立体定向脑电图相关并发症的系统评价_Journal of Epilepsy

Authors：

JeffreyP Mullin , MichaelShriver , SohaAlomar , 肖英凤 , 慕洁

Corresponding author：

Keywords：

癫痫手术; 立体定向脑电图; 立体定位; 安全性

DOI：

10.7507/2096-0247.20170056

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立体定向脑电图(SEEG)是针对难治性癫痫患者的一项术前评估手段，可定位致痫灶及可能相关的功能皮质区的解剖位置。避免大骨瓣开颅术及其植入精确性，SEEG可能减少相关并发症。然而，由于植入并发症相对较高，颅内电极被认为是具有过度侵入性的操作。此前并无关于SEEG并发症的系统文献综述及Meta分析。该研究的目的是定量回顾文献中SEEG电极植入后各种手术并发症的发生率并进行汇总评估，以便内科医生能够就该术外侵入性监测的相关潜在并发症提供准确建议。此项系统评价是基于PRISMA实现的。通过检索MEDLINE, Scopus, Web of Science数据库，用逆方差加权的固定效应模型对并发症的发生率进行分析。Meta分析与森林图的制作都是通过成熟的制表软件完成的。主要结局指标是总效应量及其95%置信区间(CI)。检索到的1 901篇文献，除重787篇后，通过标题和摘要对1 114篇文章进行了筛选。在这一阶段，排除了没有提及SEEG术后并发症或未达到纳入标准的研究。在排除1 057篇文献后，对剩余的57篇文献进行全文阅读以确定合格标准。最常见的并发症是出血[合并患病率1.0%，95%CI (0.6, 1.4)]或感染[合并患病率0.8%，95%CI(0.3, 1.2)]。确定了5例死亡[合并患病率0.3%，95%CI(0.1, 0.6)]。文章分析确定了与SEEG植入和监测相关的121例手术并发症[合并患病率1.3%，95%CI(0.9, 1.7)]。对SEEG相关并发症的实际发生率的综合评估。相比其他术外侵入性监测方法，SEEG并发症的发生率实际上更低。这些数据可能减轻一些关于“立体定位”方法的安全性的担忧，在选择不同的侵入性监测方法时做出更好的决策，并减轻深度电极植入相关的恐惧。

Citation： JeffreyP Mullin, MichaelShriver, SohaAlomar, 肖英凤, 慕洁. 立体定向脑电图相关并发症的系统评价. Journal of Epilepsy, 2017, 3(4): 354-363. doi: 10.7507/2096-0247.20170056 Copy

