The application of stereoelectroencephalography technique with ROSA on precise epileptogenic zone localization and resection_Journal of Epilepsy

Authors：

 ZHOUJian ¹ , ZHAIFeng ¹ , GUANYuguang ¹ , ZHAOMeng ¹ , LUANWei ¹ , TENGPengfei ³ , CHENShuhua ⁴ , WANGJing ² , WANGMengyang ³ ,  LUANGuoming ¹

1. Department of Functional Neurosurgery of Beijing Sanbo Brain Hospital, Capital Medical University, Beijing Key Laboratory in Epilepsy, Beijing 100093, China;
2. Department of Neurophysiological of Beijing Sanbo Brain Hospital, Capital Medical University, Beijing Key Laboratory in Epilepsy, Beijing 100093, China;
3. Department of Magnetoencephalography of Beijing Sanbo Brain Hospital, Capital Medical University, Beijing Key Laboratory in Epilepsy, Beijing 100093, China;
4. Department of Neurology of Beijing Sanbo Brain Hospital, Capital Medical University, Beijing Key Laboratory in Epilepsy, Beijing 100093, China;

Corresponding author：

LUANGuoming, Email: Luangm3@163.com

Keywords：

Intracranial electrode; Epilepsy surgery; Stereo-electroencephalography; Robotized Stereotactic Assistant(ROSA); Pre-operation eveluation

DOI：

10.7507/2096-0247.20160052

Video：

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Objective To evaluate the application of stereotactic electrode implantation on precise epileptogenic zone localization. Method Retrospectively studied 140 patients with drug-resist epilepsy from March 2012 to June 2015, who undergone a procedure of intracranial stereotactic electrode for localized epileptogenic zone. Results In 140 patients who underwent the ROSA navigated implantation of intracranial electrode, 109 are unilateral implantation, 31 are bilateral; 3 patients experienced an intracranial hematoma caused by the implantation. Preserved time of electrodes, on average, 8.4days (range 2~35 days); Obseved clinical seizures, on average, 10.8 times per pt (range 0~98 times); There were no cerebrospinal fluid leak, intracranial hematoma, electrodes fracture or patient death, except 2 pt's scalp infection (1.43%, scalp infection rate); 131 pts' seizure onset area was precisely localized; 71 pts underwent SEEG-guide resections and were followed up for more than 6 months. In the group of 71 resection pts, 56 pts were reached Engel I class, 2 were Engel Ⅱ, 3 was Engel Ⅲ and 10 were Engel IV class. Conclusion To intractable epilepsy, when non-invasive assessments can't find the epileptogenic foci, intracranial electrode implantation combined with long-term VEEG is an effective method to localize the epileptogenic foci, especially the ROSA navigated stereotactic electrode implantation, which is a micro-invasive, short-time, less-complication, safe-guaranteed, and precise technique.

Citation： ZHOUJian, ZHAIFeng, GUANYuguang, ZHAOMeng, LUANWei, TENGPengfei, CHENShuhua, WANGJing, WANGMengyang, LUANGuoming. The application of stereoelectroencephalography technique with ROSA on precise epileptogenic zone localization and resection. Journal of Epilepsy, 2016, 2(4): 290-295. doi: 10.7507/2096-0247.20160052 Copy

