Yıl 2020, Cilt 59 , Sayı 1, Sayfalar 14 - 21 2020-03-13

The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study
Floroskopi eşliğinde yerleştirilen sfenoidal elektrotların bilateral dirençli temporal lob epilepsisinde lateralizasyona olan katkısı: klinik çalışma

Aşiyan KİLİT [1] , Gönül GÜVENÇ [2] , Sabiha TÜRE [3]


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.

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.

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Birincil Dil en
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Araştırma Makaleleri
Yazarlar

Orcid: 0000-0001-6412-0739
Yazar: Aşiyan KİLİT (Sorumlu Yazar)
Kurum: Dr. Behçet Uz Children's Diseases and Surgery Training and Research Hospital, Neurosurgery Depermant, Izmir
Ülke: Turkey


Orcid: 0000-0002-9382-8610
Yazar: Gönül GÜVENÇ
Kurum: Katip Çelebi University Atatürk Training and Research Hospital, Neurosurgery Depermant, Izmir
Ülke: Turkey


Orcid: 0000-0003-1530-6611
Yazar: Sabiha TÜRE
Kurum: Katip Çelebi University Atatürk Training and Research Hospital, Neurology Depermant, Izmir
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 13 Mart 2020

Bibtex @araştırma makalesi { etd699273, journal = {Ege Tıp Dergisi}, issn = {1016-9113}, eissn = {2147-6500}, address = {}, publisher = {Ege Üniversitesi}, year = {2020}, volume = {59}, pages = {14 - 21}, doi = {10.19161/etd.699273}, title = {The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study}, key = {cite}, author = {KİLİT, Aşiyan and GÜVENÇ, Gönül and TÜRE, Sabiha} }
APA KİLİT, A , GÜVENÇ, G , TÜRE, S . (2020). The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study. Ege Tıp Dergisi , 59 (1) , 14-21 . DOI: 10.19161/etd.699273
MLA KİLİT, A , GÜVENÇ, G , TÜRE, S . "The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study". Ege Tıp Dergisi 59 (2020 ): 14-21 <http://egetipdergisi.com.tr/tr/issue/52885/699273>
Chicago KİLİT, A , GÜVENÇ, G , TÜRE, S . "The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study". Ege Tıp Dergisi 59 (2020 ): 14-21
RIS TY - JOUR T1 - The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study AU - Aşiyan KİLİT , Gönül GÜVENÇ , Sabiha TÜRE Y1 - 2020 PY - 2020 N1 - doi: 10.19161/etd.699273 DO - 10.19161/etd.699273 T2 - Ege Tıp Dergisi JF - Journal JO - JOR SP - 14 EP - 21 VL - 59 IS - 1 SN - 1016-9113-2147-6500 M3 - doi: 10.19161/etd.699273 UR - https://doi.org/10.19161/etd.699273 Y2 - 2019 ER -
EndNote %0 Ege Tıp Dergisi The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study %A Aşiyan KİLİT , Gönül GÜVENÇ , Sabiha TÜRE %T The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study %D 2020 %J Ege Tıp Dergisi %P 1016-9113-2147-6500 %V 59 %N 1 %R doi: 10.19161/etd.699273 %U 10.19161/etd.699273
ISNAD KİLİT, Aşiyan , GÜVENÇ, Gönül , TÜRE, Sabiha . "The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study". Ege Tıp Dergisi 59 / 1 (Mart 2020): 14-21 . https://doi.org/10.19161/etd.699273
AMA KİLİT A , GÜVENÇ G , TÜRE S . The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study. ETD. 2020; 59(1): 14-21.
Vancouver KİLİT A , GÜVENÇ G , TÜRE S . The contribution of sphenoidal electrodes placed under fluoroscopy in lateralization of bilateral refractory temporal lobe epilepsy: a clinical study. Ege Tıp Dergisi. 2020; 59(1): 21-14.