Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography

David King-Stephens, Emily Mirro, Peter B. Weber, Kenneth D. Laxer, Paul C. Van Ness, Vicenta Salanova, David C. Spencer, Christianne N. Heck, Alica Goldman, Barbara Jobst, Donald C. Shields, Gregory K Bergey, Stephan Eisenschenk, Gregory A. Worrell, Marvin A. Rossi, Robert E. Gross, Andrew J. Cole, Michael R. Sperling, Dileep R. Nair, Ryder P. Gwinn & 13 others Yong D. Park, Paul A. Rutecki, Nathan B. Fountain, Robert E. Wharen, Lawrence J. Hirsch, Ian O. Miller, Gregory L. Barkley, Jonathan C. Edwards, Eric B. Geller, Michel J. Berg, Toni L. Sadler, Felice T. Sun, Martha J. Morrell

Research output: Contribution to journalArticle

Abstract

Objective Patients with suspected mesial temporal lobe (MTL) epilepsy typically undergo inpatient video-electroencephalography (EEG) monitoring with scalp and/or intracranial electrodes for 1 to 2 weeks to localize and lateralize the seizure focus or foci. Chronic ambulatory electrocorticography (ECoG) in patients with MTL epilepsy may provide additional information about seizure lateralization. This analysis describes data obtained from chronic ambulatory ECoG in patients with suspected bilateral MTL epilepsy in order to assess the time required to determine the seizure lateralization and whether this information could influence treatment decisions. Methods Ambulatory ECoG was reviewed in patients with suspected bilateral MTL epilepsy who were among a larger cohort with intractable epilepsy participating in a randomized controlled trial of responsive neurostimulation. Subjects were implanted with bilateral MTL leads and a cranially implanted neurostimulator programmed to detect abnormal interictal and ictal ECoG activity. ECoG data stored by the neurostimulator were reviewed to determine the lateralization of electrographic seizures and the interval of time until independent bilateral MTL electrographic seizures were recorded. Results Eighty-two subjects were implanted with bilateral MTL leads and followed for 4.7 years on average (median 4.9 years). Independent bilateral MTL electrographic seizures were recorded in 84%. The average time to record bilateral electrographic seizures in the ambulatory setting was 41.6 days (median 13 days, range 0-376 days). Sixteen percent had only unilateral electrographic seizures after an average of 4.6 years of recording. Significance About one third of the subjects implanted with bilateral MTL electrodes required >1 month of chronic ambulatory ECoG before the first contralateral MTL electrographic seizure was recorded. Some patients with suspected bilateral MTL seizures had only unilateral electrographic seizures. Chronic ambulatory ECoG in patients with suspected bilateral MTL seizures provides data in a naturalistic setting, may complement data from inpatient video-EEG monitoring, and can contribute to treatment decisions.

Original languageEnglish (US)
Pages (from-to)959-967
Number of pages9
JournalEpilepsia
Volume56
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Temporal Lobe Epilepsy
Seizures
Temporal Lobe
Implantable Neurostimulators
Electrocorticography
Inpatients
Electroencephalography
Electrodes
Scalp
Randomized Controlled Trials
Stroke

Keywords

  • Ambulatory EEG
  • EEG monitoring
  • Electrocorticography
  • Intracranial EEG
  • Localization
  • Responsive stimulation

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

King-Stephens, D., Mirro, E., Weber, P. B., Laxer, K. D., Van Ness, P. C., Salanova, V., ... Morrell, M. J. (2015). Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography. Epilepsia, 56(6), 959-967. https://doi.org/10.1111/epi.13010

Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography. / King-Stephens, David; Mirro, Emily; Weber, Peter B.; Laxer, Kenneth D.; Van Ness, Paul C.; Salanova, Vicenta; Spencer, David C.; Heck, Christianne N.; Goldman, Alica; Jobst, Barbara; Shields, Donald C.; Bergey, Gregory K; Eisenschenk, Stephan; Worrell, Gregory A.; Rossi, Marvin A.; Gross, Robert E.; Cole, Andrew J.; Sperling, Michael R.; Nair, Dileep R.; Gwinn, Ryder P.; Park, Yong D.; Rutecki, Paul A.; Fountain, Nathan B.; Wharen, Robert E.; Hirsch, Lawrence J.; Miller, Ian O.; Barkley, Gregory L.; Edwards, Jonathan C.; Geller, Eric B.; Berg, Michel J.; Sadler, Toni L.; Sun, Felice T.; Morrell, Martha J.

In: Epilepsia, Vol. 56, No. 6, 01.06.2015, p. 959-967.

