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 language | English (US) |
---|---|
Pages (from-to) | 122-127 |
Number of pages | 6 |
Journal | Clinical Neurophysiology |
Volume | 130 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2019 |
Keywords
- Biomarker
- EEG
- LITT
- Laser
- Surgery
- TIRDA
- Temporal lobe
ASJC Scopus subject areas
- Sensory Systems
- Neurology
- Clinical Neurology
- Physiology (medical)