1.	Bancaud J, Talairach J. Functional organization of the supplementarymotor area. Data obtained by stereo-EEG. Neurochirurgie, 1967, 13(7): 343-356.
2.	Chassoux F, Devaux B, Landre E, et al. Stereoelectro encephalography in focal cortical dysplasia: a 3D approach to delineating the dysplastic cortex. Brain, 2000, 123(6): 1733-1751.
3.	Talairach J, Bancaud J, Bonis A, et al. Surgical therapy for frontalepilepsies. Adv Neurol, 1992, 57(11): 707-732.
4.	Bancaud J. Epilepsy after 60 years of age. Experience in a functional neurosurgical department. Sem Hop, 1970, 46 (4): 3138-3140.
5.	Bancaud J, Angelergues R, Bernouilli C, et al. Functional stereotaxicexploration (SEEG) of epilepsy. Electroencephalogr Clin Neurophysiol, 1970, 28(7): 85-86.
6.	Cossu M, Cardinale F, Castana L, et al. Stereo-EEG in children. Childs Nerv Syst, 2006, 22(10): 766-778.
7.	Quesney LF, Gloor P. Localization of epileptic foci. Electroencephalogr Clin Neurophysiol Suppl, 1985, 37(3): 165-200.
8.	De Almeida AN, Olivier A, Quesney F, et al. Efficacy of and morbidity associated with stereoelectroencephalography using computerized tomography-or magnetic resonance imaging-guided electrode implantation. J Neurosurg, 2006, 104(7): 483-487.
9.	Gonzalez-Martinez J, Bulacio J, Alexopoulos A, et al. Stereoelectroencephalography in the "difficult to localize" refractory focal epilepsy: early experience from a north american epilepsy center. Epilepsia, 2013, 54(1): 323-330.
10.	Cossu M, Cardinale F, Castana L, et al. Stereoelectroencephalography in the presurgical evaluation of focal epilepsy: a retrospective analysis of 215 procedures. Neurosurgery, 2005, 57(2): 706-718; discussion 706-718.https://www.researchgate.net/publication/7526465_Stereoelectroencephalography_in_the_Presurgical_Evaluation_of_Focal_Epilepsy_A_Retrospective_Analysis_of_215_Procedures.
11.	Gonzalez-Martinez J, Mullin J, Vadera S, et al. Stereotactic placementof depth electrodes in medically intractable epilepsy. J Neurosurg, 2014, 120(4): 639-644.
12.	Cross JH. Epilepsy surgery in childhood. Epilepsia, 2002, 43(8): 65-70.
13.	DeLong WB, Polissar N, Neradilek B. Timing of surgery in caudaequina syndrome with urinary retention: meta-analysis of observational studies. J Neurosurg Spine, 2008, 8(3): 305-320.
14.	Group OLo EW. The Oxford Levels of Evidence 2, in: Oxford Centrefor Evidence-Based Medicine.
15.	Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 2009, 339(4): b2535.
16.	Neyeloff JL, Fuchs SC, Moreira LB. Meta-analyses and forest plotsusing a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis. BMC Res Notes, 2012, 5(6): 52.
17.	Dorfer C, Stefanits H, Pataraia E, et al. Frameless stereotactic drilling for placement of depth electrodes in refractory epilepsy: operative technique and initial experience. Neuro Surgery, 2014, 10(7): 582-590; discussion 590-591.
18.	Balanescu B, Franklin R, Ciurea J, et al. A personalized stereotactic fixture for implantation of depth electrodes in stereoelectroencephalo graphy. Stereotact Funct Neurosurg, 2014, 92(3): 117-125.
19.	Cardinale F, Cossu M, Castana L, et al. Stereoelectroencephalography: surgical methodology, safety, and stereotactic application accuracy in 500 procedures. Neuro Surgery, 2013, 72(4): 353-366; discussion 366.
20.	Serletis D, Bulacio J, Bingaman W, et al. The stereotactic approach formapping epileptic networks: a prospective study of 200 patients. J Neuro Surg, 2014, 121(5): 1239-1246.
21.	Dylgjeri S, Taussig D, Chipaux M, et al. Insular and insulo-opercular epilepsy in childhood: an SEEG study. Seizure, 2014, 23(5): 300-308.
22.	Ross DA, Brunberg JA, Drury I, et al. Intracerebral depth electrodemonitoring in partial epilepsy: the morbidity and efficacy of placement using magnetic resonance image-guided stereotactic surgery. Neuro Surgery, 1996, 39(2): 327-333; discussion 333-334.
23.	Espinosa J, Olivier A, Andermann F, et al. Morbidity of chronicrecording with intracranial depth electrodes in 170 patients. Stereotact Funct Neuro Surg, 1994, 63(9): 63-65.
24.	Guenot M, Isnard J, Ryvlin P, et al. Neurophysiological monitoring forepilepsy surgery: the Talairach SEEG method. StereoElectroEncephaloGraphy. Indications, results, complications and therapeutic applications in a series of 100 consecutive cases. Stereotact Funct Neuro Surg, 2001, 77(11): 29-32.
25.	Munari C, Hoffmann D, Francione S, et al. Stereo-electroencephalography methodology: advantages and limits. Acta Neurol Scand Suppl, 1994, 152(3): 56-67; discussion 68-69.https://www.researchgate.net/publication/14988938_Stereo-electroencephalography_methodology_Advantages_and_limits.