Research output: Contribution to journalArticle

King-Stephens, D, Mirro, E, Weber, PB, Laxer, KD, Van Ness, PC, Salanova, V, Spencer, DC, Heck, CN, Goldman, A, Jobst, B, Shields, DC, Bergey, GK, Eisenschenk, S, Worrell, GA, Rossi, MA, Gross, RE, Cole, AJ, Sperling, MR, Nair, DR, Gwinn, RP, Park, YD, Rutecki, PA, Fountain, NB, Wharen, RE, Hirsch, LJ, Miller, IO, Barkley, GL, Edwards, JC, Geller, EB, Berg, MJ, Sadler, TL, Sun, FT & Morrell, MJ 2015, 'Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography', Epilepsia, vol. 56, no. 6, pp. 959-967. https://doi.org/10.1111/epi.13010
King-Stephens D, Mirro E, Weber PB, Laxer KD, Van Ness PC, Salanova V et al. Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography. Epilepsia. 2015 Jun 1;56(6):959-967. https://doi.org/10.1111/epi.13010
King-Stephens, David ; Mirro, Emily ; Weber, Peter B. ; Laxer, Kenneth D. ; Van Ness, Paul C. ; Salanova, Vicenta ; Spencer, David C. ; Heck, Christianne N. ; Goldman, Alica ; Jobst, Barbara ; Shields, Donald C. ; Bergey, Gregory K ; Eisenschenk, Stephan ; Worrell, Gregory A. ; Rossi, Marvin A. ; Gross, Robert E. ; Cole, Andrew J. ; Sperling, Michael R. ; Nair, Dileep R. ; Gwinn, Ryder P. ; Park, Yong D. ; Rutecki, Paul A. ; Fountain, Nathan B. ; Wharen, Robert E. ; Hirsch, Lawrence J. ; Miller, Ian O. ; Barkley, Gregory L. ; Edwards, Jonathan C. ; Geller, Eric B. ; Berg, Michel J. ; Sadler, Toni L. ; Sun, Felice T. ; Morrell, Martha J. / Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography. In: Epilepsia. 2015 ; Vol. 56, No. 6. pp. 959-967.
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abstract = "Objective Patients with suspected mesial temporal lobe (MTL) epilepsy typically undergo inpatient video-electroencephalography (EEG) monitoring with scalp and/or intracranial electrodes for 1 to 2 weeks to localize and lateralize the seizure focus or foci. Chronic ambulatory electrocorticography (ECoG) in patients with MTL epilepsy may provide additional information about seizure lateralization. This analysis describes data obtained from chronic ambulatory ECoG in patients with suspected bilateral MTL epilepsy in order to assess the time required to determine the seizure lateralization and whether this information could influence treatment decisions. Methods Ambulatory ECoG was reviewed in patients with suspected bilateral MTL epilepsy who were among a larger cohort with intractable epilepsy participating in a randomized controlled trial of responsive neurostimulation. Subjects were implanted with bilateral MTL leads and a cranially implanted neurostimulator programmed to detect abnormal interictal and ictal ECoG activity. ECoG data stored by the neurostimulator were reviewed to determine the lateralization of electrographic seizures and the interval of time until independent bilateral MTL electrographic seizures were recorded. Results Eighty-two subjects were implanted with bilateral MTL leads and followed for 4.7 years on average (median 4.9 years). Independent bilateral MTL electrographic seizures were recorded in 84{\%}. The average time to record bilateral electrographic seizures in the ambulatory setting was 41.6 days (median 13 days, range 0-376 days). Sixteen percent had only unilateral electrographic seizures after an average of 4.6 years of recording. Significance About one third of the subjects implanted with bilateral MTL electrodes required >1 month of chronic ambulatory ECoG before the first contralateral MTL electrographic seizure was recorded. Some patients with suspected bilateral MTL seizures had only unilateral electrographic seizures. Chronic ambulatory ECoG in patients with suspected bilateral MTL seizures provides data in a naturalistic setting, may complement data from inpatient video-EEG monitoring, and can contribute to treatment decisions.",
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author = "David King-Stephens and Emily Mirro and Weber, {Peter B.} and Laxer, {Kenneth D.} and {Van Ness}, {Paul C.} and Vicenta Salanova and Spencer, {David C.} and Heck, {Christianne N.} and Alica Goldman and Barbara Jobst and Shields, {Donald C.} and Bergey, {Gregory K} and Stephan Eisenschenk and Worrell, {Gregory A.} and Rossi, {Marvin A.} and Gross, {Robert E.} and Cole, {Andrew J.} and Sperling, {Michael R.} and Nair, {Dileep R.} and Gwinn, {Ryder P.} and Park, {Yong D.} and Rutecki, {Paul A.} and Fountain, {Nathan B.} and Wharen, {Robert E.} and Hirsch, {Lawrence J.} and Miller, {Ian O.} and Barkley, {Gregory L.} and Edwards, {Jonathan C.} and Geller, {Eric B.} and Berg, {Michel J.} and Sadler, {Toni L.} and Sun, {Felice T.} and Morrell, {Martha J.}",
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T1 - Lateralization of mesial temporal lobe epilepsy with chronic ambulatory electrocorticography

AU - King-Stephens, David

AU - Mirro, Emily

AU - Weber, Peter B.

AU - Laxer, Kenneth D.

