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  • Title: Clinical implications of scalp ictal EEG pattern in patients with temporal lobe epilepsy.
    Author: Liu X, Wu S, Daif A, Sun T, Chauhan V, Issa NP, Rose S, Tao JX.
    Journal: Clin Neurophysiol; 2019 Sep; 130(9):1604-1610. PubMed ID: 31319289.
    Abstract:
    OBJECTIVE: To determine the clinical implications of scalp ictal EEG pattern in patients with temporal lobe epilepsy (TLE). METHODS: Scalp EEG ictal patterns were retrospectively determined in 27 consecutive patients with medically refractory temporal lobe epilepsy who underwent phase-1 scalp video-EEG and phase-2 simultaneous scalp and intracranial video-EEG recordings for pre-surgical evaluation. RESULTS: Of the 192 temporal lobe seizures recorded during phase-1 and phase-2 scalp video-EEG studies, 124 (65%) seizures were associated with theta/alpha (5-9 Hz) ictal onset pattern, and 68 (35%) seizures were associated with delta (2-5 Hz) ictal onset pattern. Fourteen (52%) patients had exclusively theta/alpha ictal onset, 3 (11%) patients had exclusively delta ictal onset, and 10 (37%) patients had mixed theta/alpha and delta ictal onsets. MTLE was observed in 26 patients who had 124 seizures with theta/alpha ictal onset and 59 seizures with delta ictal onset. LTLE was observed in one patient who had 9 seizures with delta ictal onset. Scalp ictal EEG pattern was not significantly correlated with postsurgical seizure outcomes. CONCLUSIONS: Both scalp delta and theta/alpha ictal onset patterns can be commonly found in patients with MTLE. SIGNIFICANCE: Scalp delta ictal onset is not a unique EEG pattern for LTLE as commonly believed.
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