The prognostic role of electrocorticography in tailored temporal lobe surgery

San-Juan, Daniel; Claudia, Alfaro Tapia; Maricarmen, González-Aragón Fernández; Adriana, Martínez Mayorga; Richard, Jeffrey S.; Alonso-Vanegas, Mario

doi:10.1016/j.seizure.2011.04.006

Cited by 43 publications

(46 citation statements)

References 29 publications

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“…The present study, continuously and automatically analyzing IEDRs along the entire surgery, confirms this first observation. Hence, intraoperative monitoring of IEDRs appears to be an indirect measure of ATLR success, therefore showing its potential value as another evaluation modality in epilepsy surgery, in addition to more renowned and well-established techniques such as intraoperative electrocorticography [46,47,48,49]. …”

Section: Discussionmentioning

confidence: 99%

Continuous Intraoperative Monitoring of Temporal Lobe Epilepsy Surgery

Tyrand

Momjian²,

Pollo

et al. 2016

Stereotact Funct Neurosurg

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Background/Aims: The monitoring of interictal epileptiform discharge rates (IEDRs) all along anterior temporal lobe resections (ATLRs) has never been reported. Here the effect of ATLR on continuous IEDR monitoring is described. Methods: IEDRs computed automatically during entire interventions were recorded in 34 patients (38.2%, 13/34 depth; 61.8%, 21/34 scalp electrodes only). Monitorings were invalidated when burst suppression occurred or if initial IEDRs were <5. Results: Monitoring was successful for 69.2% (9/13) of the patients with depth recordings and for 4.8% (1/21) of the patients with scalp recordings. Burst suppressions precluded it in 30.8% (4/13) of the depth and in 57.1% (12/21) of the scalp recordings. Initial IEDRs were <5 for 38.1% (8/21) of the scalp recordings. Significant IEDR decreases were observed in 8/10 patients with successful monitoring. These decreases started with resection of the superior temporal gyrus. IEDRs decreased further with amygdalohippocampectomy in 3/5 patients. At the 12-month follow-up, all patients with IEDR decreases remained seizure free; both patients without did not. Conclusion: IEDR monitoring was possible with depth, but not with scalp electrodes. IEDR decreases started with resection of the superior temporal gyrus. A larger patient cohort is necessary to confirm the high predictive values of IEDR monitoring that could become a tool for surgery customization.

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Section: Discussionmentioning

confidence: 99%

Continuous Intraoperative Monitoring of Temporal Lobe Epilepsy Surgery

Tyrand

Momjian²,

Pollo

et al. 2016

Stereotact Funct Neurosurg

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“…ECoG is a useful tool to identify the location of the epileptogenic focus, map the extent of the irritative zone (San-juan et al, 2011) and to assess the completeness of resection. Several studies have established that tailoring surgical resection based on intra-operative ECoG findings resulted in better seizure outcomes (Oliveira et al, 2006;Tripathi et al, 2010;Van Gompel et al, 2009).…”

Section: Utility Of Ecogmentioning

confidence: 99%

“…Several studies have established that tailoring surgical resection based on intra-operative ECoG findings resulted in better seizure outcomes (Oliveira et al, 2006;Tripathi et al, 2010;Van Gompel et al, 2009). Residual hippocampal spikes that persist after resection (during surgery for mesial temporal sclerosis) correlate with poor seizure outcome after surgery (San-juan et al, 2011). ECoG is also eminently suitable for use during excision of developmental malformations of brain, and more so for excision of the highly epileptogenic cortical dysplasias (CDs).…”

Section: Utility Of Ecogmentioning

confidence: 99%

Dexmedetomidine anesthesia enhances spike generation during intra-operative electrocorticography: A promising adjunct for epilepsy surgery

et al. 2015

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“…In addition to long-term intracranial EEG recordings to identify the seizure onset zone, cortical resections are also tailored in the operating room by including areas with abundant epileptic spikes and seizure-like interictal activity (ictiform patterns) recorded with corticography. 2 Intraoperative localization based on interictal EEG activity would be much more cost-effective than chronic recording to capture spontaneous seizures.…”

mentioning

confidence: 99%

“…4,13 The value of recording interictal spikes with electrocorticography as a biomarker to tailor resections has been disputed. 2 van 't Klooster et al confirmed that spikes are not a good biomarker for the epileptogenic zone, and their removal is not correlated with a good seizure outcome. Perhaps it is time to focus on HFOs, which appear to be reliable biomarkers under appropriate recording conditions.…”

mentioning

confidence: 99%