Anterior Callosotomy and Chronic Depth Electrode Recording in the Surgical Management of Some Intractable Seizures

1983 ◽  
Vol 46 (1-4) ◽  
pp. 52-56 ◽  
Author(s):  
G. Bouvier ◽  
C. Mercier ◽  
J.M. St. Hilaire ◽  
N. Giard ◽  
R. Labrecque ◽  
...  
Keyword(s):  
Surgical Management ◽  
Depth Electrode ◽  
Electrode Recording ◽  
Intractable Seizures

scholarly journals Endonasal endoscopic surgery for temporal lobe epilepsy associated with sphenoidal encephalocele

2021 ◽  
Vol 12 ◽  
pp. 379
Author(s):  
Nobutaka Mukae ◽  
Daisuke Kuga ◽  
Daisuke Murakami ◽  
Noritaka Komune ◽  
Yusuke Miyamoto ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Temporal Region ◽  
Endoscopic Endonasal ◽  
Sphenoidal Sinus ◽  
High Frequency Oscillations ◽  
Depth Electrode ◽  
Electrode Recording ◽  
Subdural Electrode

Background: Temporal lobe epilepsy (TLE) associated with temporal lobe encephalocele is rare, and the precise epileptogenic mechanisms and surgical strategies for such cases are still unknown. Although the previous studies have reported good seizure outcomes following chronic subdural electrode recording through invasive craniotomy, only few studies have reported successful epilepsy surgery through endoscopic endonasal lesionectomy. Case Description: An 18-year-old man developed generalized convulsions at the age of 15 years. Despite treatment with optimal doses of antiepileptic drugs, episodes of speech and reading difficulties were observed 2–3 times per week. Long-term video electroencephalogram (EEG) revealed ictal activities starting from the left anterior temporal region. Magnetic resonance imaging revealed a temporal lobe encephalocele in the left lateral fossa of the sphenoidal sinus (sphenoidal encephalocele). Through the endoscopic endonasal approach, the tip of the encephalocele was exposed. A depth electrode was inserted into the encephalocele, which showed frequent spikes superimposed with high-frequency oscillations (HFOs) suggesting intrinsic epileptogenicity. The encephalocele was resected 8 mm from the tip. Twelve months postoperatively, the patient had no recurrence of seizures on tapering of the medication. Conclusion: TLE associated with sphenoidal encephalocele could be controlled with endoscopic endonasal lesionectomy, after confirming the high epileptogenicity with analysis of HFOs of intraoperative EEG recorded using an intralesional depth electrode.

Long-Term Monitoring With Digital Technology for Epilepsy

1994 ◽  
Vol 9 (1_suppl) ◽  
pp. S64-S70 ◽  
Author(s):  
Ronald P. Lesser ◽  
Peter W. Kaplan
Keyword(s):  
Surgical Management ◽  
Digital Technology ◽  
Intractable Epilepsy ◽  
Patient Evaluation ◽  
Intractable Seizures ◽  
Long Term Monitoring ◽  
Term Monitoring

The use of video-electroencephalography for the evaluation of children is reserved for inpatients with intractable "seizures." Prolonged video-electroencephalographic monitoring is used to ascertain whether the events are epileptic in nature, or to evaluate the medically intractable patient with epilepsy for surgical management of seizures. The increasing interest in the evaluation of patients with intractable epilepsy and recent technologic advances have led to a greater sophistication and versatility in patient evaluation. This paper reviews currently available technologies and newer digital acquisition and playback systems, and discusses ways of optimizing the evaluation of patients with intractable seizures. (J Child Neurol 1994;9(Suppl):S64-S70).

scholarly journals Depth Electrodes in Pediatric Epilepsy Surgery

2013 ◽  
Vol 40 (1) ◽  
pp. 48-55 ◽  
Author(s):  
Janani Kassiri ◽  
Jeff Pugh ◽  
Sharon Carline ◽  
Laura Jurasek ◽  
Thomas Snyder ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Pediatric Epilepsy ◽  
Surgical Removal ◽  
Seizure Freedom ◽  
Sufficient Information ◽  
Epileptogenic Zone ◽  
Depth Electrodes ◽  
Depth Electrode ◽  
Intractable Seizures ◽  
Clinical Scenarios

Abstract:Background:The surgical removal of the epileptogenic zone in medically intractable seizures depends on accurate localization to minimize the neurological sequelae and prevent future seizures. To date, few studies have demonstrated the use of depth electrodes in a pediatric epilepsy population. Here, we report our study of pediatric epilepsy patients at our epilepsy center who were successfully operated for medically intractable seizures following the use of intracranial depth electrodes. In addition, we detail three individuals with distinct clinical scenarios in which depth electrodes were helpful and describe our technical approach to implantation and surgery.Methods:We retrospectively reviewed 18 pediatric epilepsy patients requiring depth electrode studies who presented at the University of Alberta Comprehensive Epilepsy Program between 1999 and 2010 with medically intractable epilepsy. Patients underwent cortical resection following depth electrode placement according to the Comprehensive Epilepsy Program surgical protocols after failure of surface electroencephalogram and magnetic resonance imaging to localize ictal onset zone.Result:The ictal onset zone was successfully identified in all 18 patients. Treatment of all surgical patients resulted in successful seizure freedom (Engel class I) without neurological complications.Conclusion:Intracranial depth electrode use is safe and able to provide sufficient information for the identification of the epileptogenic zone in pediatric epilepsy patients previously not considered for epilepsy surgery.

