Safety profile of intracranial electrode implantation for video-EEG recordings in drug-resistant focal epilepsy

被引：43

作者：

Mathon, Bertrand ^{[1
,7
]}

Clemenceau, Stephane ^{[1
]}

Hasboun, Dominique ^{[2
,7
]}

Habert, Marie-Odile ^{[4
,7
]}

Belaid, Hayat ^{[1
,6
]}

Nguyen-Michel, Vi-Huong ^{[3
]}

Lambrecq, Virginie ^{[3
,6
]}

Navarro, Vincent ^{[3
,6
,7
]}

Dupont, Sophie ^{[3
,5
,6
,7
]}

Baulac, Michel ^{[3
,6
,7
]}

Cornu, Philippe ^{[1
,7
]}

Adam, Claude ^{[3
,6
]}

机构：

[1] La Pitie Salpetriere Hosp, AP HP, Dept Neurosurg, Paris, France

[2] La Pitie Salpetriere Hosp, AP HP, Dept Neuroradiol, Paris, France

[3] La Pitie Salpetriere Hosp, AP HP, Epileptol Unit, Dept Neurol, Paris, France

[4] La Pitie Salpetriere Hosp, AP HP, Dept Nucl Med, Paris, France

[5] La Pitie Salpetriere Hosp, AP HP, Dept Rehabil, Paris, France

[6] INSERM, Brain & Spine Inst, CRICM ICM, CNRS,UMRS 1127,UMR 7225, Paris, France

[7] Univ Paris 06, Sorbonne Univ, Paris, France

来源：

JOURNAL OF NEUROLOGY | 2015年 / 262卷 / 12期

关键词：

SEEG (Stereoelectroencephalography); Invasive EEG; Depth electrodes; Complications; Adverse events; Epilepsy surgery; MEDICALLY INTRACTABLE EPILEPSY; SUBDURAL GRID ELECTRODES; SURGERY WORK-UP; DEPTH ELECTRODES; PRESURGICAL EVALUATION; COMPLICATIONS; EXPERIENCE; MORBIDITY; EFFICACY; RISK;

D O I：

10.1007/s00415-015-7901-6

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Invasive electroencephalography recordings with depth or subdural electrodes are necessary to identify the ictogenic area in some drug-resistant focal epilepsies. We aimed to analyze the safety profile of intracranial electrode implantation in a tertiary center and the factors associated with its complications. We retrospectively examined complications in 163 intracranial procedures performed in adult patients. Implantation methods included oblique depth stereotactic approach (n = 128) and medial-temporal depth stereotactic approach in combination with subdural strip placement (n = 35). 1201 depth macroelectrodes, 59 bundles of microelectrodes (in 30 patients) and 148 subdural electrodes were implanted. Complications were classified as major (requiring treatment or leading to neurological impairment) or minor. The rate of overall complications was 4.9 % (n = 8), with 3.1 % (n = 5) of major complications, though no permanent morbidity or mortality was recorded. Infection occurred in 1.2 % and hemorrhage in 3.7 % of patients. One hemorrhage occurred for every 225 electrodes implanted (4.4 aEuro degrees). Microelectrodes were not responsible for any complications. Overall and hemorrhagic complications were significantly associated with MRI-negative cases (7.3 and 6.3 % versus 0 %, p = 0.04). We believe that intracranial electrode implantation has a favorable safety profile, without permanent deficit. These risks should be balanced with the benefits of invasive exploration prior to surgery. Furthermore, this study provides preliminary evidence regarding the safety of micro-macroelectrodes.

引用

页码：2699 / 2712

页数：14

共 35 条

[1] Adverse events related to extraoperative invasive EEG monitoring with subdural grid electrodes: A systematic review and meta-analysis [J].