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Kagawa K, Iida K, Hashizume A, Seyama G, Okamura A, Askoro R, Horie N. Retained Intracerebral Depth Electrode after Stereotactic Electroencephalography Monitoring: A Case Report. NMC Case Rep J 2024; 11:49-53. [PMID: 38454914 PMCID: PMC10918211 DOI: 10.2176/jns-nmc.2023-0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/13/2023] [Indexed: 03/09/2024] Open
Abstract
Stereotactic electroencephalography (SEEG) is an increasingly popular surgical modality for localizing the epileptogenic zone. Robot-guided stereotactic electrode placement has been covered in Japan by National Health Insurance since 2020. However, several surgical devices, such as the anchor bolt (a thin, hollow, metal shaft that serves as a guide screw or fixing for each electrode), have not been approved. A 14-year-old female who underwent SEEG for intractable epilepsy and required additional surgery to remove a retained depth electrode from the skull after the SEEG monitoring was finished. She had uncontrolled focal seizures consisting of nausea and laryngeal constriction at the onset. After a comprehensive presurgical evaluation, robot-guided stereotactic electrode implantation was performed to evaluate her seizures by SEEG. Nine depth electrodes were implanted through the twist drill hole. The electrodes were sutured to her skin for fixation without anchor bolts. When we attempted to remove the electrodes after 8 days of SEEG monitoring, one of the electrodes was retained. The retained electrode was removed through an additional skin incision and a small craniectomy under general anesthesia. We confirmed narrowing of the twist drill hole pathway in the internal table of the skull due to osteogenesis, which locked the electrode. This complication might be avoided if an anchor bolt had been used. This case report prompts the approval of the anchor bolts to avoid difficulty in electrode removal. Moreover, approval of a depth electrode with a thinner diameter and more consistent hardness is needed.
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Affiliation(s)
- Kota Kagawa
- Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Koji Iida
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Akira Hashizume
- Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Go Seyama
- Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Akitake Okamura
- Department of Neurosurgery, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Rofat Askoro
- Epilepsy Center, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
| | - Nobutaka Horie
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, Japan
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Fujiwara H, Kadis DS, Greiner HM, Holland KD, Arya R, Aungaroon G, Fong SL, Arthur TM, Kremer KM, Lin N, Liu W, Mangano DO FT, Skoch J, Horn PS, Tenney JR. Clinical validation of magnetoencephalography network analysis for presurgical epilepsy evaluation. Clin Neurophysiol 2022; 142:199-208. [DOI: 10.1016/j.clinph.2022.07.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/29/2022] [Accepted: 07/20/2022] [Indexed: 11/27/2022]
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Extraoperative electrical stimulation mapping in epilepsy presurgical evaluation: a proposal and review of the literature. Clin Neurol Neurosurg 2022; 214:107170. [DOI: 10.1016/j.clineuro.2022.107170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/18/2022]
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Joswig H, Gui C, Arango M, Parrent AG, MacDougall KW, Burneo JG, Steven DA. A prospective controlled study on the impact of anterior temporal lobectomy on dream content. J Neurosurg 2021; 136:717-725. [PMID: 34507280 DOI: 10.3171/2021.3.jns21164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/15/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Changes of dream ability and content in patients with brain lesions have been addressed in only about 100 case reports. All of these reports lack data regarding prelesional baseline dream content. Therefore, it was the objective of this study to prospectively assess dream content before and after anterior temporal lobectomy. METHODS Using the Hall and Van de Castle system, 30 dreams before and 21 dreams after anterior temporal lobectomy for drug-resistant epilepsy were analyzed. Fifty-five dreams before and 60 dreams after stereoelectroencephalography served as controls. RESULTS After anterior temporal lobectomy, patients had significantly less physical aggression in their dreams than preoperatively (p < 0.01, Cohen's h statistic). Dream content of patients undergoing stereoelectroencephalography showed no significant changes. CONCLUSIONS Within the default dream network, the temporal lobe may account for aggressive dream content. Impact of general anesthesia on dream content, as a possible confounder, was ruled out.
