(39/116).Twenty-nine patients were lost to follow-up after surgery,and the remaining patients were followed up for a mean length of(64.0±20.6)months(26-101 months),with 66.2%(86/130)of them in Engel class I and 33.8%(44/130)in Engel class II-IV.There were no significant differences in surgical outcome between pa-tients with different types of IEDs(P=0.794)and those with different seizure origins(P=0.299).Conclusion Patients with TLE with bitemporal IEDs can achieve effective control over seizures in a long term after surgery with comprehensive preoperative evaluation.IED characteristics and seizure origins are not associated with surgical outcome,and ictal electro-encephalography is not necessary for preoperative evaluation.
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