The prognosti̇c value of ictal eeg and semiological findings in patients with mesial temporal sclerosis after epilepsy surgery

SUMMARY THE PROGNOSTİC VALUE OF ICTAL EEG AND SEMIOLOGICAL FINDINGS IN PATIENTS WITH MESIAL TEMPORAL SCLEROSIS AFTER EPILEPSY SURGERY Purpose: The purpose of this study is to analyze ictal electrophysiological patterns and semiological characteristics of patients with operated mesial temporal lobe epilepsy with hippocampal sclerosis (MTS) as seen in scalp video-EEG monitorings and define the significance of the relevant properties in respect to postoperative outcomes. Methods: We analyzed 30 patient with TLE and pathologically proven MTS between 2005-2014. Seizures and patients were classified according to electrophysiological and semiological properties. Mean follow-up period after surgery was 69,4± 32,69 months (1-9 years). Post-surgical outcomes were classified according to Engel classification. Findings: The most common ictal patern among patern of onset and later significant patern was found as rhytmic teta activity (%63,2 and %36,8). Not having unusual propogation paterns, RTA, unilateral ictal lateralization, ictal termination and postictal slowing on the same side with MR findings was related with good prognosis. The closest relation of surgical side concordance among electrographical parameters was with postictal slowing. The most common lateralizing semiological signs were distonic hand, unilateral automatism and postictal nose rubbing. When we compare the concordance of electrophysiological and semiological findings the most concordant parameters to localize the same side was ictal EEG and termination. The investigation of the concordance among neuroimaging tests and neuropsychological test, ictal EEG and semiology the closest relation was found between MRI and ictal EEG. Results: With the help of the scalp EEG recordings in patients with MTS the type of ictal patern, ictal termination and postictal slowing lateralization gives us very significant information about the prognosis after surgery. The most effective electrophysiological and semiological parameter to determine surgical side is postictal slowing. The highest propobality of concordance to localize the same side is between ictal EEG- termination and MRI-ictal EEG.