Clinical effect of cortical electrode monitoring on intractable epilepsy caused by double pathology_Journal of Epilepsy

Authors：

WANG Zhongming ^1,2 , LI Guangli ^1,2 , PENG Qiong ^1,2 , HUANG Yahui ^1,2 , LU Jun ^1,2 , XIE Qi ³ ,  ZHOU Guiyun ^1,2

1. Epilepsy Center, Hunan Brain Hospital, Changsha 410073, China;
2. Clinical School of Medicine, Hunan University of Chinese Medicine, Changsha 410073, China;
3. Department of Rehabilitation Medicine, Hunan Brain Hospital Changsha 410073, China;

Corresponding?author：

ZHOU Guiyun, Email: 254490374@qq.com

Keywords：

Electro-Cortico-Graphy; Double pathological signs; Refractory epilepsy; Surgical treatment

DOI：

10.7507/2096-0247.202402002

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Objective To investigate the clinical effect of Electro-Cortico-Graphy (ECOG) monitoring on refractory epilepsy caused by double pathology. Methods A retrospective analysis was performed on 10 patients with refractory epilepsy who underwent surgical treatment in Hunan Brain Hospital from January 2020 to December 2021. The diagnosis of postoperative disease was dual pathology of medial temporal lobe sclerosis (MTS) and focal cortical dysplasia (FCD), and the effect of oral drugs was poor. All patients underwent full preoperative evaluation to determine the scope of excision of epileptogenic lesions. Cortical electrodes were used to monitor the location and scope of epileptic discharge during the operation. Epileptogenic lesions were excised, cortical heat cautery was performed, and then cortical EEG monitoring was performed to adjust the excision strategy. The patients were followed up for 24 to 48 months, and the prognosis was assessed according to the Engel scale. Results Among the 10 patients, 1 patient had acute subdural hemorrhage after surgery, 1 patient had speech and naming disorders, but all of them were recovered at discharge. The other patients had no neurological defects such as intracranial infection, hemiplegia, aphasia, etc. Engel grade I was observed in 9 cases (90%) and Engel grade III was observed in 1 case (10%). Conclusion Cortical electrode monitoring is safe and effective for refractory epilepsy caused by double pathological signs.

Citation： WANG Zhongming, LI Guangli, PENG Qiong, HUANG Yahui, LU Jun, XIE Qi, ZHOU Guiyun. Clinical effect of cortical electrode monitoring on intractable epilepsy caused by double pathology. Journal of Epilepsy, 2024, 10(2): 104-107. doi: 10.7507/2096-0247.202402002 Copy

1.	李家亮, 苗鵬飛, 楊全喜, 等. 腦皮層電圖監測下顯微手術治療耐藥性癲癇的效果. 中國醫藥導報, 2021, 18(26): 77-80.
2.	Yang T, Hakimian S, Schwartz TH. Intraoperative ElectroCorticoGraphy (ECog): indications, techniques, and utility in epilepsy surgery. Epileptic Disorders, 2014, 16(3): 271-279.
3.	姜卉, 姜兵, 張偉, 等. 局灶性皮層發育不良相關難治性癲癇的手術預后影響因素分析. 中國現代手術學雜志, 2023, 27(2): 139-144.
4.	孫鵬, 楊新生, 孟慶海, 等. 皮層電極監測下切除致癇性腦膠質瘤的臨床研究. 中華神經醫學雜志, 2003, 2(3): 168-169.
5.	Iasemidis LD, Zaveri HP, Sackellares JC, et al. Modelling of ECoG in temporal lobe epilepsy. Biomed Sci Instrum, 1988, 24: 187-193.
6.	艾熱木古麗·阿不都熱依木, 秦虎, 張麗娜, 等. 雙重病理征對藥物難治性顳葉內側癲癇手術預后的影響. 中國臨床神經外科雜志, 2023, 28(2): 80-82.
7.	潘隆盛, 凌至培, 徐強, 等. 皮層電極監測、圖像融合和術中磁共振精確鏡下導航技術在切除功能區癲癇灶的應用. 軍醫進修學院學報, 2012, 33(8): 819-821.
8.	Boran E, Ramantani G, Krayenbühl N, et al. High-density ECoG improves the detection of high frequency oscillations that predict seizure outcome. Clinical Neurophysiology, 2019, 130(10): 1882-1888.
9.	章衛橋, 周三權, 趙飛, 等. 皮層電極監測在顱骨缺損合并外傷性癲癇術中的運用. 中國醫師進修雜志, 2010, 33(8): 64-66.
10.	錢若兵, 傅先明, 汪業漢, 等. 皮層電極描記配合立體定向切除癲癇灶. 立體定向和功能性神經外科雜志, 2003, 16(4): 203-205.
11.	王中鳴, 王琴, 彭瓊, 等. 基于多模態影像的立體定向腦電圖在藥物難治性癲癇治療中的應用. 中國醫學裝備, 2023, 20(8): 84-87.
12.	盧軍, 王中鳴, 王琴, 等. 多模態影像融合聯合立體腦電圖對多病灶難治性癲癇的術前定位及療效. 中國實用神經疾病雜志, 2023, 26(8): 930-935.
13.	Zhu Q, Liang Y, Fan Z, et al. The utility of intraoperative ECoG in tumor-related epilepsy: Systematic review. Clinical Neurology and Neurosurgery, 2022, 212: 107054.
14.	Kuruvilla A, Flink R. Intraoperative electrocorticography in epilepsy surgery: useful or not?. Seizure, 2003, 12(8): 577-584.
15.	Ravat S, Iyer V, Panchal K, et al. Surgical outcomes in patients with intraoperative Electrocorticography (EcoG) guided epilepsy surgery-experiences of a tertiary care centre in India. International Journal of Surgery, 2016, 36: 420-428.
16.	Holthausen H, Coras R, Tang Y, et al. Multilobar unilateral hypoplasia with emphasis on the posterior quadrant and severe epilepsy in children with FCD ILAE type 1A. Epilepsia, 2022, 63(1): 42-60.

