Clinical effect of cortical electrode monitoring on intractable epilepsy caused by double pathology_Journal of Epilepsy

Authors：

WANG Zhongming ^1,2 , LI Guangli ^1,2 , PENG Qiong ^1,2 , HUANG Yahui ^1,2 , LU Jun ^1,2 , XIE Qi ³ ,  ZHOU Guiyun ^1,2

1. Epilepsy Center, Hunan Brain Hospital, Changsha 410073, China;
2. Clinical School of Medicine, Hunan University of Chinese Medicine, Changsha 410073, China;
3. Department of Rehabilitation Medicine, Hunan Brain Hospital Changsha 410073, China;

Corresponding author：

ZHOU Guiyun, Email: 254490374@qq.com

Keywords：

Electro-Cortico-Graphy; Double pathological signs; Refractory epilepsy; Surgical treatment

DOI：

10.7507/2096-0247.202402002

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Objective To investigate the clinical effect of Electro-Cortico-Graphy (ECOG) monitoring on refractory epilepsy caused by double pathology. Methods A retrospective analysis was performed on 10 patients with refractory epilepsy who underwent surgical treatment in Hunan Brain Hospital from January 2020 to December 2021. The diagnosis of postoperative disease was dual pathology of medial temporal lobe sclerosis (MTS) and focal cortical dysplasia (FCD), and the effect of oral drugs was poor. All patients underwent full preoperative evaluation to determine the scope of excision of epileptogenic lesions. Cortical electrodes were used to monitor the location and scope of epileptic discharge during the operation. Epileptogenic lesions were excised, cortical heat cautery was performed, and then cortical EEG monitoring was performed to adjust the excision strategy. The patients were followed up for 24 to 48 months, and the prognosis was assessed according to the Engel scale. Results Among the 10 patients, 1 patient had acute subdural hemorrhage after surgery, 1 patient had speech and naming disorders, but all of them were recovered at discharge. The other patients had no neurological defects such as intracranial infection, hemiplegia, aphasia, etc. Engel grade I was observed in 9 cases (90%) and Engel grade III was observed in 1 case (10%). Conclusion Cortical electrode monitoring is safe and effective for refractory epilepsy caused by double pathological signs.

Citation： WANG Zhongming, LI Guangli, PENG Qiong, HUANG Yahui, LU Jun, XIE Qi, ZHOU Guiyun. Clinical effect of cortical electrode monitoring on intractable epilepsy caused by double pathology. Journal of Epilepsy, 2024, 10(2): 104-107. doi: 10.7507/2096-0247.202402002 Copy

1.	李家亮, 苗鹏飞, 杨全喜, 等. 脑皮层电图监测下显微手术治疗耐药性癫痫的效果. 中国医药导报, 2021, 18(26): 77-80.
2.	Yang T, Hakimian S, Schwartz TH. Intraoperative ElectroCorticoGraphy (ECog): indications, techniques, and utility in epilepsy surgery. Epileptic Disorders, 2014, 16(3): 271-279.
3.	姜卉, 姜兵, 张伟, 等. 局灶性皮层发育不良相关难治性癫痫的手术预后影响因素分析. 中国现代手术学杂志, 2023, 27(2): 139-144.
4.	孙鹏, 杨新生, 孟庆海, 等. 皮层电极监测下切除致痫性脑胶质瘤的临床研究. 中华神经医学杂志, 2003, 2(3): 168-169.
5.	Iasemidis LD, Zaveri HP, Sackellares JC, et al. Modelling of ECoG in temporal lobe epilepsy. Biomed Sci Instrum, 1988, 24: 187-193.
6.	艾热木古丽·阿不都热依木, 秦虎, 张丽娜, 等. 双重病理征对药物难治性颞叶内侧癫痫手术预后的影响. 中国临床神经外科杂志, 2023, 28(2): 80-82.
7.	潘隆盛, 凌至培, 徐强, 等. 皮层电极监测、图像融合和术中磁共振精确镜下导航技术在切除功能区癫痫灶的应用. 军医进修学院学报, 2012, 33(8): 819-821.
8.	Boran E, Ramantani G, Krayenbühl N, et al. High-density ECoG improves the detection of high frequency oscillations that predict seizure outcome. Clinical Neurophysiology, 2019, 130(10): 1882-1888.
9.	章卫桥, 周三权, 赵飞, 等. 皮层电极监测在颅骨缺损合并外伤性癫痫术中的运用. 中国医师进修杂志, 2010, 33(8): 64-66.
10.	钱若兵, 傅先明, 汪业汉, 等. 皮层电极描记配合立体定向切除癫痫灶. 立体定向和功能性神经外科杂志, 2003, 16(4): 203-205.
11.	王中鸣, 王琴, 彭琼, 等. 基于多模态影像的立体定向脑电图在药物难治性癫痫治疗中的应用. 中国医学装备, 2023, 20(8): 84-87.
12.	卢军, 王中鸣, 王琴, 等. 多模态影像融合联合立体脑电图对多病灶难治性癫痫的术前定位及疗效. 中国实用神经疾病杂志, 2023, 26(8): 930-935.
13.	Zhu Q, Liang Y, Fan Z, et al. The utility of intraoperative ECoG in tumor-related epilepsy: Systematic review. Clinical Neurology and Neurosurgery, 2022, 212: 107054.
14.	Kuruvilla A, Flink R. Intraoperative electrocorticography in epilepsy surgery: useful or not?. Seizure, 2003, 12(8): 577-584.
15.	Ravat S, Iyer V, Panchal K, et al. Surgical outcomes in patients with intraoperative Electrocorticography (EcoG) guided epilepsy surgery-experiences of a tertiary care centre in India. International Journal of Surgery, 2016, 36: 420-428.
16.	Holthausen H, Coras R, Tang Y, et al. Multilobar unilateral hypoplasia with emphasis on the posterior quadrant and severe epilepsy in children with FCD ILAE type 1A. Epilepsia, 2022, 63(1): 42-60.

