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lüll Focal ictal beta discharge on scalp EEG predicts excellent outcome of frontal lobe epilepsy surgery Worrell GA; So EL; Kazemi J; O'Brien TJ; Mosewich RK; Cascino GD; Meyer FB; Marsh WREpilepsia 2002[Mar]; 43 (3): 277-82PURPOSE: To determine whether a focal beta-frequency discharge at seizure onset on scalp EEG predicts outcome of frontal lobe epilepsy (FLE) surgery. METHODS: We identified 54 consecutive patients with intractable FLE who underwent epilepsy surgery between December 1987 and December 1996. A blind review of EEGs and magnetic resonance images (MRIs) was performed. Lesional epilepsy is defined as presence of an underlying structural abnormality on MRI. RESULTS: Overall, 28 (52%) patients were seizure free, with a mean follow-up of 46.5 months. Presence of a focal beta-frequency discharge at seizure onset on scalp EEG predicted seizure-free outcome in lesional (p = 0.02) and non-lesional (p = 0.01) epilepsy patients. At least 90% of patients who had either lesional or non-lesional epilepsy were seizure free if scalp EEG revealed a focal beta discharge at ictal onset. Moreover, logistic regression analysis showed that focal ictal beta pattern and completeness of lesion resection were independently predictive of seizure-free outcome. Ictal onset with lateralized EEG activity of any kind and postresection electrocorticographic spikes did not predict surgical outcome (p > 0.05). CONCLUSIONS: Only about 25% of FLE surgical patients have a focal beta-frequency discharge at seizure onset on scalp EEG. However, its presence is highly predictive of excellent postsurgical seizure control in either lesional or non-lesional FLE surgical patients.|*Electroencephalography[MESH]|Child[MESH]|Epilepsy, Frontal Lobe/diagnosis/*physiopathology/*surgery[MESH]|Female[MESH]|Forecasting[MESH]|Humans[MESH]|Magnetic Resonance Imaging[MESH]|Male[MESH]|Predictive Value of Tests[MESH]|Scalp[MESH]|Treatment Outcome[MESH] |