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Elizabeth Barry, MD; Neil M. Sussman, MD; Michael J. O'Connor, MD; Richard N. Harner, MD

Arch Neurol. 1992;49(1):21-27.

Abstract
• We reviewed data from 48 patients after anterior temporal lobe resection for medically intractable epilepsy. All had ictal electroencephalographic (EEG) evidence of unilateral temporal lobe onset. Depth electrodes were used in 19 patients. Successful surgical outcome correlated significantly with factors that suggested a temporal lobe focus, particularly in the interictal scalp EEG. The most successful outcome occurred in patients with well-localized unilateral interictal temporal spikes (100% improved). The group with well-localized bilateral temporal spikes also did well (76% improved). Patients with extratemporal spread of the interictal spike on scalp EEG, either unilaterally or bilaterally, did less well. Only one third improved, despite extensive extracranial and intracranial monitoring, when indicated. The interictal scalp EEG may be the only EEG necessary for the presurgical evaluation of selected patients with intractable temporal lobe epilepsy.

Author Affiliations
From the Department of Neurology, University of Maryland, Baltimore (Dr Barry); Marion Merrill Dow Inc, Cincinnati, Ohio (Dr Sussman); Department of Neurosurgery, The Graduate Hospital of the University of Pennsylvania, Philadelphia (Dr O'Connor); and the Department of Neurology, Medical College of Pennsylvania, Philadelphia (Dr Harner).

Footnotes
Accepted for publication August 21, 1991.

Presented in part at the American Epilepsy Society Meeting, Seattle, Wash, November 1986 and San Francisco, Calif, November 1988.

Reprint requests to the Department of Neurology, University of Maryland Hospital, 22 S Greene St, Baltimore, MD 21201 (Dr Barry).

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