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To explore the value of the frequency and laterality of temporal interictal spikes for predicting epilepsy surgery outcome, researchers examined 55 patients with unilateral mesial temporal sclerosis (MTS) identified on MRI who underwent subsequent selective amygdalohippocampectomy or anterior medial temporal lobe resection. The authors classified interictal spikes (recorded every 5 minutes for 5 days, excluding the 10 minutes after seizures) as frequent (≥60 spikes per hour) or infrequent, and as unilateral (≥90% of spikes from the surgical side) or bilateral.
Infrequent spikes correlated with seizure freedom 1 year after surgery, whereas the degree of laterality had no prognostic implications. The authors propose that MTS patients with low …