Diagnostic outcome of surgical revision of intracranial electrode placements for seizure localization

Ricky W. Lee, Gregory A. Worrell, W. Richard Marsh, Gregory D. Cascino, Nicholas M. Wetjen, Fredric B. Meyer, Elaine C. Wirrell, Elson L. So

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

PURPOSE:: We aimed to determine the yield of revising intracranially implanted electrodes and the factors contributing to the yield. METHODS:: Patients were identified from the Mayo Clinic Epilepsy Surgery Database between 1997 and 2010. Twenty patients had revision of intracranial electrode placements because initial implantation did not localize seizure onset adequately. RESULTS:: Seizures were captured in 18 of 20 patients who underwent intracranial electrode revision, of which 10 (55.6%) showed localized seizure onset that led to a surgical resection. Seizures were improved in 9 of 10 patients who underwent resection; of these, five were seizure free. The only factors found to be statistically significant in localizing ictal onset zone after revised implantation were prior focal scalp interictal discharges and an initial intracranial EEG showing ictal onset at the edge of the electrode grid. No permanent complication was associated with revised implantation, but one patient had transient apraxia of the right foot. CONCLUSIONS:: Revised implantation could be useful in selected patients with inadequate seizure localization on initial intracranial EEG. Resective surgery was performed in 50% of patients who underwent revision of intracranial electrodes with the majority of these patients experiencing an improvement in seizure control.

Original languageEnglish (US)
Pages (from-to)199-202
Number of pages4
JournalJournal of Clinical Neurophysiology
Volume31
Issue number3
DOIs
StatePublished - Jun 2014

Keywords

  • Epilepsy surgery
  • Intracranial EEG monitoring
  • Seizure

ASJC Scopus subject areas

  • Physiology
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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