Stereoelectroencephalography Versus Subdural Strip Electrode Implantations: Feasibility, Complications, and Outcomes in 500 Intracranial Monitoring Cases for Drug-Resistant Epilepsy
Stereoelectroencephalography Versus Subdural Strip Electrode Implantations: Feasibility, Complications, and Outcomes in 500 Intracranial Monitoring Cases for Drug-Resistant Epilepsy
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DOI：
10.1093/neuros/nyaa112
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发表时间：
2020-07-01
期刊：
影响因子：
4.8
通讯作者：
Steven, David A.
中科院分区：
文献类型：
--
作者：
Joswig, Holger;Lau, Jonathan C.;Steven, David A.
背景技术背景：立体脑电描记术（SEEG）和硬膜下条形电极（SSE）均用于颅内脑电图记录，用于耐药癫痫患者的侵入性调查。目的：在本单中心研究中比较SEEG和SSE的可行性、并发症和结局。方法：患者特征、围手术期参数、并发症和结局均来自于支持性和回顾性管理的数据库，以比较SEEG和SSE病例。共分析450例患者的500例颅内脑电图监测（SEEG 145例，SSE 355例）。两组患者的年龄、性别分布和癫痫持续时间相似。每个SEEG电极的植入花费13.9 ± 7.6分钟（每个SSE为20 ± 12分钟; P <0.01）。SEEG患者的辐射暴露时间为4.3 +/- 7.7 s，剂量面积积为14.6 +/- 27.9 rad*cm（2），SSE为9.4 +/- 8.9 s，剂量面积积为21 +/- 22.4 rad*cm（2）（P <0.01）。住院时间无差异（12.2 +/- 7.2和12 +/- 6.3天）。两组的并发症发生率均较低。SEEG病例中未观察到感染（SSE后为2.3%）。出血率SEEG为2.8%，SSE为1.4%。手术结果是similar.CONCLUSION：SEEG允许靶向深部病灶与非劣于SSE和癫痫发作的结果可比SSE的安全性。
BACKGROUND: Both stereoelectroencephalography (SEEG) and subdural strip electrodes (SSE) are used for intracranial electroencephalographic recordings in the invasive investigation of patients with drug-resistant epilepsy.OBJECTIVE: To compare SEEG and SSE with respect to feasibility, complications, and outcome in this single-center study.METHODS: Patient characteristics, periprocedural parameters, complications, and outcome were acquired from a pro- and retrospectively managed databank to compare SEEG and SSE cases.RESULTS: A total of 500 intracranial electroencephalographic monitoring cases in 450 patients were analyzed (145 SEEG and 355 SSE). Both groups were of similar age, gender distribution, and duration of epilepsy. Implantation of each SEEG electrode took 13.9 7.6 min (20 +/- 12 min for each SSE; P < .01). Radiation exposure to the patient was 4.3 +/- 7.7 s to a dose area product of 14.6 +/- 27.9 rad*cm(2) for SEEG and 9.4 +/- 8.9 s with 21 +/- 22.4 rad*cm(2) for SSE (P < .01). There was no difference in the length of stay (12.2 +/- 7.2 and 12 +/- 6.3 d). The complication rate was low in both groups. No infections were seen in SEEG cases (2.3% after SSE). The rate of hemorrhage was 2.8% for SEEG and 1.4% for SSE. Surgical outcome was similar.CONCLUSION: SEEG allows targeting deeply situated foci with a non-inferior safety profile to SSE and seizure outcome comparable to SSE.