{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:38:00Z","timestamp":1772998680328,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare memory outcomes after surgery for unilateral hippocampal sclerosis (HS)\u2010associated epilepsy in patients with unilateral and bilateral ictal electrographic involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively evaluated HS patients, aged 18\u201055\u2009years and IQ \u226570. Left (<jats:italic>L<\/jats:italic>) and right (<jats:italic>R<\/jats:italic>) surgical groups underwent noninvasive video\u2010EEG monitoring and Wada test. We classified patients as <jats:italic>Ipsilateral<\/jats:italic> if ictal EEG was restricted to the HS side, or <jats:italic>Bilateral<\/jats:italic>, if at least one seizure onset occurred contralaterally to the HS, or if ictal discharge evolved to the opposite temporal region. Patients who declined surgery served as controls. Memory was evaluated on two occasions with Rey Auditory\u2010Verbal Learning Test and Rey Visual\u2010Design Learning Test. Baseline neuropsychological test scores were compared between groups. Pre\u2010 and postoperative scores were compared within each group. Reliable change index Z\u2010scores (RCI) were obtained using controls as references, and compared between surgical groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We evaluated 64 patients. Patients were classified as: <jats:italic>L\u2010Ipsilateral<\/jats:italic> (9), <jats:italic>L\u2010Bilateral<\/jats:italic> (15), <jats:italic>L\u2010Control<\/jats:italic> (9), <jats:italic>R\u2010Ipsilateral<\/jats:italic> (10), <jats:italic>R\u2010Bilateral<\/jats:italic> (9), and <jats:italic>R\u2010Control<\/jats:italic> (12). On preoperative evaluation, memory performance did not differ among surgical groups. Right HS patients did not present postoperative memory decline. <jats:italic>L\u2010Ipsilateral<\/jats:italic> group presented postoperative decline on immediate (<jats:italic>P<\/jats:italic>\u2009=\u20090.036) and delayed verbal recall (<jats:italic>P<\/jats:italic>\u2009=\u20090.011), while <jats:italic>L\u2010Bilateral<\/jats:italic> did not decline. <jats:italic>L\u2010Ipsilateral<\/jats:italic> had lower RCI Z\u2010scores, indicating delayed verbal memory decline compared to <jats:italic>L\u2010Bilateral<\/jats:italic> (<jats:italic>P<\/jats:italic>\u2009=\u20090.012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Dominant HS patients with bilateral ictal involvement presented less pronounced postoperative verbal memory decline compared to patients with exclusive ipsilateral ictal activity. Surgery was indicated in these patients regardless of memory impairment on neuropsychological testing, since resection of the left sclerotic hippocampus could result in cessation of contralateral epileptiform activity, and, therefore, improved memory function.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12834","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T09:57:18Z","timestamp":1695722238000},"page":"1532-1540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Bilateral ictal EEG is associated with better memory outcome after hippocampal sclerosis surgery"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2688-6319","authenticated-orcid":false,"given":"Humberto","family":"Castro\u2010Lima","sequence":"first","affiliation":[{"name":"Bahiana School of Medicine and Public Health  Salvador 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Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina University of Sao Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen L","family":"Jorge","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina University of Sao Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Val\u00e9rio","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina University of Sao Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen Hung","family":"Tzu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina University of Sao Paulo  S\u00e3o Paulo 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