NONEPILEPTIC SEIZURES IN TEMPORAL LOBECTOMY CANDIDATES WITH MEDICALLYREFRACTORY SEIZURES

Diagnosis of epileptic seizures is often based on temporal lobe epilep tiform abnormalities appearing on interictal EEG, when reported ictal semiologies are consistent with temporal lobe seizures. It is unclear how often such patients have non-epileptic seizures. We studied 145 pa tients who had temporal interictal EEG spikes and reported ictal semio logy characteristic of temporal lobe seizures, with long-term EEG-vide o-monitoring (LTM) for presurgical evaluation of medically refractory seizures. Nonepileptic seizures were unexpectedly recorded in 12 of th ese patients (8%). Outcomes after LTM in patients who had both epilept ic seizures and nonepileptic seizures demonstrated that the epileptic seizures usually were controlled with medications. Our observations su pport LTM as useful in diagnosis of non-epileptic seizures in this gro up of patients. We suggest that ictal recordings always should be perf ormed before epilepsy surgery, in part to avoid unintentional surgical treatment of nonepileptic seizures.