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KMID : 0877219970010010092
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Journal of Korean Epilepsy Society
1997 Volume.1 No. 1 p.92 ~ p.98
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Subdural Electrodes : Usefulness and Problems in Epilepsy Surgery and Functional Mapping
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Hong Seung-Chyul
Lee Sang-Koo
Hong Seung-Bong
Seo Dae-Won
Lee Mun-Hyang
Kim Jong-Hyun
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Abstract
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Subdural grids or strips are useful for seizure localization and functional mapping, but are not used easily due to invasiveness. If properly used, subdural electrodes can provide much information about seizure localization and brain function without significant risk. Ducting the last two and 3/4 years, 61 patients were operated upon for subdural electrode Insertion and monitored for EEG recording and functional mapping. Five cases presented with rare seizures with glial tumors. In the functionally eloquent areas. Other 56 crises were intractable epilepsy patients requiring accurate seizure focus localization and resection. Twenty-eight crises were temporal lobe epilepsy patients ; 23 patients tilth suspected neocortical temporal lobe epilepsy and 5 with bitemporal subdural strips for lateralization. Eleven cases of frontal lobe epilepsy, 5 cases of central sulcus region epilepsy, 2 cases of occipital lobe epilepsy, and 10 cases of multifocal epilepsy patients are includeded. We preferred extensive coverage for more accurate brain mapping. The mean duration of electrode insertion was 8 2 days (1-20 days). Fifty-eight patients (95.1%) went through successful resection procedures. Resection could not be performed in 3 cases due to involvement of eloquent area, poor localization of seizures, and brain swelling. Infection and transient third nerve palsy occurred in each two cases. One patient had epidural hematoma and another patient pulled out and displaced the electrode. There was no permanent neuropsychological problems 89.1% of intractable epilepsy patients fared well and showed good seizure control (Engel Class Ⅰ and Ⅱ) during the mean follow up period of 16.2 months. If used carefully and properly, subdural electrodes are very useful for seizure loc3liz3tlon and functional mapping without significant risk. Problems about repealed use of disposable electrode are discussed.
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KEYWORD
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Subdural electrode, Epilepsy surgery, EEG, Functional mapping, Complication
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