AU - Van Ness, Paul C.

AU - Salanova, Vicenta

AU - Spencer, David C.

AU - Heck, Christianne N.

AU - Goldman, Alica

AU - Jobst, Barbara

AU - Shields, Donald C.

AU - Bergey, Gregory K

AU - Eisenschenk, Stephan

AU - Worrell, Gregory A.

AU - Rossi, Marvin A.

AU - Gross, Robert E.

AU - Cole, Andrew J.

AU - Sperling, Michael R.

AU - Nair, Dileep R.

AU - Gwinn, Ryder P.

AU - Park, Yong D.

AU - Rutecki, Paul A.

AU - Fountain, Nathan B.

AU - Wharen, Robert E.

AU - Hirsch, Lawrence J.

AU - Miller, Ian O.

AU - Barkley, Gregory L.

AU - Edwards, Jonathan C.

AU - Geller, Eric B.

AU - Berg, Michel J.

AU - Sadler, Toni L.

AU - Sun, Felice T.

AU - Morrell, Martha J.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Objective Patients with suspected mesial temporal lobe (MTL) epilepsy typically undergo inpatient video-electroencephalography (EEG) monitoring with scalp and/or intracranial electrodes for 1 to 2 weeks to localize and lateralize the seizure focus or foci. Chronic ambulatory electrocorticography (ECoG) in patients with MTL epilepsy may provide additional information about seizure lateralization. This analysis describes data obtained from chronic ambulatory ECoG in patients with suspected bilateral MTL epilepsy in order to assess the time required to determine the seizure lateralization and whether this information could influence treatment decisions. Methods Ambulatory ECoG was reviewed in patients with suspected bilateral MTL epilepsy who were among a larger cohort with intractable epilepsy participating in a randomized controlled trial of responsive neurostimulation. Subjects were implanted with bilateral MTL leads and a cranially implanted neurostimulator programmed to detect abnormal interictal and ictal ECoG activity. ECoG data stored by the neurostimulator were reviewed to determine the lateralization of electrographic seizures and the interval of time until independent bilateral MTL electrographic seizures were recorded. Results Eighty-two subjects were implanted with bilateral MTL leads and followed for 4.7 years on average (median 4.9 years). Independent bilateral MTL electrographic seizures were recorded in 84%. The average time to record bilateral electrographic seizures in the ambulatory setting was 41.6 days (median 13 days, range 0-376 days). Sixteen percent had only unilateral electrographic seizures after an average of 4.6 years of recording. Significance About one third of the subjects implanted with bilateral MTL electrodes required >1 month of chronic ambulatory ECoG before the first contralateral MTL electrographic seizure was recorded. Some patients with suspected bilateral MTL seizures had only unilateral electrographic seizures. Chronic ambulatory ECoG in patients with suspected bilateral MTL seizures provides data in a naturalistic setting, may complement data from inpatient video-EEG monitoring, and can contribute to treatment decisions.

AB - Objective Patients with suspected mesial temporal lobe (MTL) epilepsy typically undergo inpatient video-electroencephalography (EEG) monitoring with scalp and/or intracranial electrodes for 1 to 2 weeks to localize and lateralize the seizure focus or foci. Chronic ambulatory electrocorticography (ECoG) in patients with MTL epilepsy may provide additional information about seizure lateralization. This analysis describes data obtained from chronic ambulatory ECoG in patients with suspected bilateral MTL epilepsy in order to assess the time required to determine the seizure lateralization and whether this information could influence treatment decisions. Methods Ambulatory ECoG was reviewed in patients with suspected bilateral MTL epilepsy who were among a larger cohort with intractable epilepsy participating in a randomized controlled trial of responsive neurostimulation. Subjects were implanted with bilateral MTL leads and a cranially implanted neurostimulator programmed to detect abnormal interictal and ictal ECoG activity. ECoG data stored by the neurostimulator were reviewed to determine the lateralization of electrographic seizures and the interval of time until independent bilateral MTL electrographic seizures were recorded. Results Eighty-two subjects were implanted with bilateral MTL leads and followed for 4.7 years on average (median 4.9 years). Independent bilateral MTL electrographic seizures were recorded in 84%. The average time to record bilateral electrographic seizures in the ambulatory setting was 41.6 days (median 13 days, range 0-376 days). Sixteen percent had only unilateral electrographic seizures after an average of 4.6 years of recording. Significance About one third of the subjects implanted with bilateral MTL electrodes required >1 month of chronic ambulatory ECoG before the first contralateral MTL electrographic seizure was recorded. Some patients with suspected bilateral MTL seizures had only unilateral electrographic seizures. Chronic ambulatory ECoG in patients with suspected bilateral MTL seizures provides data in a naturalistic setting, may complement data from inpatient video-EEG monitoring, and can contribute to treatment decisions.

KW - Ambulatory EEG

KW - EEG monitoring

KW - Electrocorticography

KW - Intracranial EEG

KW - Localization

KW - Responsive stimulation

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