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Floroskopi eşliğinde yerleştirilen sfenoidal elektrotların bilateral dirençli temporal lob epilepsisinde lateralizasyona olan katkısı: klinik çalışma

Year 2020, Volume: 59 Issue: 1, 14 - 21, 13.03.2020

Aşiyan Kilit Gönül Güvenç Sabiha Türe

https://doi.org/10.19161/etd.699273

Abstract

Amaç: Bu çalışma bilateral temporal lob epilepsisinde temporal iktal başlangıçların lateralizasyonunun saptanmasında, floroskopi eşliğinde yerleştirilen sfenoidal elektrotların saçlı deri elektrotlara katkısını değerlendirmek amacıyla yapıldı. Aynı zamanda bilgisayarlı tomografi ile sfenoidal elektrotların foramen ovaleye yakınlığı değerlendirildi.

Gereç ve Yöntem: 2010-2012 tarihleri arasında dirençli epilepsi tanısı olan, sfenoidal elektrot taktığımız 10 hastanın prospektif çalışmasını yaptık. Dirençli temporal lob epilepsisi tanısı almış ancak skalp EEG ile epileptik odak lokalizasyonu ve lateralizasyonu yapılamamış ya da video-EEG de bitemporal nöbet aktivitesi saptanarak bitemporal epilepsi tanısı almış ancak nöbet başlangıcı saptanamayan olgular değerlendirildi.
Sfenoidal elektrotlar sedasyon altında ameliyathenede çift taraflı olarak takıldı. Sfenoidal elektrotların son pozisyonu ve birçok parametre 3D tomografide değerlendirildi. Hastalar video-EEG ünitesinde monitörize edildi. Eş zamanlı sfenoidal elektrot ve saçlı deri elektrot kayıtları alındı. Sfenoidal elektrot lateralizasyon sonuçları MR, PET ve saçlı deri EEG lateralizasyonu ile karşılaştırıldı.


Bulgular: Sfenoidal elektrotların yararlılık oranı %28,1 olarak saptandı. Lateralizasyonu yapılamamış 10 olgunun ikisi lokalize, sekiz olgunun dördü lateralize edilmiştir.

Sonuç: Literatürde sfenoidal elektrotların kullanımı ve yararlılıkları hakkında yapılan en önemli eleştiri, sfenoidal elektrotların faydasını saptayabilecek kadar hasta sayısının olmamasıdır. Daha fazla hasta sayısı ile prospektif çalışma yürütmek hangi hastanın sfenoidal elektrotlardan yararlanabileceğini tanımlamada faydalı olacaktır.

Keywords

Sfenoidal elektrot dirençli epilepsi epilepsi cerrahisi.

