Surgical outcomes related to invasive EEG monitoring with subdural grids or depth electrodes in epilepsy patients

Authors

  • Prompong Chandensang Neurosurgery Surgery Unit, Department of Surgery, Faculty of Medicine, Chulalongkorn University Bangkok, Thailand
  • Krishnapundha Bunyaratavej Neurosurgery Surgery Unit, Department of Surgery, Faculty of Medicine, Chulalongkorn University

Keywords:

invasive EEG, subdural grid, depth electrode, stereo-electroencephalography, seizure, epilepsy, outcome

Abstract

Objectives: In drug-resistant epilepsy patients, who have uncertain epileptogenic foci from noninvasive investigation, resective surgery based on an invasive EEG-monitors performed with subdural grids (SDG) or depth electrodes/stereo-electroencephalography (DE/SEEG) is considered to be the best option towards achieving seizure-free state. Due to lack of such a study focusing on surgical outcomes in Thailand, the authors present those outcomes for comparison to other studies.
Methods: The authors collected data of patients who underwent invasive EEG monitoring from the database of King Chulalongkorn Memorial Hospital (KCMH) between May 2012 to May 2022. We collected basic characteristics, past history, present illness, treatment history, intraoperative findings, complication and seizure outcomes. Then, we compare our results to the other studies.
Results: Thirty patients were included. Eight patients (26.7%) underwent only SDG, 9 patients (30.0%) underwent only DE/SEEG, and 13 patients (43.3%) underwent both SDG and DE/SEEG. Engel I outcome was found in 23 patients (76.7%) and complications were found in 4 patients (13.3%).
Conclusion: Invasive EEG monitoring surgery in KCMH had good outcomes in seizure control and low complication rate. