Gewalin Aungaroon1, Alonso Zea Vera1, Paul S Horn2, Anna W Byars1, Hansel M Greiner1, Jeffrey R Tenney1, Todd M Arthur1, Nathan E Crone3, Katherine D Holland1, Francesco T Mangano4, Ravindra Arya5. 1. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 2. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 3. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 4. Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 5. Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address: Ravindra.Arya@cchmc.org.
Abstract
OBJECTIVE: This study examined the incidence, thresholds, and determinants of electrical cortical stimulation (ECS)-induced after-discharges (ADs) and seizures. METHODS: Electrocorticograph recordings were reviewed to determine incidence of ECS-induced ADs and seizures. Multivariable analyses for predictors of AD/seizure occurrence and their thresholds were performed. RESULTS: In 122 patients, the incidence of ADs and seizures was 77% (94/122) and 35% (43/122) respectively. Males (odds ratio [OR] 2.92, 95% CI 1.21-7.38, p=0.02) and MRI-negative patients (OR 3.69, 95% CI 1.24-13.7, p=0.03) were found to have higher odds of ECS-induced ADs. A significant trend for decreasing AD thresholds with age was seen (regression co-efficient -0.151, 95% CI -0.267 to -0.035, p=0.011). ECS-induced seizures were more likely in patients with lateralized functional imaging (OR 6.62, 95% CI 1.36-55.56, p=0.036, for positron emission tomography) and presence of ADs (OR 3.50, 95% CI 1.12-13.36, p=0.043). CONCLUSIONS: ECS is associated with a high incidence of ADs and seizures. With age, current thresholds decrease and the probability for AD/seizure occurrence increases. SIGNIFICANCE: ADs and seizures during ECS brain mapping are potentially hazardous and affect its functional validity. Thus, safer method(s) for brain mapping with improved neurophysiologic validity are desirable.
OBJECTIVE: This study examined the incidence, thresholds, and determinants of electrical cortical stimulation (ECS)-induced after-discharges (ADs) and seizures. METHODS: Electrocorticograph recordings were reviewed to determine incidence of ECS-induced ADs and seizures. Multivariable analyses for predictors of AD/seizure occurrence and their thresholds were performed. RESULTS: In 122 patients, the incidence of ADs and seizures was 77% (94/122) and 35% (43/122) respectively. Males (odds ratio [OR] 2.92, 95% CI 1.21-7.38, p=0.02) and MRI-negative patients (OR 3.69, 95% CI 1.24-13.7, p=0.03) were found to have higher odds of ECS-induced ADs. A significant trend for decreasing AD thresholds with age was seen (regression co-efficient -0.151, 95% CI -0.267 to -0.035, p=0.011). ECS-induced seizures were more likely in patients with lateralized functional imaging (OR 6.62, 95% CI 1.36-55.56, p=0.036, for positron emission tomography) and presence of ADs (OR 3.50, 95% CI 1.12-13.36, p=0.043). CONCLUSIONS: ECS is associated with a high incidence of ADs and seizures. With age, current thresholds decrease and the probability for AD/seizure occurrence increases. SIGNIFICANCE: ADs and seizures during ECS brain mapping are potentially hazardous and affect its functional validity. Thus, safer method(s) for brain mapping with improved neurophysiologic validity are desirable.
Authors: Rachel H Muster; Jacob S Young; Peter Y M Woo; Ramin A Morshed; Gayathri Warrier; Sofia Kakaizada; Annette M Molinaro; Mitchel S Berger; Shawn L Hervey-Jumper Journal: Neurosurgery Date: 2021-05-13 Impact factor: 4.654
Authors: Daniel L Drane; Nigel P Pedersen; David S Sabsevitz; Cady Block; Adam S Dickey; Abdulrahman Alwaki; Ammar Kheder Journal: Front Neurol Date: 2021-04-12 Impact factor: 4.003
Authors: Yujing Wang; Mark A Hays; Christopher Coogan; Joon Y Kang; Adeen Flinker; Ravindra Arya; Anna Korzeniewska; Nathan E Crone Journal: Front Hum Neurosci Date: 2021-04-14 Impact factor: 3.169