Cortical stimulation: evaluation of the impact on the surgical decision, depending on electrographic patterns
Abstract number :
2.398
Submission category :
3. Neurophysiology / 3E. Brain Stimulation
Year :
2021
Submission ID :
1886516
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:56 AM
Authors :
Elma Paredes- Aragon, MD - London Health Sciences Centre; Jorge Burneo, Dr. - Head of Neurology, Department of Clinical Neurological Sciences, London Health Sciences Centre; david diosy, Dr. - Epileptologist, Department of Clinical Neurological Sciences, London Health Sciences Centre; Michelle-Lee Jones, Dr. - Epileptologist, Department of Clinical Neurological Sciences, London Health Sciences Centre; keith MacDougall, Dr. - Neurosurgeon, Department of Clinical Neurological Sciences, London Health Sciences Centre; Seyed Mirsattari, PhD - Epileptologist, Department of Clinical Neurological Sciences, London Health Sciences Centre; andrew Parrent, Dr. - Neurosurgeon, Department of Clinical Neurological Sciences, London Health Sciences Centre; David Steven, Dr. - Head of Neurosurgery, Department of Clinical Neurological Sciences, London Health Sciences Centre; Ana Suller-Marti, Dr. - Epileptologist, Department of Clinical Neurological Sciences, London Health Sciences Centre
Rationale: To describe the impact of cortical stimulation (CS) in patients implanted with depth electrodes (DE) in decision-making for surgical planning for treatment of medically resistant epilepsy (MRE).
Methods: Patients with MRE that underwent DE implantation from October 2018 - March 2021 for surgical planning admitted in the Epilepsy Monitoring Unit that had CS for surgical planning were selected. Demographic data was collected, as well as history of epilepsy, presurgical investigations, results from DE evaluation, CS (time, frequency, location, duration, afterdischarges), surgical decision and outcomes after surgery treatment.
Results: A total of 61 patients were implanted with DE, 23 patients have been analyzed and 15 met inclusion criteria. Mean age at implantation was 35 years (20-64 years; SD 11), 52% were female (n=12). The most frequent reason for SEEG implantation was suspicion of mesial vs. neocortical epilepsy (n=7, 30%), followed by lesional epilepsy (n= 6, 26%) and suspicion of more than once foci (n=5, 21%). Initial hypothesis of epileptogenic zone was mesial temporal in 56.5% (n=13), followed by neocortical temporal and mesial frontal (n=3, 13% each). The mean length of stay was 14 days (25-6 days). In 58.3% (n=7) seizures were stimulated. In 66% of patients (n= 10), surgery was decided. Hypothesis of epileptogenic zone was correct in 58.3% (n=7) of cases. Afterdischarges did not change the decision for surgery or the final hypothesis (p=0.59 and p=0.38, respectively) in outcome. The resection area changed in 53% (n=8) of cases after CS was concluded, when compared to initial hypothesis of epileptogenic zone.
Conclusions: CS may have an impact in the surgical may improve surgical decisions and outcomes of patients with DE implantation. CS should be encouraged as a part of presurgical planning in all cases.
Funding: Please list any funding that was received in support of this abstract.: No funding was required to support this abstract.
Neurophysiology