| Lateralization of temporal lobe foci: depth versus subdural electrodes. | |
| | |
MedLine Citation:
|
PMID: 11336899 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: Definitive localization of an epileptic focus correlates with a favorable outcome following epilepsy surgery. This study was undertaken to determine the incremental value of data yielded for surgical decision making when using subdural electrodes alone and in addition to depth electrodes for temporal lobe epilepsy. METHODS: Standardized placement for intracranial electrodes included: (1) longitudinal placement of bilateral temporal lobe depth electrodes; (2) bilateral subtemporal subdural strips; and (3) bilateral orbitofrontal subdural strips. Sixty-three events were randomly reviewed for: (1) subdural electrodes alone; and (2) depth electrodes in conjunction with subdural electrodes. RESULTS: Of the 63 seizures, 54 (85.7%) demonstrated congruent lateralization to ipsilateral subtemporal subdural strip electrodes (based on depth electrode localization) when subdural strip electrodes were utilized alone. In 3 of 22 patients, 7 seizures demonstrated 'false localization' on subdural electrode analysis alone when compared with depth recording and post-surgical outcome. For these 3 patients, retrospective review of neuroimaging demonstrated suboptimal ipsilateral placement of subtemporal subdural electrodes with the most mesial electrode lateral to the collateral sulcus. Four additional patients had suboptimal placement of subtemporal subdural electrodes. Two of these 4 patients had congruent localization with subdural electrodes to ipsilateral depth electrodes despite suboptimal placement. Subtemporal subdural electrodes accurately localized for all seizures from the mesial temporal lobe when the mesial electrodes of the subtemporal subdural strip recorded mesial to the collateral sulcus from the parahippocampal region. CONCLUSION: We conclude that although there are high concordance rates between subdural and depth electrodes, localization of seizure onset based on subdural strip electrodes alone may result in inaccurate focus identification with potential for possible suboptimal treatment of temporal lobe epilepsy. When subtemporal subdural electrodes provide recording from the parahippocampal region, there is accurate localization of the seizure focus. If suboptimal placement occurs lateral to the collateral sulcus, the electroencephalographer cannot make a definitive identification of the seizure focus. |
| | |
Authors:
|
S Eisenschenk; R L Gilmore; J E Cibula; S N Roper |
Related Documents
:
|
6830489 - Bilateral blindness in temporal arteritis with skip areas. 18059239 - Oral necrotizing microvasculitis in a patient affected by kawasaki disease. 11790989 - Giant cell arteritis. 14740439 - Pulmonary artery involvement in wegener's granulomatosis. 12975759 - Takayasu's disease. 8296659 - Pooled intravenous immunoglobulin in the management of systemic vasculitis. 17015129 - Intraoperative dynamic angiography to detect resolution of bow hunter's syndrome: techn... 15243149 - Measuring carotid stenosis on contrast-enhanced magnetic resonance angiography: diagnos... 18046529 - Atrial tachycardias following circumferential pulmonary vein ablation: observations dur... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology Volume: 112 ISSN: 1388-2457 ISO Abbreviation: Clin Neurophysiol Publication Date: 2001 May |
Date Detail:
|
Created Date: 2001-05-04 Completed Date: 2001-06-28 Revised Date: 2008-09-10 |
Medline Journal Info:
|
Nlm Unique ID: 100883319 Medline TA: Clin Neurophysiol Country: Netherlands |
Other Details:
|
Languages: eng Pagination: 836-44 Citation Subset: IM |
Affiliation:
|
Department of Neurology, University of Florida, University of Florida Brain Institute, 100 South Newell Drive, Room L3-100, Gainesville, FL 32601-0236, USA. eisensj@neurology.ufl.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Brain Mapping
/
methods* Cognition Electrodes Electroencephalography / instrumentation, methods* Epilepsy, Temporal Lobe / physiopathology*, surgery Functional Laterality / physiology* Hippocampus / pathology, physiopathology* Humans Magnetic Resonance Imaging Reproducibility of Results Temporal Lobe / pathology, physiopathology*, surgery Video Recording |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Mutual information analysis of the EEG in patients with Alzheimer's disease.
Next Document: High-resolution EEG: a new realistic geometry spline Laplacian estimation technique.