Analysis of Morbidity and Outcomes Associated With Use of Subdural Grids vs Stereoelectroencephalography in Patients With Intractable Epilepsy

Autor: Omotola A Hope, Gretchen Von Allmen, Stephen A. Thompson, Jessica A. Johnson, Nitin Tandon, Giridhar P. Kalamangalam, Brian A. Tong, Elliott R. Friedman, Melissa S. Thomas, Jeremy D. Slater
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Drug Resistant Epilepsy
Adolescent
Operative Time
Blood Loss
Surgical
Subdural Space
Electroencephalography
Stereoelectroencephalography
Neurosurgical Procedures
Stereotaxic Techniques
03 medical and health sciences
Epilepsy
Young Adult
0302 clinical medicine
Postoperative Complications
Robotic Surgical Procedures
Medicine
Humans
Surgical Wound Infection
Epilepsy surgery
Blood Transfusion
030212 general & internal medicine
Subdural space
Young adult
Adverse effect
Original Investigation
Hematoma
medicine.diagnostic_test
business.industry
Length of Stay
medicine.disease
Surgery
Electrodes
Implanted
medicine.anatomical_structure
Treatment Outcome
Stereotaxic technique
Female
Neurology (clinical)
Electrocorticography
business
030217 neurology & neurosurgery
Zdroj: JAMA neurology. 76(6)
ISSN: 2168-6157
Popis: IMPORTANCE: A major change has occurred in the evaluation of epilepsy with the availability of robotic stereoelectroencephalography (SEEG) for seizure localization. However, the comparative morbidity and outcomes of this minimally invasive procedure relative to traditional subdural electrode (SDE) implantation are unknown. OBJECTIVE: To perform a comparative analysis of the relative efficacy, procedural morbidity, and epilepsy outcomes consequent to SEEG and SDE in similar patient populations and performed by a single surgeon at 1 center. DESIGN, SETTING AND PARTICIPANTS: Overall, 239 patients with medically intractable epilepsy underwent 260 consecutive intracranial electroencephalographic procedures to localize their epilepsy. Procedures were performed from November 1, 2004, through June 30, 2017, and data were analyzed in June 2017 and August 2018. INTERVENTIONS: Implantation of SDE using standard techniques vs SEEG using a stereotactic robot, followed by resection or laser ablation of the seizure focus. MAIN OUTCOMES AND MEASURES: Length of surgical procedure, surgical complications, opiate use, and seizure outcomes using the Engel Epilepsy Surgery Outcome Scale. RESULTS: Of the 260 cases included in the study (54.6% female; mean [SD] age at evaluation, 30.3 [13.1] years), the SEEG (n = 121) and SDE (n = 139) groups were similar in age (mean [SD], 30.1 [12.2] vs 30.6 [13.8] years), sex (47.1% vs 43.9% male), numbers of failed anticonvulsants (mean [SD], 5.7 [2.5] vs 5.6 [2.5]), and duration of epilepsy (mean [SD], 16.4 [12.0] vs17.2 [12.1] years). A much greater proportion of SDE vs SEEG cases were lesional (99 [71.2%] vs 53 [43.8%]; P
Databáze: OpenAIRE
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