1.	Rosenow F, Luders H. Presurgical evaluation of epilepsy. Brain, 2001, 124(2):1683-1670.
2.	Jorge Genzalez-Martinez, Juan Bulacio. Stereoelectroencephalo-graphy in the "difficult to localize" refractory focal epilepsy:early experience from a North American epilepsy center. Epilepsia, 2013, 54(2):323-330.
3.	Cossu M, Cardinale F, Castana L, et al. Stereoelectroencephalo-graphy in the presurgical evaluation of focal epilepsy:a retrospective analysis of 215 procedures. Neurosurgery, 2005, 57(8):706-718.
4.	Jorg Wellmer, Ferdinand von, der Groeben, et al. Risks and benefits of invasive epilepsy surgery workup with implanted subdural and depth electrodes. Epilepsia, 2012, 53(8):1322-1332.
5.	Scott C, Fish D, Smith S, et al. Presurgical evaluation of patients with epilepsy and normal MRI:role of scalp video-EEG telemetry. J Neurol Neurosurg Psychiatry, 1999, 66(8):69-71.
6.	Chapman K, Wyllie E, Najm I, et al.Seizure outcome after epilepsy surgery in patients with normal preoperative MRI. J Neurol Neurosurg Psychiatry, 2005, 76(4):710-713.
7.	Talairach J, Tournoux P, Musolino A, et al. Stereotaxic exploration in frontal epilepsy. Adv Neurol, 1992, 57(8):651-688.
8.	Rasmussen T. Tailoring of cortical excisions for frontal lobe epilepsy. Can J Neurol Sci, 1991, 18(Suppl 4):606-610.
9.	Williamson P, Jobst B. Frontal lobe epilepsy. Adv Neurol, 2000, 84(11):215-242.
10.	Aileen Mc Gonigal, Fabrice Bartolomei, Jean Regis, et al. Stereoelectroencephalography in presurgical assessment of MRI-negative epilepsy. Brain, 2007, 130(5):3169-3183.
11.	Bancaud J, Angelergues R, Bernouilli C, et al. Functional stereotaxic exploration (SEEG) of epilepsy. Electroencephalogr Clin Neurophysiol, 1970, 28(6):85-86.
12.	Guenot M, Isnard J, Ryvlin P, et al. Neurophysiological monitoring for epilepsy surgery:the talairach SEEG method-results, complications and therapeutic applications in a series of 100 consecutive cases. Stereotact Funct Neurosurg, 2001, 77(2):29-32.
13.	Hamer H, Morris H, Mascha E, et al.Complications of invasive video-EEG monitoring with subdural grid electrodes. Neurology, 2002, 58(11):97-103.
14.	Burneo J, Steven D, McLachlan R, et al. Morbidity associated with the use of intracranial electrodes for epilepsy surgery. Can J Neurol Sci, 2006, 33(10):223-227.
15.	Wong C, Birkett J, Byth K, et al. Risk factors for complications during intracranial electrode recording in presurgical evaluation of drug resistant partial epilepsy. Acta Neurochir (Wien), 2009, 151(6):37-50.
16.	Najm I, Bingaman W, L_ders H. The use of subdural grids in the management of focal malformations due to abnormal cortical development. Neurosurg Clin, 2002, 13(3):87-92.
17.	杨岸超, 孟凡刚, 张建国, 等.颅内电极长程记录在癫痫外科中的应用价值.中华神经外科杂志, 2010, 26(11):1013-1016.
18.	马元施, 石先俊, 李维, 等.立体脑电图与硬膜下皮层电极监测在癫痫评估中的比较——立体脑电图具有更少的出血和感染并发症.癫痫杂志, 2015, 1(3):203-208.
19.	Van Gompel JJ, Worrell GA, Bell MI, et a1.Intracranial electroencephalography with subdural grid electrodes:techniques, complications, and outcomes.Neurosurgery, 2008, 63(2):498-506.
20.	Fountas KN, Smith JR.Subdural electrode-associated complications:a 20-year experience. Stereotact Funct Neurosurg, 2007, 85(3):264-272.
21.	Rydenhag B, Silander H. Complications of epilepsy surgery after 654 procedures in Sweden, September 1990-1995:a multicenter study based on the Swedish National Epilepsy Surgery Register. Neurosurgery, 2001, 49(4):51-56.
22.	Jeffrey P Mullin, Daniel Sexton, Jorge Gonzalez-Martinez, et al. Outcomes of subdural gride electrode monitoring in the Stereoelectroencephalography. Era World Neurosurg, 2016, 89(7):255-258.

