Implantation and reimplantation of intracranial EEG electrodes in patients considering epilepsy surgery

Article Article scientifique Article Implantation and reimplantation of intracranial EEG electrodes in patients considering epilepsy surgery eng 2023-10-23 2023-11-01 author Eelbode Céline Neurology division, Geneva University Hospitals, Geneva, Switzerland.,Clinical Neuroscience Department, University of Geneva, Faculty of Medicine, Geneva, Switzerland. 858246 author Spinelli Laurent 0000-0001-7682-2041 Neurology division, Geneva University Hospitals, Geneva, Switzerland.,Clinical Neuroscience Department, University of Geneva, Faculty of Medicine, Geneva, Switzerland. 105795 author Corniola Marco Vincenzo 0000-0003-4447-4585 Clinical Neuroscience Department, University of Geneva, Faculty of Medicine, Geneva, Switzerland.,Neurosurgery Division, Geneva University Hospitals, Geneva, Switzerland.,Neurosurgery Division, Rennes University Hospital, Rennes, France.,INSERM UMR 1099 LTSI, University of Rennes, Rennes, France. 583144 Département des neurosciences cliniques (OTONO) author Momjian Shahan Marc Clinical Neuroscience Department, University of Geneva, Faculty of Medicine, Geneva, Switzerland.,Neurosurgery Division, Geneva University Hospitals, Geneva, Switzerland. 84022 Département des neurosciences cliniques (OTONO) author Seeck Margitta Neurology division, Geneva University Hospitals, Geneva, Switzerland.,Clinical Neuroscience Department, University of Geneva, Faculty of Medicine, Geneva, Switzerland. 133679 Département des neurosciences cliniques (OTONO) author Schaller Karl Lothard Clinical Neuroscience Department, University of Geneva, Faculty of Medicine, Geneva, Switzerland.,Neurosurgery Division, Geneva University Hospitals, Geneva, Switzerland. 658606 Département des neurosciences cliniques (OTONO) author Megevand Pierre Bastien 0000-0002-0427-547X Neurology division, Geneva University Hospitals, Geneva, Switzerland.,Clinical Neuroscience Department, University of Geneva, Faculty of Medicine, Geneva, Switzerland. 510484 Département des neurosciences cliniques (OTONO) 10.1002/epi4.12846 37873557 2470-9239 In patients with drug-resistant epilepsy who are considering surgery, intracranial EEG (iEEG) helps delineate the putative epileptogenic zone. In a minority of patients, iEEG fails to identify seizure onsets. In such cases, it might be worthwhile to reimplant more iEEG electrodes. The consequences of such a strategy for the patient are unknown. We matched 12 patients in whom the initially implanted iEEG electrodes did not delineate the seizure onset zone precisely enough to offer resective surgery, and in whom additional iEEG electrodes were implanted during the same inpatient stay, to controls who did not undergo reimplantation. Seven cases and eight controls proceeded to resective surgery. No intracranial infection occurred. One control suffered an intracranial hemorrhage. Three cases and two controls suffered from a post-operative neurological or neuropsychological deficit. We found no difference in post-operative seizure control between cases and controls. Compared to an ILAE score of 5 (ie, stable seizure frequency in the absence of resective surgery), cases showed significant improvement. Reimplantation of iEEG electrodes can offer the possibility of resective epilepsy surgery to patients in whom the initial iEEG investigation was inconclusive, without compromising on the risk of complications or seizure control. Complications Outcome Seizure onset zone Dewey 616.8 Swiss National Science Foundation Predict and Monitor Epilepsy After a First Seizure: The Swiss-First Study 180365 CH Programmes Swiss National Science Foundation Neuronal biomarkers of seizure activity in human epilepsy 194507 CH Careers 53 Département de neurosciences fondamentales 21A 61 Département des neurosciences cliniques 226 false 1361 Human Neuron Lab 1034 119 Epilepsie et Chirurgie 149 513 Groupe Schaller Karl Lothard (neurochirurgie) 851 Epilepsia open a0b20bbd-6b2c-49e0-960c-ec8fcbda78ed Article (Published version) Public Epilepsia Open - 2023 - Eelbode - I.pdf 350831 application/pdf CC BY-4.0 f7e1b1657ceb884686b291abc878f01caf6bd2f0c1689f6c21ead2f5971e85ff 667fffc5-0abd-4d5e-bba3-a1c070b9f1b5 Supplemental data Public epi412846-sup-0001-supinfo.docx 22588 application/vnd.openxmlformats-officedocument.wordprocessingml.document CC BY-4.0 e1080b23d0b72e24b8bd355d50520d8b30d57598f9aaff13e708669d9a9f57e8 openAccess Faculté de médecine / Section de médecine fondamentale / Département de neurosciences fondamentales Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques

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Implantation and reimplantation of intracranial EEG electrodes in patients considering epilepsy surgery	Epilepsia open			2023	57	77

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