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Affiliation(s)
- Holger Joswig
- 1HMU Health and Medical University Potsdam, Ernst von Bergmann Hospital, Department of Neurosurgery, Potsdam, Germany
| | - Chloe Gui
- 2Department of Surgery, Division of Neurosurgery, University of Toronto, Ontario; and
| | - Miguel Arango
- Departments of3Anesthesia and Perioperative Medicine
| | | | | | - Jorge G Burneo
- 4Clinical Neurological Sciences.,5Epidemiology and Biostatistics, and.,6NeuroEpidemiology Unit, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - David A Steven
- 4Clinical Neurological Sciences.,5Epidemiology and Biostatistics, and
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Seizure Freedom in Temporal Plus Epilepsy Surgery Following Stereo-Electroencephalography. Can J Neurol Sci 2021; 47:374-381. [PMID: 32036799 DOI: 10.1017/cjn.2020.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND "Temporal plus" epilepsy (TPE) is a term that is used when the epileptogenic zone (EZ) extends beyond the boundaries of the temporal lobe. Stereotactic electroencephalography (SEEG) has been essential to identify additional EZs in adjacent structures that might be part of the temporal lobe/limbic network. OBJECTIVE We present a small case series of temporal plus cases successfully identified by SEEG who were seizure-free after resective surgery. METHODS We conducted a retrospective analysis of 156 patients who underwent SEEG in 5 years. Six cases had TPE and underwent anterior temporal lobectomy (ATL) with additional extra-temporal resections. RESULTS Five cases had a focus on the right hemisphere and one on the left. Three cases were non-lesional and three were lesional. Mean follow-up time since surgery was 2.9 years (SD ± 1.8). Three patients had subdural electrodes investigation prior or in addition to SEEG. All patients underwent standard ATL and additional extra-temporal resections during the same procedure or at a later date. All patients were seizure-free at their last follow-up appointment (Engel Ia = 3; Engel Ib = 2; Engel Ic = 1). Pathology was nonspecific/gliosis for all six cases. CONCLUSION TPE might explain some of the failures in temporal lobe epilepsy surgery. We present a small case series of six patients in whom SEEG successfully identified this phenomenon and surgery proved effective.
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Arévalo-Astrada MA, McLachlan RS, Suller-Marti A, Parrent AG, MacDougall KW, Mirsattari SM, Diosy D, Hayman-Abello B, Hayman-Abello S, Miles A, Steven DA, Burneo JG. Epilepsy surgery in stroke-related epilepsy. Seizure 2021; 88:116-124. [PMID: 33848790 DOI: 10.1016/j.seizure.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To provide a descriptive analysis on the presurgical evaluation and surgical management of a cohort of patients with stroke related epilepsy (SRE). METHODS We retrospectively examined the clinical characteristics, results of non-invasive and invasive presurgical evaluation, surgical management and outcome of consecutive patients with drug-resistant SRE in our institution from January 1, 2013 to January 1, 2020. RESULTS Twenty-one of 420 patients (5%) who underwent intracranial EEG (iEEG), resective epilepsy surgery and/or vagus nerve stimulation (VNS) placement, had SRE. Of 13 patients who had iEEG, the ictal onset (IO) was exclusively within the stroke lesion in only one patient. In five patients the IO was extra-lesional and in the remaining seven patients it included the stroke lesion as well as extra-lesional structures. The IO included the mesial temporal region in 11 of the 13 patients (85%). The posterior margin of the stroke lesion was always involved. Five patients underwent surgery without iEEG. In total, 10 patients underwent resective surgery, four VNS placement and two had both corpus callosotomy and VNS placement. Of the patients who had resective surgery, nine were Engel I or II at last follow up. CONCLUSION We found that seizures in patients with drug resistant SRE were more frequently originated in the mesial temporal region than in the stroke lesion itself. Despite the complex epileptic network underlying drug-resistant SRE, a thorough presurgical assessment and adequate use of surgical options can lead to excellent surgical outcomes.
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Affiliation(s)
- Miguel A Arévalo-Astrada
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - Richard S McLachlan
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - Ana Suller-Marti
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - Andrew G Parrent
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - Keith W MacDougall
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - Seyed M Mirsattari
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - David Diosy
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - Brent Hayman-Abello
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5; Department of Psychology, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - Susan Hayman-Abello
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5; Department of Psychology, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - Ashley Miles
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5; Department of Psychology, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - David A Steven
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5
| | - Jorge G Burneo
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5; Neuro-Epidemiology Unit, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Rd. London, Ontario, Canada, N6A 5A5.
