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KMID : 0877219980020010020
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Journal of Korean Epilepsy Society
1998 Volume.2 No. 1 p.20 ~ p.25
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Chronic Subdural Strip Electrode Recordings as Preperative Evaluation for Epilpsy Surgery
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Son Eun-Ik
Kim Eal-Maan
Yi Sang-Doe
Kim Ji-Eun
Lee Chang-Young
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Abstract
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One of the important factors in providing good results from epilepsy surgery is the accuracy of identifying the epileptogenic focus. We report a retrospective series of 50 consecutive patients who underwent chronic intracranial recordings with subdural strip electrodes. All patients had previously undergone chronic EEG/Video monitoring with scalp and sphenoidal electrodes. The mesial temporal subdural electrodes were easily introduced to the inner uppermost part of the parahippocampal gyrus and excellent recordings of interictal and ictal events were obtained. Postoperative CT scans and simple craniograms demonstrated correct positioning of the electrodes. All patients were monitored for 2 to 14 days (mean : 4.3 days) of implantation to obtain enough seizures (mean :5.9 seizures). The recordings enabled sufficiently accurate localization for focal resection in 34 (68%) of 50 cases with only one minor complication. Most electrodes were localized over the lateral and mesiobasal cortex of temporal lobe. However, additional strip electrodes were covered on the frontal, parietal and occipital lobe cortex in ten cases to prevent sampling error. This procedure is a relatively safe and effective method for resolving difficult diagnostic issues and a valuable alternative to placing intracerebral depth electrodes.
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KEYWORD
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Epilepsy surgery, Subdural strip electrode, Intracranial recording, Temporal lobe epilepsy, Complication
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