1. 李家亮, 苗鹏飞, 杨全喜, 等. 脑皮层电图监测下显微手术治疗耐药性癫痫的效果. 中国医药导报, 2021, 18(26): 77-80.
2. Yang T, Hakimian S, Schwartz TH. Intraoperative ElectroCorticoGraphy (ECog): indications, techniques, and utility in epilepsy surgery. Epileptic Disorders, 2014, 16(3): 271-279.
3. 姜卉, 姜兵, 张伟, 等. 局灶性皮层发育不良相关难治性癫痫的手术预后影响因素分析. 中国现代手术学杂志, 2023, 27(2): 139-144.
4. 孙鹏, 杨新生, 孟庆海, 等. 皮层电极监测下切除致痫性脑胶质瘤的临床研究. 中华神经医学杂志, 2003, 2(3): 168-169.
5. Iasemidis LD, Zaveri HP, Sackellares JC, et al. Modelling of ECoG in temporal lobe epilepsy. Biomed Sci Instrum, 1988, 24: 187-193.
6. 艾热木古丽·阿不都热依木, 秦虎, 张丽娜, 等. 双重病理征对药物难治性颞叶内侧癫痫手术预后的影响. 中国临床神经外科杂志, 2023, 28(2): 80-82.
7. 潘隆盛, 凌至培, 徐强, 等. 皮层电极监测、图像融合和术中磁共振精确镜下导航技术在切除功能区癫痫灶的应用. 军医进修学院学报, 2012, 33(8): 819-821.
8. Boran E, Ramantani G, Krayenbühl N, et al. High-density ECoG improves the detection of high frequency oscillations that predict seizure outcome. Clinical Neurophysiology, 2019, 130(10): 1882-1888.
9. 章卫桥, 周三权, 赵飞, 等. 皮层电极监测在颅骨缺损合并外伤性癫痫术中的运用. 中国医师进修杂志, 2010, 33(8): 64-66.
10. 钱若兵, 傅先明, 汪业汉, 等. 皮层电极描记配合立体定向切除癫痫灶. 立体定向和功能性神经外科杂志, 2003, 16(4): 203-205.
11. 王中鸣, 王琴, 彭琼, 等. 基于多模态影像的立体定向脑电图在药物难治性癫痫治疗中的应用. 中国医学装备, 2023, 20(8): 84-87.
12. 卢军, 王中鸣, 王琴, 等. 多模态影像融合联合立体脑电图对多病灶难治性癫痫的术前定位及疗效. 中国实用神经疾病杂志, 2023, 26(8): 930-935.
13. Zhu Q, Liang Y, Fan Z, et al. The utility of intraoperative ECoG in tumor-related epilepsy: Systematic review. Clinical Neurology and Neurosurgery, 2022, 212: 107054.
14. Kuruvilla A, Flink R. Intraoperative electrocorticography in epilepsy surgery: useful or not?. Seizure, 2003, 12(8): 577-584.
15. Ravat S, Iyer V, Panchal K, et al. Surgical outcomes in patients with intraoperative Electrocorticography (EcoG) guided epilepsy surgery-experiences of a tertiary care centre in India. International Journal of Surgery, 2016, 36: 420-428.
16. Holthausen H, Coras R, Tang Y, et al. Multilobar unilateral hypoplasia with emphasis on the posterior quadrant and severe epilepsy in children with FCD ILAE type 1A. Epilepsia, 2022, 63(1): 42-60.

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