Utility of sphenoidal electrodes for review of ictal tracings.
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Electrodes↗
Biomedical subjects
Scott Mintzer
Publications and source records attributed to Scott Mintzer.
Relative utility of sphenoidal and temporal surface electrodes for localization of ictal onset in temporal lobe epilepsy.
OBJECTIVES: To compare localization of ictal onsets in patients with possible temporal lobe epilepsy (TLE) using true temporal electrodes (TE), at positions T1 and T2, and sphenoidal electrodes (SpE). METHODS: A total of 101 ictal tracings in 31 patients with possible TLE were independently reviewed by two readers and graded as meeting (TE+, SpE+) or not meeting (TE-, SpE-) strictly-defined mesial temporal onset criteria. TE and SpE were reviewed in separate montages, with ad lib adjustment of filters and sensitivity. Discrepancies between TE and SpE were noted, with inter-reader disagreements resolved by a third reviewer. RESULTS: All seizures scored as SpE+ were also scored as TE+, with one exception. The sole SpE+/TE- seizure did not add incremental useful information in that patient, who had other, similar seizures which were TE+. Five seizures in 4 patients were scored as TE+ and SpE-, most due malfunction of SpE prior to seizure onset. One of these seizures was scored TE+/SpE- in a patient believed to have neocortical epilepsy. CONCLUSIONS: In this series, SpE were unnecessary to detect seizures which meet strict mesial temporal onset criteria and did not yield useful information for surgical evaluation beyond that provided by TE. It remains unclear if SpE are more helpful than TE in distinguishing lateral from mesial ictal onset. Digital review of ictal tracings may resolve discrepancies between TE and SpE.
Adolescent↗
Comorbidity of ictal fear and panic disorder.
Purpose. We sought to determine the prevalence of psychiatric conditions, particularly panic disorder, in epilepsy patients with ictal fear.Methods. A consecutive series of 12 patients with ictal fear underwent psychiatric evaluation, via either formal consultation with a psychiatrist or standardized interview using the Mini International Neuropsychiatric Interview; the latter was addended to create an instrument specifically for use in epilepsy patients (MINI-Epi).Results. Four of the twelve patients (33%) with ictal fear had a comorbid diagnosis of panic disorder. One of these developed panic attacks only after epilepsy surgery, and another worsened after surgery, while in the other two panic attacks were not related to any surgical procedure. Two patients had other anxiety disorders. Eight patients (67%) had current or past depression; this did not appear to be related to the presence of panic disorder.Conclusion. A specific comorbidity exists between focal epilepsy with ictal fear and panic disorder. Involvement of the amygdala in both temporal lobe epilepsy and panic disorder may underlie this. The predisposition to panic disorder in these patients may be exacerbated by anterior temporal lobectomy.
Journal Article↗