Stereo-EEG ictal/interictal patterns and underlying pathologies

Roberta Di Giacomo, Reinaldo Uribe-San-Martin, Roberto Mai, Stefano Francione, Lino Nobili, Ivana Sartori, Francesca Gozzo, Veronica Pelliccia, Marco Onofrj, Giorgio Lo Russo, Marco de Curtis, Laura Tassi

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To define Stereo-EEG (SEEG) ictal and interictal patterns associated with different pathologies in a cohort of patients with drug-resistant focal epilepsy. Methods: We retrospectively analyzed findings from 102 patient with epilepsy due to Polymicrogyria (PMG), Periventricular Nodular Heterotopia (PNH), Focal Cortical Dysplasia (FCD) type I, IIa, IIb and Hippocampal Sclerosis (HS). Ictal and interictal SEEG recordings were reviewed to describe Seizure Onset Zone (SEEG-SOZ) patterns and to define the Lesional and Irritative Zones. Results: Five SEEG-SOZ patterns were identified: significant associations were found between low-voltage fast activity and PMG and between repetitive fast spikes bursts and FCD type IIa. A trend was found between fast activity and PNH, rhythmic sharp activity and FCD type I, repetitive fast spikes bursts and FCD type IIb, slow burst and HS. In 62 of the 102 patients, a complete surgical resection of the SEEG-SOZ was performed, and in 12 patients a partial resection was carried out to preserve eloquent areas. In 18 patients (15 with PNH) the SEEG-SOZ was thermo-coagulated. Seizure freedom was achieved in 58% of surgically treated patients and in 72% of those treated with thermocoagulation (mean ± SD follow-up 5.9 ± 2.3 years). Seizure freedom after surgery was achieved in 84% of the patients with PMG, FCD I, IIa and IIb presenting with characteristic SEEG-SOZ patterns. With the exception of FCD type II, interictal activity was not sufficient to identify SEEG-SOZ boundaries. Conclusion: The study demonstrates that specific histopathologies correlate with particular neurophysiological patterns, reflecting lesion-specific seizure patterns in focal epilepsies.

Original languageEnglish
Pages (from-to)54-60
Number of pages7
JournalSeizure
Volume72
DOIs
Publication statusPublished - Nov 2019

Keywords

  • Epilepsy surgery
  • Epileptogenic zone
  • Interictal activity
  • Malformations of cortical development
  • Seizure onset zone
  • Stereo-EEG

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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