26.	Mc Gonigal A, Bartolomei F, Regis J, et al. Stereoelectroencephalography in presurgical assessment of MRI-negative epilepsy. Brain, 2007, 130(2): 3169-3183.
27.	So N, Gloor P, Quesney LF, et al. Depth electrode investigations inpatients with bitemporal epileptiform abnormalities. Ann Neurol, 1989, 25 (4): 423-431.
28.	Vadera S, Mullin J, Bulacio J, et al. Stereoelectroencephalo graphy following subdural grid placement for difficult tolocalize epilepsy. Neuro Surgery, 2013, 72(10): 723-729; discussion 729.https://cwru.pure.elsevier.com/en/publications/stereoelectroencephalography-following-subdural-grid-placement-fo-2.
29.	Van Roost D, Solymosi L, Schramm J, et al. Depth electrode implantation in the length axis of the hippocampus for the presurgical evaluation of medial temporal lobe epilepsy: a computed tomography-based stereotactic insertion technique and its accuracy. Neuro Surgery, 1998, 43(8): 819-826; discussion 826-827.http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00006123-199810000-00059.
30.	Nowell M, Rodionov R, Diehl B, et al. A novel method for implementation of frameless StereoEEG in epilepsy surgery. Neuro Surgery, 2014, 10(8): 525-533; discussion 533-534.https://www.ncbi.nlm.nih.gov/pubmed/?term=%5D+A+novel+method+for+implementation+of+frameless+StereoEEG+in+epilepsy+surgery.
31.	Olivier A, Gloor P, Quesney LF, et al. The indications for and the role of depth electrode recording in epilepsy. Appl Neurophysiol, 1983, 46(2): 33-36.
32.	Kratimenos GP, Thomas DG, Shorvon SD, et al. Stereotactic insertion of intracerebral electrodes in the investigation of epilepsy. Br J Neuro Surg, 1993, 7(4): 45-52.
33.	Arya R, Mangano FT, Horn PS, et al. Adverse events related toextraoperative invasive EEG monitoring with subdural grid electrodes: a systematic review and meta-analysis. Epilepsia, 2013, 54(3): 828-839.
34.	Tebo CC, Evins AI, Christos PJ, et al. Evolution of cranial epilepsysurgery complication rates: a 32-year systematic review and meta-analysis. J Neuro Surg, 2014, 120(8): 1415-1427.
35.	Tanriverdi T, Ajlan A, Poulin N, et al. Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution. J Neuro Surg, 2009, 110(2): 1111-1123.
36.	Maxwell RE, Gates JR, Fiol ME, et al. Clinical evaluation of adepth electroencephalography electrode. Neuro Surgery, 1983, 12(4): 561-564.http://www.ncbi.nlm.nih.gov/pubmed/6866240.
37.	Munari C, Giallonardo AT, Brunet P, et al. Stereotactic investigations in frontal lobe epilepsies. Acta Neurochir Suppl (Wien), 1989, 46(9): 9-12.http://rd.springer.com/chapter/10.1007/978-3-7091-9029-6_2.
38.	Abhinav K, Prakash S, Sandeman DR. Use of robot-guided stereotacticplacement of intracerebral electrodes for investigation of focal epilepsy: initialexperience in the UK. Br J Neuro Surg, 2013, 27(2): 704-705.
39.	Blauwblomme T, David O, Minotti L, et al. Prognostic value of insularlobe involvement in temporal lobe epilepsy: a stereoelectroencephalographic study. Epilepsia, 2013, 54(11): 1658-1667.
40.	Cossu M, Fuschillo D, Cardinale F, et al. Stereo-EEG-guided radio frequency thermocoagulations of epileptogenic grey-matter nodular heterotopy. J Neurol Neurosurg Psychiatry, 2014, 85(10): 611-617.
41.	Dorfmeuller G, Ferrand-Sorbets S, Fohlen M, et al. Outcome of surgery in children with focal cortical dysplasia younger than 5 years explored by stereo-electroencephalography. Childs Nerv Syst, 2014, 30(6): 1875-1883.
42.	Ortler M, Sohm F, Eisner W, et al. Frame-based vs frameless placement of intrahippocampal depth electrodes in patients with refractory epilepsy: a comparative in vivo (application) study. Neuro Surgery, 2011, 68(12): 881-887; discussion 887.http://journals.lww.com/neurosurgery/Abstract/2011/04000/Frame_Based_vs_Frameless_Placement_of.15.aspx.
43.	Taussig D, Chipaux M, Lebas A, et al. Stereo-electroencephalography(SEEG) in 65 children: an effective and safe diagnostic method for presurgical diagnosis, independent of age. Epileptic Disord, 2014, 16(3): 280-295.
44.	Munyon C, Sweet J, Luders H, et al. The 3-dimensional grid: a novelapproach to stereoelectroencephalography.Neuro Surgery, 2015, 11(7): 127-133; discussion 133-134.https://www.researchgate.net/publication/271140241_The_3-Dimensional_Grid_A_Novel_Approach_to_Stereoelectroencephalography.
45.	Cardinale F, Cossu M. SEEG has the lowest rate of complications. J Neuro Surg, 2015, 122(6): 475-477.
46.	Hader WJ, Tellez-Zenteno J, Metcalfe A, et al. Complications of epilepsy surgery: a systematic review of focal surgical resections and invasive EEG monitoring. Epilepsia, 2013, 54(11): 840-847.

