Correlative Study between Magnetic Resonance Imaging (MRI) Findings and Interictal Spike Rate in Patients with Refractory Temporal Lobe Epilepsy

Document Type : Original Article (s)

Authors

1 Associate Professor, Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Professor, Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Resident of Epilepsy Fellowship, Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Interictal spikes not only are used to diagnose epilepsy, its syndromes, and therapeutic guidelines in patients with epilepsy, but also may be a window to understand anatomy, severity, and epilepsy outcomes better. The aim of this study was to investigate the relationship between interictal spike rate and magnetic resonance imaging (MRI) findings.Methods: This descriptive cross-sectional study was performed on patients with refractory temporal lobe epilepsy admitted to epilepsy monitoring unit, Ayatollah Kashani hospital, Isfahan, Iran. Brain MRI (with epilepsy protocol) and all files related to long-term monitoring (LTM) of patients were studied, and then, the spike rate was calculated for each patient. Clinical information of patients as well as MRI and interictal findings were placed in separate tables designed for this purpose. Analysis of these findings consisted of two parts. In the first part, descriptive statistics (frequency and percentage), and for second part, inferential statistics (Spearman correlation coefficient and multivariate logistic regression) were used.Findings: This study was done on 70 patients with refractory temporal lobe epilepsy, 44 men (62.9%) and 26 women (37.1%). The mean age of the participants was 29.00 ± 10.49 years (10-60). Spearman's correlation coefficient showed a significant relationship between spike rate and MRI findings (P < 0.050). The results of regression analysis showed that only two lesions of "Hippocampus and Amygdala sclerosis" and "tumor and tumor-like lesions" could predict spike rate among MRI lesions. Normal MRI could also predict the amount of spikes.Conclusion: It seems that a combination of brain MRI with physiological measurements, including interictal spike rate, can determine subtypes of refractory temporal lobe epilepsy, and can lead to better diagnosis and treatment.

Keywords

References

  1. Sayehmiri K, Tavan H, Sayehmire F, Mohamadi I. Prevalence of epilepsy in Iran using meta-analysis and systematic review. J Adv Med Biomed Res 2015; 23(97): 112-121. [In Persian].
  2. Ropper AH, Samuels MA, Klein J. Adams and Victor's principles of neurology. 11th ed. New York, NY: McGraw-Hill Education; 2019.
  3. Asadi-Pooya AA, Stewart GR, Abrams DJ, Sharan A. Prevalence and Incidence of Drug-Resistant Mesial Temporal Lobe Epilepsy in the United States. World Neurosurg 2017; 99: 662-6.
  4. Skidmore CT. Adult focal epilepsies. Continuum (Minneap Minn) 2016; 22(1 Epilepsy): 94-115.
  5. Nair DR. Management of drug-resistant epilepsy. Continuum (Minneap Minn) 2016; 22(1 Epilepsy): 157-72.
  6. Dantas FG, Yacubian EM, Jorge CL, Pedreira CC, Bueno JF, Valerio RM. Clinical and EEG analysis of mesial and lateral temporal lobe seizures. Arq Neuropsiquiatr 1998; 56(3A): 341-9.
  7. Basiri R, Shariatzadeh A, Wiebe S, Aghakhani Y. Focal epilepsy without interictal spikes on scalp EEG: A common finding of uncertain significance. Epilepsy Res 2019; 150: 1-6.
  8. Rosati A, Aghakhani Y, Bernasconi A, Olivier A, Andermann F, Gotman J, et al. Intractable temporal lobe epilepsy with rare spikes is less severe than with frequent spikes. Neurology 2003; 60(8): 1290-5.
  9. Hirsch LJ, LaRoche SM, Gaspard N, Gerard E, Svoronos A, Herman ST, et al. American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology: 2012 version. J Clin Neurophysiol 2013; 30(1): 1-27.
  10. Jankovic J, Mazziotta J, Pomeroy S. Bradley's neurology in clinical practice: Neurological disorders. Philadelphia, PA: Elsevier/Saunders; 2016. p. 1563-615.
  11. Robert DG. Blair. Temporal lobe epilepsy semiology. Epilepsy Res Treat 2012; 2012: 751510.
  12. Bauer D, Quigg M. Optimizing management of medically responsive epilepsy. Continuum (Minneap Minn) 2019; 25(2): 343-61.
  13. Lai V, Mak HK, Yung AW, Ho WY, Hung KN. Neuroimaging techniques in epilepsy. Hong Kong Med J 2010; 16(4): 292-8.
  14. Urbach H. MRI in Epilepsy. New York, NY: Springer; 2013.
  15. Moosa ANV, Ruggieri P. Magnetic resonance imaging in evaluation for epilepsy surgery. 2015.
  16. Miller JW, Gotman J. The meaning of interictal spikes in temporal lobe epilepsy: Should we count them? Neurology 2008; 71(6): 392-3.
Journal of Isfahan Medical School
Volume 37, Issue 536 - Serial Number 536
May and June 2019
Pages 876-882

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History

  • Receive Date: 04 August 2019
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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