Clinical Utility of Postictal EEG Pattern and Semiology in Temporal Lobe Epilepsy

J Korean Neurol Assoc > Volume 14(2); 1996 > Article

Journal of the Korean Neurological Association 1996;14(2): 415-424.

측두엽간질에서 발작직후 뇌파소견 및 증상의 임상적 유용성

권오영, 허균*, 김장성*, 주인수*, 윤수한**, 조경기**

경상대학교 의과대학 신경과학교실, 아주대학교 의과대학 신경과학교실*, 신경외과학교실**

Clinical Utility of Postictal EEG Pattern and Semiology in Temporal Lobe Epilepsy

Oh-Young Kwon, M.D., Kyoon Huh*, M.D., Jang-Sung Kim*, M.D., In-Soo Joo*, M.D., Soo-Han Yoon**, M.D., Kyung-Gi Cho, M.D.**

Department of Neurology* and Neurosurgery**, College of Medicine, Ajou University Department of Neurology, College of Medicine, Kyungsang University

Abstract

We investigated the postictal EEG and semiology in temporal lobe epilepsy in order to evaluate their possible clinical utility. Fifty four well lateralized seizures in 10 patients, recorded during presurgical evaluation, were analysed in regard to the frequency, pattern and location of the EEG activity (42 seizures with scalp-sphenoidal electrodes, 27 seizures with intracranial electrodes). Postictal EEG changes were very heterogenous, at best categorized to several patterns: ① θ+δ slowing ② attenuation ③ spike activation, among them θ+δslowing was mosts frequently encountered. The lateralizing value of the earliest pattern was 59.3% using intracranial electrodes but only 23.3% using scalp- sphenoidal electrodes. Postictal semiology also showed a variety of behavioral manifestation such as confusion(81.5%) , lip smacking(40.7%) , hand automatism (18.5%) . Lip smacking was more often seen following the left temporal seizure (16 out of 22, p<0.05) . Behavioral distinction between ictal and postictal semiology was not possible. Postictal EEG and semiology appears to be consisting of heterogenous mechanisms and wide spectrum. We feel that the clinical utility is limited.