Lateralizing and localizing value of seizure semiology: Comparison with scalp EEG, MRI and PET in patients successfully treated with resective epilepsy surgery.

Purpose: To evaluate the lateralizing and localizing value of seizure semiology in patients who became completely seizure free after resective epilepsy surgery.

Methods: We analyzed seizures of patients who were seizure free after focal resection limited to the temporal lobe (30 patients), frontal lobe (27 patients), parietal lobe (8 patients) and occipital lobe (8 patients). Three investigators independently analyzed video segments of seizures blinded to clinical information and attempted to lateralize and localize the seizure focus, based on pre-defined criteria.

Ictal single photon emission computed tomography in epileptic auras.

Objectives: Little is known about whether ictal single photon emission computed tomography (SPECT) during an isolated aura can localize the epileptogenic zone (EZ). This study seeks to evaluate the yield of ictal SPECT injection in isolated epileptic auras.

Methods: We identified 20 patients with focal epilepsy studied during 26 isolated auras by ictal interictal subtraction SPECT coregistered to magnetic resonance imaging (SISCOM).

Pseudotemporal ictal patterns compared with mesial and neocortical temporal ictal patterns.

Purpose: This study analyzes falsely localizing pseudotemporal ictal EEG patterns, to test if it is possible to differentiate them from those in "true" temporal lobe epilepsy.

Methods: We retrospectively studied 33 patients who had epilepsy surgery and a favorable outcome (Engel I), belonging to three groups: 10 patients (37 seizures) with pseudotemporal ictal patterns (PT), 12 patients (45 seizures) with mesial temporal epilepsy because of hippocampal sclerosis (HS), and 11 patients (41 seizures) with neocortical temporal epilepsy (NT). Ictal EEGs were analyzed visually according to predetermined criteria and by using a source localization program (BESA5.

Correlations between ictal propagation and response to electrical cortical stimulation: a cortico-cortical evoked potential study.

Objective: To better understand the process of ictal propagation in epilepsy by using cortico-cortical evoked potential (CCEP), which reveals the brain networks.

Methods: Intracranial EEG recordings of 11 seizures from 11 patients with pharmacoresistant focal epilepsy were studied to identify the propagation sites and times. Six patients had a history of secondary generalization (Gen (+) group) and five patients did not (Gen (-) group).

A randomized study comparing DCR with and without excision of the posterior mucosal flap.

Aim: A prospective randomized study was carried out to compare the success rate of external dacryocystorhinostomy (DCR) with and without excision of the posterior sac mucosal flap.

Methods: Forty patients (Group A) underwent DCR without excision of the posterior sac mucosal flap, and the results obtained were compared with those of another series of 40 patients (Group B) where DCR was performed with excision of the posterior sac flap. A large posterior flap was excised from the lacrimal sac and a large, mobile, anteriorly-hinged, nasal mucosal flap was fashioned.