LI Chengjun * , XU Mingxia * , LIN Yuanxiang , WANG Feng , YAO Peisen , YU Lianghong , KANG Dezhi , LIN Zhangya
  • Department of Neurosurgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China;
LIN Yuanxiang, Email: lyx99070@163.com
Intractable epilepsy; Subdural ectrodes; Stereoelectroencephalography; Epileptogenic zones
10.7507/2096-0247.20200049
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Objective To explore the advantages and disadvantages of using two intracranial EEG (iEEG) monitoring methods—Subdural ectrodes electroencephalography (SDEG)and Stereoelectroencephalography (SEEG), in patients with “difficult to locate” Intractable Epilepsy. Methods Retrospectively analyzed the data of 60 patients with SDEG monitoring (49 cases) and SEEG monitoring (11 cases) from January 2010 to December 2018 in the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical. Observe and statistically compare the differences in the evaluation results of epileptic zones, surgical efficacy and related complications of the two groups of patients, and review the relevant literature. Results The results showed that the two groups of SDEG and SEEG had no significant difference in the positive rate and surgical resection rate of epileptogenic zones, but the bilateral implantation rate of SEEG (5/11, 45.5%) was higher than that of SDEG (18/49, 36.7%). At present, there was no significant difference in the postoperative outcome among patients with epileptic zones resected after SDEG and SEEG monitoring (P>0.05). However, due to the limitation of the number of SEEG cases, it is not yet possible to conclude that the two effects were the same. There was a statistically significant difference in the total incidence of serious complications of bleeding or infection between the two groups (SDEG 20 cases vs. SEEG 1 case, P<0.05). There was a statistically significant difference in the total incidence of significant headache or cerebral edema between the two groups (SDEG 26 cases vs. SEEG 2 cases, P<0.05). There was a statistically significant difference in the incidence of cerebrospinal fluid leakage, subcutaneous fluid incision, and poor healing of incision after epileptic resection (SDEG 14 cases vs. SEEG 0 case, P<0.05); there were no significant differences in dysfunction of speech, muscle strength between the two groups (P>0.05). Conclusion SEEG has fewer complications than SDEG, SEEG is safer than SDEG. The two kinds of iEEG monitoring methods have advantages in the localization of epileptogenic zones and the differentiation of functional areas. The effective combination of the two methods in the future may be more conducive to the location of epileptic zones and functional areas.

Citation： LI Chengjun, XU Mingxia, LIN Yuanxiang, WANG Feng, YAO Peisen, YU Lianghong, KANG Dezhi, LIN Zhangya. Comparison of the application of two kinds of iEEG monitoring methods (SEEG vs. SDEG) in patients with “difficult to locate” Intractable Epilepsy. Journal of Epilepsy, 2020, 6(4): 307-314. doi: 10.7507/2096-0247.20200049 Copy

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