Search

In recent years, the clinical usefulness of the Wada test (WT) has been debated among researchers in the field. Therefore, we aimed to assess its contribution to the prediction of change in verbal learning and verbal memory function after epilepsy surgery. Data from 56 patients with temporal lobe epilepsy who underwent WT and subsequent surgery were analyzed retrospectively. Additionally, a standard neuropsychological assessment evaluating attentional, learning and memory, visuospatial, language, and executive function was performed both before and 12 months after surgery. Hierarchical linear regression analyses were used to determine the incremental value of WT results over socio-demographic, clinical, and neuropsychological characteristics in predicting postsurgical change in patients' verbal learning and verbal memory function. The incorporation of WT results significantly improved the prediction models of postsurgical change in verbal learning (∆R2 = 0.233, p =.032) and verbal memory function (∆R2 = 0.386, p =.005). Presurgical performance and WT scores accounted for 41.8% of the variance in postsurgical change in verbal learning function, and 51.1% of the variance in postsurgical change in verbal memory function. Our findings confirm that WT results are of significant incremental value for the prediction of postsurgical change in verbal learning and verbal memory function. Thus, the WT contributes to determining the risks of epilepsy surgery and, therefore, remains an important part of the presurgical work-up of selected patients with clear clinical indications. [ABSTRACT FROM AUTHOR]

Ischemic and hemorrhagic strokes are established etiological factors for recurrent seizures. Still, only few prospective data are available to predict post-stroke epilepsy and to choose the best point in time and anticonvulsive agent for treatment. In a prospective study we evaluated 264 consecutive stroke patients and assessed their post-stroke epilepsy risk within a follow-up of 1 year. Data on ten risk items concerning the stroke localisation, persisting neurological deficit, stroke subtype, established diagnosis of vascular encephalopathy, early- and late-onset seizures were collected using a post-stroke epilepsy risk scale (PoSERS). All patients underwent brain imaging with either CT, MRI or both and 148 patients underwent electroencephalography. The overall frequency of early-onset seizures within 14 days was 4.5%, of at least one late seizure 6.4% and of epilepsy 3.8%. Chi-Square tests showed significantly higher relative frequencies of seven of the ten clinical characteristics in post-stroke epilepsy patients. The total scale showed moderate sensitivity (70%) and positive predictive value (87.5%) while specificity (99.6%) and negative predictive value (98.8%) were relatively high. The EEG showed little value in predicting post-stroke epilepsy. The PoSERS appears to be a valuable tool to predict the risk for post-stroke epilepsy within the first few days after a stroke. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the predictive value of intraoperative electro-corticography (ECoG) in patients with unilateral hippocampal sclerosis (HS) undergoing transsylvian selective amygdalohippocampectomy (sAHE). ECoG was recorded before and after resection in 22 patients with medication-resistant mesial temporal lobe epilepsy. The sAHE was performed, regardless of ECoG findings. ECoG findings recorded from the mesiobasal temporal lobe (MTL) and lateral temporal lobe (LTL) before and after the sAHE were correlated with seizure outcome 12 months later. Ten patients had right-sided and 12 left-sided HS. Average age was 37.1 years. Pre-resection spikes were restricted to the MTL in 11 patients and to the LTL in one. In three patients spikes were recorded from MTL and LTL and in seven no spikes were recorded before the resection. Fifteen patients (68%) remained completely seizure-free and 19 (86%) were in Engel's class I post-operatively. Patients with pre-resection spikes restricted to the MTL ( n=11) remained seizure-free more frequently (9/11, 82%) compared with other patients (6/11, 55%; P=0.36). Pre-resection ECoG may be helpful in the prediction of seizure outcome in patients undergoing sAHE for mesial temporal lobe epilepsy. A larger study including more than 100 patients is needed to determine the predictive value of ECoG in patients with mesial temporal lobe epilepsy. [ABSTRACT FROM AUTHOR]

Copyright of Somnologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)