References

  • Engel J Jr. Bilateral temporal lobe epilepsy. In: Wolf P(ed). Epileptic seizures and syndromes. 1.ed. London: John Libbey; 1994: 359-68.
  • Mattson RH. Drug treatment of uncontrolled seizures. Theodore WH (ed). Surgical Treatment of Epilepsy, 2nd ed. New York: Elsevier; 1992: 29-35.
  • Engel J Jr. Recent advances in surgical treatment of temporal lobe epilepsy. Acta Neurol Scand 1992; 86 (Suppl140): 71-80.
  • Wieser HG, Engel J Jr, Williamson PD, Babb TL, Gloor P. Surgically remediable temporal lobe syndromes. In: Engel J Jr (ed) Surgical treatment of the epilepsies. 2nd ed.New York: RavenPress; 1993: 49-63.
  • Lüders HO, AwadI. Conceptual considerations. In: Lüders HO (ed) Epilepsy surgery. New York: Ravenpress; 1992: 51–62.
  • Ebner A, Lüders HO. Subdural electrodes. In: Lüders HO and Comair YG (ed). Epilepsy surgery. Philadelphia: Lippincott Williams and Wilkins Press; 2001:593- 6.
  • King DW, So EL, Marcus R, Gallagher BB. Techniques and applications of sphenoidal recording. J Clin Neurophysiol 1986; 3 (1): 51-65.
  • Jasper HH. Electricalsigns of epileptic discharge. Electroencephalogr Clin Neurophysiol 1949; 1 (1): 11-8.
  • Jones DP. Recording of the basal electroencephalogram with sphenoidal needle electrodes. Electroencephalogr Clin Neurophysiol 1951; 3 (1): 100.
  • Ives JR, Gloor P. Technical contribution: new sphenoidal electrode assembly to permit long-term monitoring of the patients ictal or interictal EEG. Electroencephalogr Clin Neurophysiol 1977; 42 (4): 575–80.
  • Sperling MR, Engel J Jr. Sphenoidal electrodes. J Clin Neurophysiol 1986; 3 (1): 67-73.
  • Kristensen O, Sindrup EH. Sphenoidal electrodes: their use and value in the electroencephalographic investigation of complex partial epilepsy. Acta Neurol Scand 1978; 58 (3): 157–66.
  • Pampiglione G, Kerridge J. EEG abnormalities from the temporal lobe studied with sphenoidal electrodes. J Neurol Neurosurg Psychiatry 1956; 19 (2): 117–29.
  • Homan RW, Herman J, Purdy P.Cerebral location of international 10–20 system electrode placement. Electroencephalogr Clin Neurophysiol 1987; 66 (4): 376-82.
  • Krauss GL, Lesser RP, Fisher RS, Arroyo S. Anterior cheek electrodes are comparable to sphenoidal electrodes for the identification of ictal activity. Electroencephalog Clin Neurophysiol 1992;83(6):333-8.
  • So EL, Ruggles KH, Ahmann PA, Trudeau P, Weatherford K. Yield of sphenoidal recording in sleep-deprived out patients. J ClinNeurophysiol 1994; 11 (2): 226–30.
  • Marks DA, Katz A, Booke J, Spencer DD, Spencer SS. Comparison and correlation of surface and sphenoidal electrodes with simultaneous intracranial recording: an interictal study. Electroencephalogr Clin Neurophysiol 1992; 82 (1): 23-9.
  • Wilkus RJ, Vossler DG, Rudd TG. Salivary ductal penetration during insertion of a sphenoidal electrode. Electroencephalogr Clin Neurophysiol 1990; 76 (2): 36.
  • Kanner AM, Ramirez L, Jones JC. The utility of placing sphenoidal electrodes under the foramen ovale with fluoroscopic guidance. J Clin Neurophysiol 1995; 12 (1): 72-81.
  • Wilkus RJ, Thompson PM. Sphenoidal electrode positions and basal EEG during long term monitoring. Epilepsia 1985; 26 (2): 137–42.
  • Fenton DS, Geremia GK, Dowd AM, Papathanasiou MA, Greenlee WM, Huckman MS. Precise placement of sphenoidal electrodes via fluoroscopic guidance. AJNR Am J Neuroradiol 1997; 18 (4): 776-79.
  • DeToledo JC. Convulsive syncope following placement of sphenoidal electrodes. Brain Dev 1999; 21 (3): 213-15.
  • Jorge I, Jaime P, Kanner A M. Trancient facial palsy in sphenoidal electrode placement. Epilepsia1996; 37 (12): 1239-41.
  • Sperling MR, Mendiuys JR, Engel Jr J. Mesial temporal spikes: a simultaneous comparison of sphenoidal, nasopharyngeal and ear electrodes. Epilepsia 1986; 27 (1): 81–6.
  • Hamaneh MB, Kaiboriboon K, Dimitriu D, et al. Method for the Inclusion of Sphenoidal Electrodes in Realistic EEG Source Imaging. J Clin Neurophysiol 2014; 31 (5): 429–36.

The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study

Year 2020, Volume: 59 Issue: 1, 14 - 21, 13.03.2020

Aşiyan Kilit Gönül Güvenç Sabiha Türe

https://doi.org/10.19161/etd.699273

Abstract

Aim: The aim of this study is to investigate the contribution of sphenoidal electrodes placed under fluoroscopic guidance to scalp electrodes, in the lateralization of temporal ictal onsets in bilateral refractory temporal lobe epilepsy. Also we determine the actual locations of sphenoidal electrodes by computerized tomography.

Materials and Methods: We performed a prospective study on 10 patients with intractable epilepsy who has underwent sphenoidal electrode placement from 2010 to 2012. Refractory temporal lobe epilepsy patients whose localization and lateralization of epileptic focus couldn’t established with scalp EEG, or patients diagnosed bitemporal epilepsy with bitemporal seizure activity in video-EEG but no seizure onset identified, were evaluated. Sphenoidal electrodes placed double-sided to patients under sedation in the operating room. The control of the sphenoidal electrodes’ last position and several parameters displayed with 3D tomography. Patients monitorized at video-EEG unit. Simultaneously sphenoidal electrodes and scalp electrodes recordings obtained. Sphenoidal electrode lateralization results are compared with MRI, PET, SCALP EEG lateralization.


Results: The utility rate of sphenoidal electrode recordings were found to be 28.1%. 2 of 10 cases lateralized were localized, 4 of 8 patients were lateralized by sphenoidal electrodes.

Conclusion: Sphenoidal electrodes and scalp electrodes are similar in their ability to detect seizures. The optimal placement of sphenoidal electrodes with our technique provided additional localizing and lateralizing information in this series.

Keywords

Sphenoidal electrode refractory epilepsy epilepsy surgery.

