Simultaneous Frame-assisted Stereotactic Placement of Subdural Grid Electrodes and Intracerebral Depth Electrodes.


Journal

Journal of neurological surgery. Part A, Central European neurosurgery
ISSN: 2193-6323
Titre abrégé: J Neurol Surg A Cent Eur Neurosurg
Pays: Germany
ID NLM: 101580767

Informations de publication

Date de publication:
Sep 2019
Historique:
pubmed: 15 5 2019
medline: 18 12 2019
entrez: 15 5 2019
Statut: ppublish

Résumé

 In complex cases of drug-resistant focal epilepsy, the precise localization of the epileptogenic zone requires simultaneous implantation of depth and subdural grid electrodes. This study describes a new simple frame-assisted method that facilitates the simultaneous placement of both types of intracranial electrodes.  Ten consecutive patients were evaluated and divided into two groups. Group A included patients with simultaneous frame-assisted placement of depth and subdural grid electrodes. In group B, depth electrodes were implanted stereotactically; grid electrodes were implanted in a separate surgery.  The placement of the subdural grid was accurate as individually designed by the epileptologists in all five patients from group A. In group B, one patient showed a slight and another one a significant deviation of the subdural grid position postoperatively. The mean surgical time in group A was shorter (280±62 minutes) compared with the mean duration of the surgical procedures in group B (336±51 minutes).  The frame-assisted placement of subdural grid electrodes facilitates the surgical procedure for invasive video-electroencephalography monitoring in complex cases of drug-resistant focal epilepsy in which a combination of depth electrodes and subdural grid electrodes is needed, by reducing the surgical time and guaranteeing highly accurate electrode localizations.

Sections du résumé

BACKGROUND AND STUDY AIMS OBJECTIVE
 In complex cases of drug-resistant focal epilepsy, the precise localization of the epileptogenic zone requires simultaneous implantation of depth and subdural grid electrodes. This study describes a new simple frame-assisted method that facilitates the simultaneous placement of both types of intracranial electrodes.
MATERIAL AND METHODS METHODS
 Ten consecutive patients were evaluated and divided into two groups. Group A included patients with simultaneous frame-assisted placement of depth and subdural grid electrodes. In group B, depth electrodes were implanted stereotactically; grid electrodes were implanted in a separate surgery.
RESULTS RESULTS
 The placement of the subdural grid was accurate as individually designed by the epileptologists in all five patients from group A. In group B, one patient showed a slight and another one a significant deviation of the subdural grid position postoperatively. The mean surgical time in group A was shorter (280±62 minutes) compared with the mean duration of the surgical procedures in group B (336±51 minutes).
CONCLUSION CONCLUSIONS
 The frame-assisted placement of subdural grid electrodes facilitates the surgical procedure for invasive video-electroencephalography monitoring in complex cases of drug-resistant focal epilepsy in which a combination of depth electrodes and subdural grid electrodes is needed, by reducing the surgical time and guaranteeing highly accurate electrode localizations.

Identifiants

pubmed: 31083743
doi: 10.1055/s-0039-1685193
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

353-358

Informations de copyright

Georg Thieme Verlag KG Stuttgart · New York.

Déclaration de conflit d'intérêts

None

Auteurs

Peter C Reinacher (PC)

Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Freiburg, Germany.
Medical Faculty, Freiburg University, Freiburg, Germany.

Dirk-Matthias Altenmüller (DM)

Medical Faculty, Freiburg University, Freiburg, Germany.
Department of Epileptology, Freiburg University Medical Center, Freiburg, Germany.

Marie T Krüger (MT)

Medical Faculty, Freiburg University, Freiburg, Germany.
Department of Neurosurgery, Freiburg University Medical Center, Freiburg, Germany.

Andreas Schulze-Bonhage (A)

Medical Faculty, Freiburg University, Freiburg, Germany.
Department of Epileptology, Freiburg University Medical Center, Freiburg, Germany.

Horst Urbach (H)

Medical Faculty, Freiburg University, Freiburg, Germany.
Department of Neuroradiology, Freiburg University Medical Center, Freiburg, Germany.

Michael Trippel (M)

Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Freiburg, Germany.
Medical Faculty, Freiburg University, Freiburg, Germany.

Volker A Coenen (VA)

Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Freiburg, Germany.
Medical Faculty, Freiburg University, Freiburg, Germany.

Daniel Delev (D)

Medical Faculty, Freiburg University, Freiburg, Germany.
Department of Neurosurgery, Freiburg University Medical Center, Freiburg, Germany.

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Classifications MeSH