1. Bancaud J, Talairach J. Functional organization of the supplementarymotor area. Data obtained by stereo-EEG. Neurochirurgie, 1967, 13(7): 343-356.
2. Chassoux F, Devaux B, Landre E, et al. Stereoelectro encephalography in focal cortical dysplasia: a 3D approach to delineating the dysplastic cortex. Brain, 2000, 123(6): 1733-1751.
3. Talairach J, Bancaud J, Bonis A, et al. Surgical therapy for frontalepilepsies. Adv Neurol, 1992, 57(11): 707-732.
4. Bancaud J. Epilepsy after 60 years of age. Experience in a functional neurosurgical department. Sem Hop, 1970, 46 (4): 3138-3140.
5. Bancaud J, Angelergues R, Bernouilli C, et al. Functional stereotaxicexploration (SEEG) of epilepsy. Electroencephalogr Clin Neurophysiol, 1970, 28(7): 85-86.
6. Cossu M, Cardinale F, Castana L, et al. Stereo-EEG in children. Childs Nerv Syst, 2006, 22(10): 766-778.
7. Quesney LF, Gloor P. Localization of epileptic foci. Electroencephalogr Clin Neurophysiol Suppl, 1985, 37(3): 165-200.
8. De Almeida AN, Olivier A, Quesney F, et al. Efficacy of and morbidity associated with stereoelectroencephalography using computerized tomography-or magnetic resonance imaging-guided electrode implantation. J Neurosurg, 2006, 104(7): 483-487.
9. Gonzalez-Martinez J, Bulacio J, Alexopoulos A, et al. Stereoelectroencephalography in the "difficult to localize" refractory focal epilepsy: early experience from a north american epilepsy center. Epilepsia, 2013, 54(1): 323-330.
10. Cossu M, Cardinale F, Castana L, et al. Stereoelectroencephalography in the presurgical evaluation of focal epilepsy: a retrospective analysis of 215 procedures. Neurosurgery, 2005, 57(2): 706-718; discussion 706-718.https://www.researchgate.net/publication/7526465_Stereoelectroencephalography_in_the_Presurgical_Evaluation_of_Focal_Epilepsy_A_Retrospective_Analysis_of_215_Procedures.
11. Gonzalez-Martinez J, Mullin J, Vadera S, et al. Stereotactic placementof depth electrodes in medically intractable epilepsy. J Neurosurg, 2014, 120(4): 639-644.
12. Cross JH. Epilepsy surgery in childhood. Epilepsia, 2002, 43(8): 65-70.
13. DeLong WB, Polissar N, Neradilek B. Timing of surgery in caudaequina syndrome with urinary retention: meta-analysis of observational studies. J Neurosurg Spine, 2008, 8(3): 305-320.
14. Group OLo EW. The Oxford Levels of Evidence 2, in: Oxford Centrefor Evidence-Based Medicine.
15. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 2009, 339(4): b2535.
16. Neyeloff JL, Fuchs SC, Moreira LB. Meta-analyses and forest plotsusing a microsoft excel spreadsheet: step-by-step guide focusing on descriptive data analysis. BMC Res Notes, 2012, 5(6): 52.
17. Dorfer C, Stefanits H, Pataraia E, et al. Frameless stereotactic drilling for placement of depth electrodes in refractory epilepsy: operative technique and initial experience. Neuro Surgery, 2014, 10(7): 582-590; discussion 590-591.
18. Balanescu B, Franklin R, Ciurea J, et al. A personalized stereotactic fixture for implantation of depth electrodes in stereoelectroencephalo graphy. Stereotact Funct Neurosurg, 2014, 92(3): 117-125.
