open access

Vol 51, No 3 (2017)
Original research articles
Submitted: 2016-07-14
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Intracranial video-EEG monitoring in presurgical evaluation of patients with refractory epilepsy

Marlena Hupalo, Rafal Wojcik, Dariusz J. Jaskolski
DOI: 10.1016/j.pjnns.2017.02.002
·
Neurol Neurochir Pol 2017;51(3):201-207.

open access

Vol 51, No 3 (2017)
Original research articles
Submitted: 2016-07-14

Abstract

Objective

Reviewing our experience in intracranial video-EEG monitoring in the presurgical evaluation of patients with refractory epilepsy.

Methods

We report on 62 out of 202 (31%) patients with refractory epilepsy, who underwent a long term video-EEG monitoring (LTM). The epileptogenic zone (EZ) was localised either based on the results of LTM or after intracranial EEG recordings from depth, subdural or foramen ovale electrodes. The decision on the location of the electrodes was based upon semiology of the seizures, EEG findings and the lesions visualised in MRI brain scan. Intraoperative corticography was carried out before and right after the resection of the seizure onset zone.

Results

The video-EEG monitoring could localise EZ in 43 (69%) cases based. The remaining patients underwent invasive diagnostics: 10 (53%) had intracerebral depth electrodes, 6 (31%) depth and subdural and 3 (16%) foramen ovale electrodes. Intracranial video EEG recordings showed seizure focus in all the patients. Ten of them had EZ in mesial temporal structures, 4 in accessory motor area, 3 at the base of the frontal lobe and 2 in parietal lobe. There was one case of an asymptomatic intracerebral haematoma at the electrode. All patients were subsequently operated on. In 15 (79%) cases the seizures subsided (follow-up from 2 to 5 years), in 4 (21%) they decreased.

Conclusions

The intracranial EEG is required in all patients with normal MRI (so-called nonlesional cases) in whom EZ is suspected to be located in the hippocampus, insula or in the basal parts of the frontal lobe.

Abstract

Objective

Reviewing our experience in intracranial video-EEG monitoring in the presurgical evaluation of patients with refractory epilepsy.

Methods

We report on 62 out of 202 (31%) patients with refractory epilepsy, who underwent a long term video-EEG monitoring (LTM). The epileptogenic zone (EZ) was localised either based on the results of LTM or after intracranial EEG recordings from depth, subdural or foramen ovale electrodes. The decision on the location of the electrodes was based upon semiology of the seizures, EEG findings and the lesions visualised in MRI brain scan. Intraoperative corticography was carried out before and right after the resection of the seizure onset zone.

Results

The video-EEG monitoring could localise EZ in 43 (69%) cases based. The remaining patients underwent invasive diagnostics: 10 (53%) had intracerebral depth electrodes, 6 (31%) depth and subdural and 3 (16%) foramen ovale electrodes. Intracranial video EEG recordings showed seizure focus in all the patients. Ten of them had EZ in mesial temporal structures, 4 in accessory motor area, 3 at the base of the frontal lobe and 2 in parietal lobe. There was one case of an asymptomatic intracerebral haematoma at the electrode. All patients were subsequently operated on. In 15 (79%) cases the seizures subsided (follow-up from 2 to 5 years), in 4 (21%) they decreased.

Conclusions

The intracranial EEG is required in all patients with normal MRI (so-called nonlesional cases) in whom EZ is suspected to be located in the hippocampus, insula or in the basal parts of the frontal lobe.

Get Citation

Keywords

Refractory epilepsy, Presurgical evaluation, Depth electrodes, Streoelectroencephalography, Electrocorticography

About this article
Title

Intracranial video-EEG monitoring in presurgical evaluation of patients with refractory epilepsy

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 3 (2017)

Pages

201-207

DOI

10.1016/j.pjnns.2017.02.002

Bibliographic record

Neurol Neurochir Pol 2017;51(3):201-207.

Keywords

Refractory epilepsy
Presurgical evaluation
Depth electrodes
Streoelectroencephalography
Electrocorticography

Authors

Marlena Hupalo
Rafal Wojcik
Dariusz J. Jaskolski

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