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Yamamoto T. Recent Advancement of Technologies and the Transition to New Concepts in Epilepsy Surgery. Neurol Med Chir (Tokyo) 2020; 60:581-593. [PMID: 33208586 PMCID: PMC7803704 DOI: 10.2176/nmc.ra.2020-0197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Fruitful progress and change have been accomplished in epilepsy surgery as science and technology advance. Stereotactic electroencephalography (SEEG) was originally developed by Talairach and Bancaud at Hôspital Sainte-Anne in the middle of the 20th century. SEEG has survived, and is now being recognized once again, especially with the development of neurosurgical robots. Many epilepsy centers have already replaced invasive monitoring with subdural electrodes (SDEs) by SEEG with depth electrodes worldwide. SEEG has advantages in terms of complication rates as shown in the previous reports. However, it would be more indispensable to demonstrate how much SEEG has contributed to improving seizure outcomes in epilepsy surgery. Vagus nerve stimulation (VNS) has been an only implantable device since 1990s, and has obtained the autostimulation mode which responds to ictal tachycardia. In addition to VNS, responsive neurostimulator (RNS) joined in the options of palliative treatment for medically refractory epilepsy. RNS is winning popularity in the United States because the device has abilities of both neurostimulation and recording of ambulatory electrocorticography (ECoG). Deep brain stimulation (DBS) has also attained approval as an adjunctive therapy in Europe and the United States. Ablative procedures such as SEEG-guided radiofrequency thermocoagulation (RF-TC) and laser interstitial thermal therapy (LITT) have been developed as less invasive options in epilepsy surgery. There will be more alternatives and tools in this field than ever before. Consequently, we will need to define benefits, indications, and limitations of these new technologies and concepts while adjusting ourselves to a period of fundamental transition in our foreseeable future.
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Affiliation(s)
- Takamichi Yamamoto
- Department of Neurosurgery, Comprehensive Epilepsy Center, Seirei Hamamatsu General Hospital
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Joswig H, Lau JC, Abdallat M, Parrent AG, MacDougall KW, McLachlan RS, Burneo JG, Steven DA. Stereoelectroencephalography Versus Subdural Strip Electrode Implantations: Feasibility, Complications, and Outcomes in 500 Intracranial Monitoring Cases for Drug-Resistant Epilepsy. Neurosurgery 2020; 87:E23-E30. [DOI: 10.1093/neuros/nyaa112] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 02/16/2020] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Both stereoelectroencephalography (SEEG) and subdural strip electrodes (SSE) are used for intracranial electroencephalographic recordings in the invasive investigation of patients with drug-resistant epilepsy.
OBJECTIVE
To compare SEEG and SSE with respect to feasibility, complications, and outcome in this single-center study.
METHODS
Patient characteristics, periprocedural parameters, complications, and outcome were acquired from a pro- and retrospectively managed databank to compare SEEG and SSE cases.
RESULTS
A total of 500 intracranial electroencephalographic monitoring cases in 450 patients were analyzed (145 SEEG and 355 SSE). Both groups were of similar age, gender distribution, and duration of epilepsy. Implantation of each SEEG electrode took 13.9 ± 7.6 min (20 ± 12 min for each SSE; P < .01). Radiation exposure to the patient was 4.3 ± 7.7 s to a dose area product of 14.6 ± 27.9 rad*cm2 for SEEG and 9.4 ± 8.9 s with 21 ± 22.4 rad*cm2 for SSE (P < .01). There was no difference in the length of stay (12.2 ± 7.2 and 12 ± 6.3 d). The complication rate was low in both groups. No infections were seen in SEEG cases (2.3% after SSE). The rate of hemorrhage was 2.8% for SEEG and 1.4% for SSE. Surgical outcome was similar.
CONCLUSION
SEEG allows targeting deeply situated foci with a non-inferior safety profile to SSE and seizure outcome comparable to SSE.
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Affiliation(s)
- Holger Joswig
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada
- HMU Health and Medical University Potsdam, Department of Neurosurgery, Ernst von Bergmann Hospital, Potsdam, Germany
| | - Jonathan C Lau
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Mahmoud Abdallat
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Neurosurgery, University of Jordan, Amman, Jordan
| | - Andrew G Parrent
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Keith W MacDougall
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Richard S McLachlan
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Jorge G Burneo
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - David A Steven
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
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Aldosari MM, Joswig H, Marti AS, Parrent A, Mirsattari SM. Non-lesional eating epilepsy with temporo-insular onset: A stereo-EEG study. Epilepsy Behav Rep 2020; 14:100368. [PMID: 32642636 PMCID: PMC7334470 DOI: 10.1016/j.ebr.2020.100368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 11/23/2022] Open
Abstract
Eating Epilepsy (EE) is a rare and often under-recognized form of reflex epilepsy, which manifests with seizures triggered during meals, with or without spontaneous seizures. The electro-clinical manifestations of EE are distinct with variable response to antiseizure drugs. We report the case of a 34-year-old man who was seen for a 4-year history of drug-resistant focal impaired awareness seizures associated with eating without a structural cause. Scalp video-EEG delineated a right temporal seizure focus with atypical features. Subsequent stereo-EEG revealed synchronized seizure onset from the right mesial temporal region and the right inferior insula. Resective surgery of the involved areas rendered this patient seizure-free with 3 years' follow-up. In non-lesional cases of drug-resistant EE, the epileptogenic zone can be large and deep, and therefore stereo-EEG was helpful in determining the seizure onset zone.