1. Rosenow F, Luders H. Presurgical evaluation of epilepsy. Brain, 2001, 124(2):1683-1670.
2. Jorge Genzalez-Martinez, Juan Bulacio. Stereoelectroencephalo-graphy in the "difficult to localize" refractory focal epilepsy:early experience from a North American epilepsy center. Epilepsia, 2013, 54(2):323-330.
3. Cossu M, Cardinale F, Castana L, et al. Stereoelectroencephalo-graphy in the presurgical evaluation of focal epilepsy:a retrospective analysis of 215 procedures. Neurosurgery, 2005, 57(8):706-718.
4. Jorg Wellmer, Ferdinand von, der Groeben, et al. Risks and benefits of invasive epilepsy surgery workup with implanted subdural and depth electrodes. Epilepsia, 2012, 53(8):1322-1332.
5. Scott C, Fish D, Smith S, et al. Presurgical evaluation of patients with epilepsy and normal MRI:role of scalp video-EEG telemetry. J Neurol Neurosurg Psychiatry, 1999, 66(8):69-71.
6. Chapman K, Wyllie E, Najm I, et al.Seizure outcome after epilepsy surgery in patients with normal preoperative MRI. J Neurol Neurosurg Psychiatry, 2005, 76(4):710-713.
7. Talairach J, Tournoux P, Musolino A, et al. Stereotaxic exploration in frontal epilepsy. Adv Neurol, 1992, 57(8):651-688.
8. Rasmussen T. Tailoring of cortical excisions for frontal lobe epilepsy. Can J Neurol Sci, 1991, 18(Suppl 4):606-610.
9. Williamson P, Jobst B. Frontal lobe epilepsy. Adv Neurol, 2000, 84(11):215-242.
10. Aileen Mc Gonigal, Fabrice Bartolomei, Jean Regis, et al. Stereoelectroencephalography in presurgical assessment of MRI-negative epilepsy. Brain, 2007, 130(5):3169-3183.
11. Bancaud J, Angelergues R, Bernouilli C, et al. Functional stereotaxic exploration (SEEG) of epilepsy. Electroencephalogr Clin Neurophysiol, 1970, 28(6):85-86.
12. Guenot M, Isnard J, Ryvlin P, et al. Neurophysiological monitoring for epilepsy surgery:the talairach SEEG method-results, complications and therapeutic applications in a series of 100 consecutive cases. Stereotact Funct Neurosurg, 2001, 77(2):29-32.
13. Hamer H, Morris H, Mascha E, et al.Complications of invasive video-EEG monitoring with subdural grid electrodes. Neurology, 2002, 58(11):97-103.
14. Burneo J, Steven D, McLachlan R, et al. Morbidity associated with the use of intracranial electrodes for epilepsy surgery. Can J Neurol Sci, 2006, 33(10):223-227.
15. Wong C, Birkett J, Byth K, et al. Risk factors for complications during intracranial electrode recording in presurgical evaluation of drug resistant partial epilepsy. Acta Neurochir (Wien), 2009, 151(6):37-50.
16. Najm I, Bingaman W, L_ders H. The use of subdural grids in the management of focal malformations due to abnormal cortical development. Neurosurg Clin, 2002, 13(3):87-92.
17. 杨岸超, 孟凡刚, 张建国, 等.颅内电极长程记录在癫痫外科中的应用价值.中华神经外科杂志, 2010, 26(11):1013-1016.
18. 马元施, 石先俊, 李维, 等.立体脑电图与硬膜下皮层电极监测在癫痫评估中的比较——立体脑电图具有更少的出血和感染并发症.癫痫杂志, 2015, 1(3):203-208.
19. Van Gompel JJ, Worrell GA, Bell MI, et a1.Intracranial electroencephalography with subdural grid electrodes:techniques, complications, and outcomes.Neurosurgery, 2008, 63(2):498-506.
20. Fountas KN, Smith JR.Subdural electrode-associated complications:a 20-year experience. Stereotact Funct Neurosurg, 2007, 85(3):264-272.
21. Rydenhag B, Silander H. Complications of epilepsy surgery after 654 procedures in Sweden, September 1990-1995:a multicenter study based on the Swedish National Epilepsy Surgery Register. Neurosurgery, 2001, 49(4):51-56.
22. Jeffrey P Mullin, Daniel Sexton, Jorge Gonzalez-Martinez, et al. Outcomes of subdural gride electrode monitoring in the Stereoelectroencephalography. Era World Neurosurg, 2016, 89(7):255-258.

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The application of stereoelectroencephalography technique with ROSA on precise epileptogenic zone localization and resection

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