References

  • Engel J Jr. Bilateral temporal lobe epilepsy. In: Wolf P(ed). Epileptic seizures and syndromes. 1.ed. London: John Libbey; 1994: 359-68.
  • Mattson RH. Drug treatment of uncontrolled seizures. Theodore WH (ed). Surgical Treatment of Epilepsy, 2nd ed. New York: Elsevier; 1992: 29-35.
  • Engel J Jr. Recent advances in surgical treatment of temporal lobe epilepsy. Acta Neurol Scand 1992; 86 (Suppl140): 71-80.
  • Wieser HG, Engel J Jr, Williamson PD, Babb TL, Gloor P. Surgically remediable temporal lobe syndromes. In: Engel J Jr (ed) Surgical treatment of the epilepsies. 2nd ed.New York: RavenPress; 1993: 49-63.
  • Lüders HO, AwadI. Conceptual considerations. In: Lüders HO (ed) Epilepsy surgery. New York: Ravenpress; 1992: 51–62.
  • Ebner A, Lüders HO. Subdural electrodes. In: Lüders HO and Comair YG (ed). Epilepsy surgery. Philadelphia: Lippincott Williams and Wilkins Press; 2001:593- 6.
  • King DW, So EL, Marcus R, Gallagher BB. Techniques and applications of sphenoidal recording. J Clin Neurophysiol 1986; 3 (1): 51-65.
  • Jasper HH. Electricalsigns of epileptic discharge. Electroencephalogr Clin Neurophysiol 1949; 1 (1): 11-8.
  • Jones DP. Recording of the basal electroencephalogram with sphenoidal needle electrodes. Electroencephalogr Clin Neurophysiol 1951; 3 (1): 100.
  • Ives JR, Gloor P. Technical contribution: new sphenoidal electrode assembly to permit long-term monitoring of the patients ictal or interictal EEG. Electroencephalogr Clin Neurophysiol 1977; 42 (4): 575–80.
  • Sperling MR, Engel J Jr. Sphenoidal electrodes. J Clin Neurophysiol 1986; 3 (1): 67-73.
  • Kristensen O, Sindrup EH. Sphenoidal electrodes: their use and value in the electroencephalographic investigation of complex partial epilepsy. Acta Neurol Scand 1978; 58 (3): 157–66.
  • Pampiglione G, Kerridge J. EEG abnormalities from the temporal lobe studied with sphenoidal electrodes. J Neurol Neurosurg Psychiatry 1956; 19 (2): 117–29.
  • Homan RW, Herman J, Purdy P.Cerebral location of international 10–20 system electrode placement. Electroencephalogr Clin Neurophysiol 1987; 66 (4): 376-82.
  • Krauss GL, Lesser RP, Fisher RS, Arroyo S. Anterior cheek electrodes are comparable to sphenoidal electrodes for the identification of ictal activity. Electroencephalog Clin Neurophysiol 1992;83(6):333-8.
  • So EL, Ruggles KH, Ahmann PA, Trudeau P, Weatherford K. Yield of sphenoidal recording in sleep-deprived out patients. J ClinNeurophysiol 1994; 11 (2): 226–30.
  • Marks DA, Katz A, Booke J, Spencer DD, Spencer SS. Comparison and correlation of surface and sphenoidal electrodes with simultaneous intracranial recording: an interictal study. Electroencephalogr Clin Neurophysiol 1992; 82 (1): 23-9.
  • Wilkus RJ, Vossler DG, Rudd TG. Salivary ductal penetration during insertion of a sphenoidal electrode. Electroencephalogr Clin Neurophysiol 1990; 76 (2): 36.
  • Kanner AM, Ramirez L, Jones JC. The utility of placing sphenoidal electrodes under the foramen ovale with fluoroscopic guidance. J Clin Neurophysiol 1995; 12 (1): 72-81.
  • Wilkus RJ, Thompson PM. Sphenoidal electrode positions and basal EEG during long term monitoring. Epilepsia 1985; 26 (2): 137–42.
  • Fenton DS, Geremia GK, Dowd AM, Papathanasiou MA, Greenlee WM, Huckman MS. Precise placement of sphenoidal electrodes via fluoroscopic guidance. AJNR Am J Neuroradiol 1997; 18 (4): 776-79.
  • DeToledo JC. Convulsive syncope following placement of sphenoidal electrodes. Brain Dev 1999; 21 (3): 213-15.
  • Jorge I, Jaime P, Kanner A M. Trancient facial palsy in sphenoidal electrode placement. Epilepsia1996; 37 (12): 1239-41.
  • Sperling MR, Mendiuys JR, Engel Jr J. Mesial temporal spikes: a simultaneous comparison of sphenoidal, nasopharyngeal and ear electrodes. Epilepsia 1986; 27 (1): 81–6.
  • Hamaneh MB, Kaiboriboon K, Dimitriu D, et al. Method for the Inclusion of Sphenoidal Electrodes in Realistic EEG Source Imaging. J Clin Neurophysiol 2014; 31 (5): 429–36.
There are 25 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

Aşiyan Kilit 0000-0001-6412-0739

Gönül Güvenç 0000-0002-9382-8610

Sabiha Türe 0000-0003-1530-6611

Publication Date March 13, 2020
Submission Date October 16, 2018
Published in Issue Year 2020Volume: 59 Issue: 1

Cite

Vancouver Kilit A, Güvenç G, Türe S. The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study. EJM. 2020;59(1):14-21.
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