Methodology, outcome, safety and in vivo accuracy in traditional frame-based stereoelectroencephalography

Autor: Jim Dings, Olaf E. M. G. Schijns, Albert Colon, Lars E. van der Loo, G. Louis Wagner, Govert Hoogland, Pieter L. Kubben
Přispěvatelé: RS: MHeNs - R3 - Neuroscience, MUMC+: MA Med Staf Spec Neurochirurgie (9), MUMC+: MA Niet Med Staf Neurochirurgie (9)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Adult
Male
Drug Resistant Epilepsy
medicine.medical_specialty
Complications
Adolescent
Electroencephalography
DEPTH ELECTRODES
Stereoelectroencephalography
030218 nuclear medicine & medical imaging
Stereotaxic Techniques
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Epilepsy surgery
Linear regression
medicine
TEMPORAL-LOBE EPILEPSY
Humans
Stereotaxy
COMPUTED-TOMOGRAPHY
INTRACTABLE EPILEPSY
Neuroradiology
FUNCTIONAL STEREOTAXIC EXPLORATION
SURGERY WORK-UP
medicine.diagnostic_test
business.industry
In vivo accuracy
Middle Aged
Outcome (probability)
Electrodes
Implanted
Surgery
PRESURGICAL EVALUATION
REFRACTORY FOCAL EPILEPSY
Stereotaxic technique
IMAGE FUSION
Female
Neurology (clinical)
Radiology
Original Article - Functional
business
030217 neurology & neurosurgery
DEEP BRAIN-STIMULATION
Zdroj: Acta Neurochirurgica, 159(9), 1733-1746. Springer
Acta Neurochirurgica
ISSN: 0942-0940
0001-6268
Popis: Background Stereoelectroencephalography (SEEG) is an established diagnostic technique for the localization of the epileptogenic zone in drug-resistant epilepsy. In vivo accuracy of SEEG electrode positioning is of paramount importance since higher accuracy may lead to more precise resective surgery, better seizure outcome and reduction of complications. Objective To describe experiences with the SEEG technique in our comprehensive epilepsy center, to illustrate surgical methodology, to evaluate in vivo application accuracy and to consider the diagnostic yield of SEEG implantations. Methods All patients who underwent SEEG implantations between September 2008 and April 2016 were analyzed. Planned electrode trajectories were compared with post-implantation trajectories after fusion of pre- and postoperative imaging. Quantitative analysis of deviation using Euclidean distance and directional errors was performed. Explanatory variables for electrode accuracy were analyzed using linear regression modeling. The surgical methodology, procedure-related complications and diagnostic yield were reported. Results Seventy-six implantations were performed in 71 patients, and a total of 902 electrodes were implanted. Median entry and target point deviations were 1.54 mm and 2.93 mm. Several factors that predicted entry and target point accuracy were identified. The rate of major complications was 2.6%. SEEG led to surgical therapy of various modalities in 53 patients (69.7%). Conclusions This study demonstrated that entry and target point localization errors can be predicted by linear regression models, which can aid in identification of high-risk electrode trajectories and further enhancement of accuracy. SEEG is a reliable technique, as demonstrated by the high accuracy of conventional frame-based implantation methodology and the good diagnostic yield.
Databáze: OpenAIRE
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