Utility and reliability of ictal scalp EEG in children with epilepsy candidates to a surgical treatment.

Utility and reliability of ictal scalp EEG in children with epilepsy candid ates to a surgical treatment. Ictal scalp EEG is largely utilised during presurgical evaluations but its reliability and utility, nowadays, remain discussed. Among 63 children studied Sor epilepsy surgery at Grenoble Hospital, 16 ( m ales, 8 females) were submitted to a video-EEG monitoring. Mean age at eval uation was 11.3 years (3-16) with a seizure onset ranging from 2 days to II years (m: 2 years) and an average duration of the epilepsy of 9,2 years (2 -14). Five patients had had febrile convulsions. Art anatomical lesion was found in all children but 2: 3 mesial temporal sclerosis, 7 low-grade tumor s, 2 cortical dysplasias, I Rasmussen encephalitis and I tuberous sclerosis . Interictal EEG showed localized (lobar) slow waves in only 5 patients local ized spikes in 8. In 3 children slow waves and spikes involved the same lob e. I We recorded 92 seizures. A well localised low voltage fast activity ch aracterized the ictal onset 33 times, a flattening was Sound in other 33 ca ses. A stereo-EEG was carried out in 12 children, on the basis of ictal scalp EE G. Fifteen patients,were operated on. With a follow-up ranging from 24 to 7 2 months, II are seizure free (68.7%) and among them, the surgical strategy was defined on the only; basis of correlations obtained between video-EEG recordings and anatomical data in 4. Interictal and above all, ictal Video-EEG permit a better definition of the epilepsy of the patients. A low voltage fast activity or a flattening seem s to be the most frequent and constant characteristic of initial ictal acti vity.