COMPARISON OF MESIAL VERSUS NEOCORTICAL ONSET TEMPORAL-LOBE SEIZURES - NEURODIAGNOSTIC FINDINGS AND SURGICAL OUTCOME

We compared historical features, surface EEG findings, results of intr acarotid sodium amobarbital memory testing (IAT), and outcome after an terotemporal lobectomy (ATL) in patients with mesiotemporal lobe seizu re onset with those with more diffuse temporal lobe seizure onset (int racranial EEG). Forty-eight patients evaluated consecutively between J uly 1985 and October 1991 with both scalp/sphenoidal and intracranial EEG were shown to have seizures originating in one temporal lobe. No p atients had temporal lobe tumor or vascular malformation. Thirty-seven of the 48 patients had seizure onset in the amygdala/hippocampus (amy g/hipp). Eleven of the 48 had either temporal neocortical onset or sim ultaneous amyg/hipp and neocortical onset. Patients with mesial onset seizures were more likely to have lateralized memory impairment on IAT (p = 0.05). We noted a trend toward a difference in age of first risk for epilepsy between the two groups (p = 0.09) but not for a differen ce in any specific risk factor. There were no significant differences in surface EEG interictal findings. Unlike in previous studies, compar ison of outcome between the two groups showed no difference in seizure -free outcome. Sudden unexpected death (SUD) was more frequent in neoc ortical seizure patients who were not seizure-free (p < 0.05).