PURPOSE: In presurgical evaluation of temporal lobe epilepsy (TLE), invasive methods are necessary if results of various noninvasive methods are not sufficiently convergent enough to identify the epileptogenic area accurately. To detect the epileptiform discharges originating specifically from the mesial temporal lobe, we applied the cavernous sinus catheterization technique. METHODS: We placed Seeker Lite-10 guide wire electrodes into bilateral cavernous sinus through the internal jugular veins to record EEG (cavernous sinus EEG) in 6 patients with intractable TLE. Scalp EEG was simultaneously recorded in all 6 and electrocorticogram (ECoG) was also recorded in 4. RESULTS: The cavernous sinus EEG demonstrated clear epileptiform discharges, sometimes even when they were absent on the simultaneously recorded scalp EEG. The epileptiform discharges recorded from the cavernous sinus electrodes were specifically associated with those in the mesial temporal region on ECoG. Ictal EEG pattern originating from mesial temporal lobe was also clearly documented on the cavernous sinus EEG. CONCLUSIONS: This new, semi-invasive method of identifying epileptogenic areas can detect the epileptiform discharges specifically arising from the mesial temporal lobe; it is as useful as or complements the invasive techniques such as foramen ovale or depth recording.
PURPOSE: In presurgical evaluation of temporal lobe epilepsy (TLE), invasive methods are necessary if results of various noninvasive methods are not sufficiently convergent enough to identify the epileptogenic area accurately. To detect the epileptiform discharges originating specifically from the mesial temporal lobe, we applied the cavernous sinus catheterization technique. METHODS: We placed Seeker Lite-10 guide wire electrodes into bilateral cavernous sinus through the internal jugular veins to record EEG (cavernous sinus EEG) in 6 patients with intractable TLE. Scalp EEG was simultaneously recorded in all 6 and electrocorticogram (ECoG) was also recorded in 4. RESULTS: The cavernous sinus EEG demonstrated clear epileptiform discharges, sometimes even when they were absent on the simultaneously recorded scalp EEG. The epileptiform discharges recorded from the cavernous sinus electrodes were specifically associated with those in the mesial temporal region on ECoG. Ictal EEG pattern originating from mesial temporal lobe was also clearly documented on the cavernous sinus EEG. CONCLUSIONS: This new, semi-invasive method of identifying epileptogenic areas can detect the epileptiform discharges specifically arising from the mesial temporal lobe; it is as useful as or complements the invasive techniques such as foramen ovale or depth recording.
Authors: Thomas J Oxley; Nicholas L Opie; Sam E John; Gil S Rind; Stephen M Ronayne; Tracey L Wheeler; Jack W Judy; Alan J McDonald; Anthony Dornom; Timothy J H Lovell; Christopher Steward; David J Garrett; Bradford A Moffat; Elaine H Lui; Nawaf Yassi; Bruce C V Campbell; Yan T Wong; Kate E Fox; Ewan S Nurse; Iwan E Bennett; Sébastien H Bauquier; Kishan A Liyanage; Nicole R van der Nagel; Piero Perucca; Arman Ahnood; Katherine P Gill; Bernard Yan; Leonid Churilov; Christopher R French; Patricia M Desmond; Malcolm K Horne; Lynette Kiers; Steven Prawer; Stephen M Davis; Anthony N Burkitt; Peter J Mitchell; David B Grayden; Clive N May; Terence J O'Brien Journal: Nat Biotechnol Date: 2016-02-08 Impact factor: 54.908
Authors: Sam E John; Nicholas L Opie; Yan T Wong; Gil S Rind; Stephen M Ronayne; Giulia Gerboni; Sebastien H Bauquier; Terence J O'Brien; Clive N May; David B Grayden; Thomas J Oxley Journal: Sci Rep Date: 2018-05-30 Impact factor: 4.379
Authors: Gregor Strobbe; Evelien Carrette; José David López; Victoria Montes Restrepo; Dirk Van Roost; Alfred Meurs; Kristl Vonck; Paul Boon; Stefaan Vandenberghe; Pieter van Mierlo Journal: Neuroimage Clin Date: 2016-01-20 Impact factor: 4.881