19. Cardinale F, Cossu M, Castana L, et al. Stereoelectroencephalography: surgical methodology, safety, and stereotactic application accuracy in 500 procedures. Neuro Surgery, 2013, 72(4): 353-366; discussion 366.
20. Serletis D, Bulacio J, Bingaman W, et al. The stereotactic approach formapping epileptic networks: a prospective study of 200 patients. J Neuro Surg, 2014, 121(5): 1239-1246.
21. Dylgjeri S, Taussig D, Chipaux M, et al. Insular and insulo-opercular epilepsy in childhood: an SEEG study. Seizure, 2014, 23(5): 300-308.
22. Ross DA, Brunberg JA, Drury I, et al. Intracerebral depth electrodemonitoring in partial epilepsy: the morbidity and efficacy of placement using magnetic resonance image-guided stereotactic surgery. Neuro Surgery, 1996, 39(2): 327-333; discussion 333-334.
23. Espinosa J, Olivier A, Andermann F, et al. Morbidity of chronicrecording with intracranial depth electrodes in 170 patients. Stereotact Funct Neuro Surg, 1994, 63(9): 63-65.
24. Guenot M, Isnard J, Ryvlin P, et al. Neurophysiological monitoring forepilepsy surgery: the Talairach SEEG method. StereoElectroEncephaloGraphy. Indications, results, complications and therapeutic applications in a series of 100 consecutive cases. Stereotact Funct Neuro Surg, 2001, 77(11): 29-32.
25. Munari C, Hoffmann D, Francione S, et al. Stereo-electroencephalography methodology: advantages and limits. Acta Neurol Scand Suppl, 1994, 152(3): 56-67; discussion 68-69.https://www.researchgate.net/publication/14988938_Stereo-electroencephalography_methodology_Advantages_and_limits.
26. Mc Gonigal A, Bartolomei F, Regis J, et al. Stereoelectroencephalography in presurgical assessment of MRI-negative epilepsy. Brain, 2007, 130(2): 3169-3183.
27. So N, Gloor P, Quesney LF, et al. Depth electrode investigations inpatients with bitemporal epileptiform abnormalities. Ann Neurol, 1989, 25 (4): 423-431.
28. Vadera S, Mullin J, Bulacio J, et al. Stereoelectroencephalo graphy following subdural grid placement for difficult tolocalize epilepsy. Neuro Surgery, 2013, 72(10): 723-729; discussion 729.https://cwru.pure.elsevier.com/en/publications/stereoelectroencephalography-following-subdural-grid-placement-fo-2.
29. Van Roost D, Solymosi L, Schramm J, et al. Depth electrode implantation in the length axis of the hippocampus for the presurgical evaluation of medial temporal lobe epilepsy: a computed tomography-based stereotactic insertion technique and its accuracy. Neuro Surgery, 1998, 43(8): 819-826; discussion 826-827.http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00006123-199810000-00059.
30. Nowell M, Rodionov R, Diehl B, et al. A novel method for implementation of frameless StereoEEG in epilepsy surgery. Neuro Surgery, 2014, 10(8): 525-533; discussion 533-534.https://www.ncbi.nlm.nih.gov/pubmed/?term=%5D+A+novel+method+for+implementation+of+frameless+StereoEEG+in+epilepsy+surgery.
31. Olivier A, Gloor P, Quesney LF, et al. The indications for and the role of depth electrode recording in epilepsy. Appl Neurophysiol, 1983, 46(2): 33-36.
32. Kratimenos GP, Thomas DG, Shorvon SD, et al. Stereotactic insertion of intracerebral electrodes in the investigation of epilepsy. Br J Neuro Surg, 1993, 7(4): 45-52.