1. 李家亮, 苗鵬飛, 楊全喜, 等. 腦皮層電圖監測下顯微手術治療耐藥性癲癇的效果. 中國醫藥導報, 2021, 18(26): 77-80.
2. Yang T, Hakimian S, Schwartz TH. Intraoperative ElectroCorticoGraphy (ECog): indications, techniques, and utility in epilepsy surgery. Epileptic Disorders, 2014, 16(3): 271-279.
3. 姜卉, 姜兵, 張偉, 等. 局灶性皮層發育不良相關難治性癲癇的手術預后影響因素分析. 中國現代手術學雜志, 2023, 27(2): 139-144.
4. 孫鵬, 楊新生, 孟慶海, 等. 皮層電極監測下切除致癇性腦膠質瘤的臨床研究. 中華神經醫學雜志, 2003, 2(3): 168-169.
5. Iasemidis LD, Zaveri HP, Sackellares JC, et al. Modelling of ECoG in temporal lobe epilepsy. Biomed Sci Instrum, 1988, 24: 187-193.
6. 艾熱木古麗·阿不都熱依木, 秦虎, 張麗娜, 等. 雙重病理征對藥物難治性顳葉內側癲癇手術預后的影響. 中國臨床神經外科雜志, 2023, 28(2): 80-82.
7. 潘隆盛, 凌至培, 徐強, 等. 皮層電極監測、圖像融合和術中磁共振精確鏡下導航技術在切除功能區癲癇灶的應用. 軍醫進修學院學報, 2012, 33(8): 819-821.
8. Boran E, Ramantani G, Krayenbühl N, et al. High-density ECoG improves the detection of high frequency oscillations that predict seizure outcome. Clinical Neurophysiology, 2019, 130(10): 1882-1888.
9. 章衛橋, 周三權, 趙飛, 等. 皮層電極監測在顱骨缺損合并外傷性癲癇術中的運用. 中國醫師進修雜志, 2010, 33(8): 64-66.
10. 錢若兵, 傅先明, 汪業漢, 等. 皮層電極描記配合立體定向切除癲癇灶. 立體定向和功能性神經外科雜志, 2003, 16(4): 203-205.
11. 王中鳴, 王琴, 彭瓊, 等. 基于多模態影像的立體定向腦電圖在藥物難治性癲癇治療中的應用. 中國醫學裝備, 2023, 20(8): 84-87.
12. 盧軍, 王中鳴, 王琴, 等. 多模態影像融合聯合立體腦電圖對多病灶難治性癲癇的術前定位及療效. 中國實用神經疾病雜志, 2023, 26(8): 930-935.
13. Zhu Q, Liang Y, Fan Z, et al. The utility of intraoperative ECoG in tumor-related epilepsy: Systematic review. Clinical Neurology and Neurosurgery, 2022, 212: 107054.
14. Kuruvilla A, Flink R. Intraoperative electrocorticography in epilepsy surgery: useful or not?. Seizure, 2003, 12(8): 577-584.
15. Ravat S, Iyer V, Panchal K, et al. Surgical outcomes in patients with intraoperative Electrocorticography (EcoG) guided epilepsy surgery-experiences of a tertiary care centre in India. International Journal of Surgery, 2016, 36: 420-428.
16. Holthausen H, Coras R, Tang Y, et al. Multilobar unilateral hypoplasia with emphasis on the posterior quadrant and severe epilepsy in children with FCD ILAE type 1A. Epilepsia, 2022, 63(1): 42-60.

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