Ictal electroencephalography (EEG) does not appear to help determine the best approach to surgery in pediatric patients if magnetic resonance imaging (MRI) findings and other presurgical data have pinpointed the epileptogenic focus, according to retrospective analysis that included 115 children .
- Investigators looked at children with epilepsy who had surgical resection based on a lesion that was identified by MRI and corroborated by other presurgical findings.
- Ictal video EEG findings were divided into 2 groups; ictal EEG findings were labeled “positive” if the identified location of the lesion agreed with the location indicated by the MRI, or “negative” if results were discordant with the MRI findings.
- The analysis found no differences in seizure-free outcomes when negative and positive EEGs were compared.
- A positive ictal EEG was not linked with better clinical outcomes regardless of the surgical site or the pathology of the lesion.
- EEGs had limited predictive value, which prompted researchers to question whether they are worth doing if MRI findings and related presurgical data confirm the location of the epileptogenic site.
MRI supersedes ictal EEG when other presurgical data are concordant. Seizure. 2017; 53:18-22. DOI: http://dx.doi.org/10.1016/j.seizure.2017.10.013.