33. Arya R, Mangano FT, Horn PS, et al. Adverse events related toextraoperative invasive EEG monitoring with subdural grid electrodes: a systematic review and meta-analysis. Epilepsia, 2013, 54(3): 828-839.
34. Tebo CC, Evins AI, Christos PJ, et al. Evolution of cranial epilepsysurgery complication rates: a 32-year systematic review and meta-analysis. J Neuro Surg, 2014, 120(8): 1415-1427.
35. Tanriverdi T, Ajlan A, Poulin N, et al. Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution. J Neuro Surg, 2009, 110(2): 1111-1123.
36. Maxwell RE, Gates JR, Fiol ME, et al. Clinical evaluation of adepth electroencephalography electrode. Neuro Surgery, 1983, 12(4): 561-564.http://www.ncbi.nlm.nih.gov/pubmed/6866240.
37. Munari C, Giallonardo AT, Brunet P, et al. Stereotactic investigations in frontal lobe epilepsies. Acta Neurochir Suppl (Wien), 1989, 46(9): 9-12.http://rd.springer.com/chapter/10.1007/978-3-7091-9029-6_2.
38. Abhinav K, Prakash S, Sandeman DR. Use of robot-guided stereotacticplacement of intracerebral electrodes for investigation of focal epilepsy: initialexperience in the UK. Br J Neuro Surg, 2013, 27(2): 704-705.
39. Blauwblomme T, David O, Minotti L, et al. Prognostic value of insularlobe involvement in temporal lobe epilepsy: a stereoelectroencephalographic study. Epilepsia, 2013, 54(11): 1658-1667.
40. Cossu M, Fuschillo D, Cardinale F, et al. Stereo-EEG-guided radio frequency thermocoagulations of epileptogenic grey-matter nodular heterotopy. J Neurol Neurosurg Psychiatry, 2014, 85(10): 611-617.
41. Dorfmeuller G, Ferrand-Sorbets S, Fohlen M, et al. Outcome of surgery in children with focal cortical dysplasia younger than 5 years explored by stereo-electroencephalography. Childs Nerv Syst, 2014, 30(6): 1875-1883.
42. Ortler M, Sohm F, Eisner W, et al. Frame-based vs frameless placement of intrahippocampal depth electrodes in patients with refractory epilepsy: a comparative in vivo (application) study. Neuro Surgery, 2011, 68(12): 881-887; discussion 887.http://journals.lww.com/neurosurgery/Abstract/2011/04000/Frame_Based_vs_Frameless_Placement_of.15.aspx.
43. Taussig D, Chipaux M, Lebas A, et al. Stereo-electroencephalography(SEEG) in 65 children: an effective and safe diagnostic method for presurgical diagnosis, independent of age. Epileptic Disord, 2014, 16(3): 280-295.
44. Munyon C, Sweet J, Luders H, et al. The 3-dimensional grid: a novelapproach to stereoelectroencephalography.Neuro Surgery, 2015, 11(7): 127-133; discussion 133-134.https://www.researchgate.net/publication/271140241_The_3-Dimensional_Grid_A_Novel_Approach_to_Stereoelectroencephalography.
45. Cardinale F, Cossu M. SEEG has the lowest rate of complications. J Neuro Surg, 2015, 122(6): 475-477.
46. Hader WJ, Tellez-Zenteno J, Metcalfe A, et al. Complications of epilepsy surgery: a systematic review of focal surgical resections and invasive EEG monitoring. Epilepsia, 2013, 54(11): 840-847.

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立体定向脑电图相关并发症的系统评价

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