The Indications for and the Role of Depth Electrode Recording in Epilepsy

1983 ◽  
Vol 46 (1-4) ◽  
pp. 33-36 ◽  
Author(s):  
André Olivier ◽  
Peter Gloor ◽  
Felipe Quesney ◽  
Frederick Andermann
Keyword(s):  
Depth Electrode ◽  
Electrode Recording

1H-MRS imaging in intractable frontal lobe epilepsies characterized by depth electrode recording

NeuroImage ◽  
2005 ◽  
Vol 26 (4) ◽  
pp. 1174-1183 ◽  
Author(s):  
M. Guye ◽  
J.P. Ranjeva ◽  
Y. Le Fur ◽  
F. Bartolomei ◽  
S. Confort-Gouny ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
1H Mrs ◽  
Depth Electrode ◽  
Electrode Recording

The Place of Stereotactic Depth Electrode Recording in Epilepsy

1985 ◽  
Vol 48 (1-6) ◽  
pp. 395-399 ◽  
Author(s):  
André Olivier ◽  
Peter Gloor ◽  
L. Frederick Andermann ◽  
Felipe Quesney
Keyword(s):  
Depth Electrode ◽  
Electrode Recording

Corpus Callosotomy for Refractory Seizures in a Patient with Cortical Heterotopia: Case Report

Neurosurgery ◽  
1989 ◽  
Vol 25 (4) ◽  
pp. 633-636 ◽  
Author(s):  
Michael Stearns ◽  
Aizik L. Wolf ◽  
Elizabeth Barry ◽  
Gregory Bergey ◽  
Fouad Gellad
Keyword(s):  
Cerebral Cortex ◽  
Case Report ◽  
Surgical Management ◽  
Neuronal Migration ◽  
Corpus Callosotomy ◽  
Intractable Seizures ◽  
Refractory Seizures ◽  
Atonic Seizures

Abstract Heterotopia of the cerebral cortex, a disorder of neuronal migration, may be associated with medically intractable seizures. We report on a patient with bihemispheric cortical heterotopia who had medically intractable atonic seizures that were successfully treated by corpus callosotomy. The clinical and radiographic aspects of cortical heterotopia and the surgical management of seizures associated with heterotopia are discussed.

Occipitotemporal hippocampal depth electrodes in intracranial epilepsy monitoring: safety and utility

2013 ◽  
Vol 118 (2) ◽  
pp. 345-352 ◽  
Author(s):  
Kimon Bekelis ◽  
Atman Desai ◽  
Alex Kotlyar ◽  
Vijay Thadani ◽  
Barbara C. Jobst ◽  
...  
Keyword(s):  
Hippocampal Formation ◽  
Imaging Techniques ◽  
Drill Hole ◽  
Mesial Temporal Sclerosis ◽  
Depth Electrodes ◽  
Depth Electrode ◽  
Intractable Seizures ◽  
Temporal Lobe Resection ◽  
Temporal Localization ◽  
Epilepsy Monitoring

Object Intracranial monitoring for epilepsy has been proven to enhance diagnostic accuracy and provide localizing information for surgical treatment of intractable seizures. The authors investigated the usefulness of hippocampal depth electrodes in the era of more advanced imaging techniques. Methods Between 1988 and 2010, 100 patients underwent occipitotemporal hippocampal depth electrode (OHDE) implantation as part of invasive seizure monitoring, and their charts were retrospectively reviewed. The authors' technique involved the stereotactically guided (using the Leksell model G frame) implantation of a 12-contact depth electrode directed along the long axis of the hippocampus, through an occipital twist drill hole. Results Of the 100 patients (mean age 35.0 years [range 13–58 years], 51% male) who underwent intracranial investigation, 84 underwent resection of the seizure focus. Magnetic resonance imaging revealed mesial temporal sclerosis (MTS) in 27% of patients, showed abnormal findings without MTS in 55% of patients, and showed normal findings in 18% of patients. One patient developed a small asymptomatic occipital hemorrhage around the electrode tract. The use of OHDEs enabled epilepsy resection in 45.7% of patients who eventually underwent standard or selective temporal lobe resection. The hippocampal formation was spared during surgery because data obtained from the depth electrodes showed no or only secondary involvement in 14% of patients with preoperative temporal localization. The use of OHDEs prevented resections in 12% of patients with radiographic evidence of MTS. Eighty-three percent of patients who underwent resection had Engel Class I (68%) or II (15%) outcome at 2 years of follow-up. Conclusions The use of OHDEs for intracranial epilepsy monitoring has a favorable risk profile, and in the authors' experience it proved to be a valuable component of intracranial investigation. The use of OHDEs can provide the sole evidence for resection of some epileptogenic foci and can also result in hippocampal sparing or prevent likely unsuccessful resection in other patients.

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