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The value of ictal scalp EEG in focal epilepsies surgery: a retrospective analysis

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Abstract

Objective

To describe the association between preoperative ictal scalp electroencephalogram (EEG) results and surgical outcomes in patients with focal epilepsies.

Methods

The data of consecutive patients with focal epilepsies who received surgical treatments at our center from January 2012 to December 2021 were retrospectively analyzed.

Results

Our data showed that 44.2% (322/729) of patients had ictal EEG recorded on video EEG monitoring during preoperative evaluation, of which 60.6% (195/322) had a concordant ictal EEG results. No significant difference of surgery outcomes between patients with and without ictal EEG was discovered. Among MRI-negative patients, those with concordant ictal EEG had a significantly better outcome than those without ictal EEG (75.7% vs. 43.8%, p = 0.024). Further logistic regression analysis showed that concordant ictal EEG was an independent predictor for a favorable outcome (OR = 4.430, 95%CI 1.175–16.694, p = 0.028). Among MRI-positive patients, those with extra-temporal lesions and discordant ictal EEG results had a worse outcome compared to those without an ictal EEG result (44.7% vs. 68.8%, p = 0.005). Further logistic regression analysis showed that discordant ictal EEG was an independent predictor of worse outcome (OR = 0.387, 95%CI 0.186–0.807, p = 0.011) in these patients. Furthermore, our data indicated that the number of seizures was not associated with the concordance rates of the ictal EEG, nor the surgical outcomes.

Conclusions

The value of ictal scalp EEG for epilepsy surgery varies widely among patients. A concordant ictal EEG predicts a good surgical outcome in MRI-negative patients, whereas a discordant ictal EEG predicts a poor postoperative outcome in lesional extratemporal lobe epilepsy.

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Data Availability

The data that support the findings of this study are available from the corresponding author, [hua zhang], upon reasonable request.

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Funding

This work was supported by the National Natural Science Foundation of China (Program No. 82371459) and the Innovation Capability Support Program of Shaanxi (Program No. 2021LCZX-01).

Author information

Author notes

  1. Huanfa Li and Qiang Meng contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Comprehensive Epilepsy Center, The First Affiliated Hospital of **’an JiaoTong University, No.277, Yanta West Road, **’an, 710061, China

    Huanfa Li, Qiang Meng, Yong Liu, Hao Wu, Yicong Dong, Yutao Ren, Jiale Zhang, Changwang Du, Shan Dong, **aofang Liu & Hua Zhang

  2. Clinical Research Center for Refractory Epilepsy of Shaanxi Province, **’an, 710061, China

    Huanfa Li, Qiang Meng, Yong Liu, Changwang Du, Shan Dong, **aofang Liu & Hua Zhang

  3. Center of Brain Science, The First Affiliated Hospital of **’an Jiaotong University, **’an, 710061, China

    Hao Wu, Yicong Dong & Hua Zhang

  4. Center for Mitochondrial Biology and Medicine, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, **’an Jiaotong University, **’an, China

    Hao Wu

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  1. Huanfa Li
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Correspondence to Hua Zhang.

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The study was approved by the Ethics Committee of the First Affiliated Hospital of **’an Jiaotong University.

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Li, H., Meng, Q., Liu, Y. et al. The value of ictal scalp EEG in focal epilepsies surgery: a retrospective analysis. Neurol Sci (2024). https://doi.org/10.1007/s10072-024-07657-8

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