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Affiliation(s)
- Mubarak M. Aldosari
- Epilepsy Program, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
- Epilepsy Program, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Holger Joswig
- Epilepsy Program, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Ana Suller Marti
- Epilepsy Program, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Andrew Parrent
- Epilepsy Program, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Seyed M. Mirsattari
- Epilepsy Program, Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
- Department of Medical Biophysics, Western University, London, Ontario, Canada
- Department of Medical Imaging, Western University, London, Ontario, Canada
- Department of Psychology, Western University, London, Ontario, Canada
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Cardinale F, Rizzi M, Vignati E, Cossu M, Castana L, d’Orio P, Revay M, Costanza MD, Tassi L, Mai R, Sartori I, Nobili L, Gozzo F, Pelliccia V, Mariani V, Lo Russo G, Francione S. Stereoelectroencephalography: retrospective analysis of 742 procedures in a single centre. Brain 2019; 142:2688-2704. [DOI: 10.1093/brain/awz196] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 04/24/2019] [Accepted: 05/06/2019] [Indexed: 11/13/2022] Open
Abstract
AbstractThis retrospective description of a surgical series is aimed at reporting on indications, methodology, results on seizures, outcome predictors and complications from a 20-year stereoelectroencephalography (SEEG) activity performed at a single epilepsy surgery centre. Prospectively collected data from a consecutive series of 742 SEEG procedures carried out on 713 patients were reviewed and described. Long-term seizure outcome of SEEG-guided resections was defined as a binomial variable: absence (ILAE classes 1–2) or recurrence (ILAE classes 3–6) of disabling seizures. Predictors of seizure outcome were analysed by preliminary uni/bivariate analyses followed by multivariate logistic regression. Furthermore, results on seizures of these subjects were compared with those obtained in 1128 patients operated on after only non-invasive evaluation. Survival analyses were also carried out, limited to patients with a minimum follow-up of 10 years. Resective surgery has been indicated for 570 patients (79.9%). Two-hundred and seventy-nine of 470 patients operated on (59.4%) were free of disabling seizures at least 2 years after resective surgery. Negative magnetic resonance and post-surgical lesion remnant were significant risk factors for seizure recurrence, while type II focal cortical dysplasia, balloon cells, glioneuronal tumours, hippocampal sclerosis, older age at epilepsy onset and periventricular nodular heterotopy were significantly associated with seizure freedom. Twenty-five of 153 patients who underwent radio-frequency thermal coagulation (16.3%) were optimal responders. Thirteen of 742 (1.8%) procedures were complicated by unexpected events, including three (0.4%) major complications and one fatality (0.1%). In conclusion, SEEG is a safe and efficient methodology for invasive definition of the epileptogenic zone in the most challenging patients. Despite the progressive increase of MRI-negative cases, the proportion of seizure-free patients did not decrease throughout the years.
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Affiliation(s)
- Francesco Cardinale
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Michele Rizzi
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Elena Vignati
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Massimo Cossu
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Laura Castana
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Piergiorgio d’Orio
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
- Neuroscience Institute, CNR, Parma, Italy
| | - Martina Revay
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
- Neurosurgery Residency Program, University of Milan, Milan, Italy
| | - Martina Della Costanza
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
- Neurosurgery Unit, Polytechnic, University of Marche, Ancona, Italy
| | - Laura Tassi
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Roberto Mai
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Ivana Sartori
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Lino Nobili
- Child Neuropsychiatry Unit, IRCCS ‘G. Gaslini’ Institute, DINOGMI, University of Genoa, Genoa, Italy
| | - Francesca Gozzo
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Veronica Pelliccia
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
- Department of Neuroscience, University of Parma, Parma, Italy
| | - Valeria Mariani
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giorgio Lo Russo
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
| | - Stefano Francione
- ‘Claudio Munari’ Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy
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