Continuous Intraoperative Monitoring of Temporal Lobe Epilepsy Surgery.

Tyrand, Rémi; Momjian, Shahan; Pollo, Claudio; Lysakowski, Christopher; Lascano, Agustina M; Vulliémoz, Serge; Schaller, Karl; Boëx, Colette (2016). Continuous Intraoperative Monitoring of Temporal Lobe Epilepsy Surgery. Stereotactic and functional neurosurgery, 94(6), pp. 404-412. Karger 10.1159/000452842

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Pollo, Claudio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1011-6125

Publisher:

Karger

Language:

English

Submitter:

Nicole Söll

Date Deposited:

06 Apr 2017 10:28

Last Modified:

22 Dec 2017 02:30

Publisher DOI:

10.1159/000452842

PubMed ID:

27997922

BORIS DOI:

10.7892/boris.93657

URI:

https://boris.unibe.ch/id/eprint/93657

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