Peter C Reinacher1,2, Dirk-Matthias Altenmüller2,3, Marie T Krüger2,4, Andreas Schulze-Bonhage2,3, Horst Urbach2,5, Michael Trippel1,2, Volker A Coenen1,2, Daniel Delev2,4. 1. Department of Stereotactic and Functional Neurosurgery, Freiburg University Medical Center, Freiburg, Germany. 2. Medical Faculty, Freiburg University, Freiburg, Germany. 3. Department of Epileptology, Freiburg University Medical Center, Freiburg, Germany. 4. Department of Neurosurgery, Freiburg University Medical Center, Freiburg, Germany. 5. Department of Neuroradiology, Freiburg University Medical Center, Freiburg, Germany.
Abstract
BACKGROUND AND STUDY AIMS: 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: 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: 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: 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. Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND AND STUDY AIMS: 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: 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: 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: 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. Georg Thieme Verlag KG Stuttgart · New York.