De novo temporal intermittent rhythmic delta activity after laser interstitial thermal therapy for mesial temporal lobe epilepsy predicts poor seizure outcome

William O. Tatum, Neeharika Thottempudi, Vivek Gupta, Anteneh M. Feyissa, Sanjeet S. Grewal, Robert E Wharen, Jr, Michael A. Pizzi

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Objective: To evaluate EEG abnormalities, particularly development of temporal intermittent rhythmic delta activity (TIRDA) after laser interstitial thermal therapy (LITT) and assess the role of further surgery after LITT. Methods: We retrospectively identified consecutive cases of LITT for the prevalence of post-operative TIRDA. We assessed baseline demographics, clinical variables including age of seizure onset, age at surgery, pre-operative and post-operative EEG changes. Results: 40 patients underwent LITT for drug-resistant temporal lobe epilepsy (TLE), 29 met inclusion criteria. Median duration of follow-up was 15 months. Ten patients had post-LITT ipsilateral TIRDA, another two demonstrated post-operative TIRDA but they occurred contralateral to the side of ablation. None of the patients with TIRDA on their post-LITT EEG became seizure-free. Six out of 29 patients (21%) eventually required anterior temporal lobectomy (ATL), and of those 6 patients 4 (66%) had evidence of TIRDA on their post-LITT follow up EEG. The sensitivity and specificity of post-LITT TIRDA in predicting surgical failure was 57.14% and 100% respectively. Conclusions: Post-LITT TIRDA may serve as a biomarker to predict unsuccessful seizure outcome following LITT and be an early indicator for ATL. Significance: The presence of TIRDA following LITT should prompt early consideration for reoperation.

Original languageEnglish (US)
Pages (from-to)122-127
Number of pages6
JournalClinical Neurophysiology
Volume130
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • Biomarker
  • EEG
  • Laser
  • LITT
  • Surgery
  • Temporal lobe
  • TIRDA

ASJC Scopus subject areas

  • Sensory Systems
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Fingerprint Dive into the research topics of 'De novo temporal intermittent rhythmic delta activity after laser interstitial thermal therapy for mesial temporal lobe epilepsy predicts poor seizure outcome'. Together they form a unique fingerprint.

  • Cite this