Table 1.
Patient characteristics and outcome and standard clinical work-up
| Patient | Sex | Duration epilepsy to surgery, years | Age at surgery, years | Seizure pattern | Follow-up, months | Post-surgery seizure reduction, % | Engel outcome | Semiology suspected focus | MRI | VEM | PET | SPECT |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | M | 12 | 25 | Weekly to monthly | 39 | 98 | I | L Fronto-temporal | Normal | L Fronto-temporal (spikes/seizures) | L Frontal (orbital) L Temporal (mesial) | L Frontal (posterior) |
| 2 | F | 33 | 54 | Weekly to monthly | 30 | 80 | II | L Temporal | Normal | L Anterior quadrant (spikes/seizures) | R Temporal (anteromesial) L Temporal (mesial) | L Temporal (anterior) |
| 3 | M | 31 | 51 | Weekly to monthly | 26 | 100 | I | R Temporal | Normal | R Anterior quadrant (spikes/seizures) | R Temporal (mesial, anterolateral) | R Temporal (lateral) |
| 4 | F | 25 | 27 | Multiple daily | 23 | 99 | I | L Frontal (hand/leg) | Normal | L Fronto-central (spikes/seizures) | L Frontal (lateral)L Parietal (lateral) | L Frontal (lateral) L Parietal (lateral) |
| 5 | F | 8 | 29 | Daily to weekly | 21 | 59 | III | R Temporal | Normal | R Lateral temporal (spikes/seizures) | Normal | Not captured |
| 6 | F | 4 | 36 | Daily to weekly | 20 | 100 | I | L Temporal | Normal | L Anterior temporal (spikes/seizures) | L Temporal (anterior pole) | L Temporal (lateral) |
| 7 | M | 32 | 39 | Multiple daily | 21 | 99 | I | R Frontal (face/hand) | Normal | R Frontal (spikes/seizures) | L Temporal (mesial) | R Frontal (lateral) R Temporal (lateral) |
| 8 | M | 5 | 20 | Daily to weekly | 20 | 100 | I | L Parietal | Normal | L Parieto-occipital (spikes/seizures) | Vertex (bilateral, sensorimotor strip) | L Temporal (lateral) |
| 9 | M | 6 | 25 | Daily to weekly | 22 | 98 | I | L Temporal | Normal | L Anterior quadrant (spikes) | L Temporal (anterior pole) | Not captured |
| 10 | F | 4 | 10 | Multiple daily | 26 | 99 | II | R Parietal (paracentral lobule) | Normal | L Fronto-central (spikes/seizures) | R Frontal (superior frontal gyrus) R Parietal (paracentral lobule) | Not captured |
| 11 | F | 33 | 36 | Multiple daily | 17 | 99 | I | R Frontal (face/hand/leg) | Multilobar dysplasia | R Fronto-central (spikes/seizures) | Not done | Not captured |
| 12 | M | 32 | 49 | Daily to weekly | 15 | 60 | III | L Temporo-parietal | Multilobar dysplasia | L Posterior quadrant (spikes/seizures) | L Occipito-parietal junction | Not captured |
| 13 | M | 20 | 33 | Daily to weekly | 14 | 100 | I | R Frontal | R Frontal gliosis | R Frontal (spikes/seizures) | Not done | Not captured |
All patients had severe refractory disabling seizures that improved after surgery, most with an Engel I outcome. Although Patient 10, a young female, had a 99% seizure reduction after surgery, her postoperative focal seizures, which carried a different semiology, were still disabling (Engel II outcome). No clear MRI abnormality was seen in 10 patients while three patients had complex lesions. ICEEG was performed in nine patients: 64-electrode array (Patients 1, 10, 11, 12, and 13); 32-electrode array plus ipsilateral 8-electrode hippocampal depth (Patients 5 and 6); an intra-operative depth electrode (Patient 8); and bilateral hippocampal-depth electrodes (Patient 2).
ICEEG = intracranial EEG.