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NEUROLOGY 1985;35:1567
© 1985 American Academy of Neurology

Reliability and accuracy of localization by scalp ictal EEG

Susan S. Spencer, MD, Peter D. Williamson, MD, Samuel L. Bridgers, MD, Richard H. Mattson, MD, Domenic V. Cicchetti, PhD and Dennis D. Spencer, MD

From the Departments of Neurolugy (Drs. S. Spencer, Williamson, Bridgers, and Mattson), Surgery (Neurosurgery) (Dr. D. Spencer), and Psychiatry (Dr. Cicchetti), Yale University School of Medicine, New Haven, CT, and West Haven VA Medical Center, West Haven, CT.

One hundred forty-four scalp ictal EEGs from 54 patients were analyzed independently by three electroencephalographers for side and lobe of seizure onset. Observers did not know the patients' identities. Accuracy was determined by depth EEG. We found 58 to 60% agreement between observers for lobe, and 64 to 74% for side, of seizure onset; 21 to 38% agreement with depth EEG for lobe, and 46 to 49% agreement for side, of seizure onset; best accuracy for lateralization of seizure onset in temporal lobe seizures, but erroneous in 3 to 17%. More formal criteria are needed before scalp ictal records can be used reliably or accurately for localization.

Address correspondence and reprint requests to Dr. Spencer, Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510.

Supported by the Neurological Research Center (Epilepsy) NIH grant #NS06208-18.

Accepted for publication February 12, 1985.




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