ArticleEpilepsia2023
Seizure onset patterns predict outcome after stereo-electroencephalography-guided laser amygdalohippocampotomy.
Article in Epilepsia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Bayesian Estimation Improves Prediction of Outcomes After Epilepsy Surgery.Annals of clinical and translational neurology · 2026Pooled it
- Divergent Propagation Networks Define Two Pathophysiologically Distinct Electroclinical Phenotypes in Mesial Temporal Lobe Epilepsy.Journal of clinical neurology (Seoul, Korea) · 2026Article
- Seminars in epileptology: Presurgical epilepsy evaluation.Epileptic disorders : international epilepsy journal with videotape · 2025Review
- Evaluation of limbic microstructural abnormalities in temporal lobe epilepsy: A neurite orientation distribution and density imaging study.Epilepsia · 2025Article
- Reproducibility of temporally evolving seizure patterns and network connectivity in focal epilepsy.Frontiers in neurology · 2025Article
- Delineating structural and metabolic abnormalities in amygdala and hippocampal subfields for different seizure-onset patterns via stereotactic electroencephalography.CNS neuroscience & therapeutics · 2024Article
- Comparative effectiveness of stereotactic, subdural, or hybrid intracranial EEG monitoring in epilepsy surgery.Journal of neurosurgery · 2024Article
- EEG Ictal Power Dynamics, Function-Structure Associations, and Epilepsy Surgical Outcomes.Neurology · 2024Article
- Magnetoencephalography for Epilepsy Presurgical Evaluation.Current neurology and neuroscience reports · 2024Review
- Cell-type specific and multiscale dynamics of human focal seizures in limbic structures.Brain : a journal of neurology · 2023Article
- Epilepsy-Related Mortality After Laser Interstitial Thermal Therapy in Patients With Drug-Resistant Epilepsy.Neurology · 2023Observational
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Authors and funding
23 authors at 10 institutions in 1 country.
Funding
Abstract
objectiveStereotactic laser amygdalohippocampotomy (SLAH) is an appealing option for patients with temporal lobe epilepsy, who often require intracranial monitoring to confirm mesial temporal seizure onset. However, given limited spatial sampling, it is possible that stereotactic electroencephalography (stereo-EEG) may miss seizure onset elsewhere. We hypothesized that stereo-EEG seizure onset patterns (SOPs) may differentiate between primary onset and secondary spread and predict postoperative seizure control. In this study, we characterized the 2-year outcomes of patients who underwent single-fiber SLAH after stereo-EEG and evaluated whether stereo-EEG SOPs predict postoperative seizure freedom.
methodsThis retrospective five-center study included patients with or without mesial temporal sclerosis (MTS) who underwent stereo-EEG followed by single-fiber SLAH between August 2014 and January 2022. Patients with causative hippocampal lesions apart from MTS or for whom the SLAH was considered palliative were excluded. An SOP catalogue was developed based on literature review. The dominant pattern for each patient was used for survival analysis. The primary outcome was 2-year Engel I classification or recurrent seizures before then, stratified by SOP category.
resultsFifty-eight patients were included, with a mean follow-up duration of 39 ± 12 months after SLAH. Overall 1-, 2-, and 3-year Engel I seizure freedom probability was 54%, 36%, and 33%, respectively. Patients with SOPs, including low-voltage fast activity or low-frequency repetitive spiking, had a 46% 2-year seizure freedom probability, compared to 0% for patients with alpha or theta frequency repetitive spiking or theta or delta frequency rhythmic slowing (log-rank test, p = .00015). SIGNIFICANCE: Patients who underwent SLAH after stereo-EEG had a low probability of seizure freedom at 2 years, but SOPs successfully predicted seizure recurrence in a subset of patients. This study provides proof of concept that SOPs distinguish between hippocampal seizure onset and spread and supports using SOPs to improve selection of SLAH candidates.
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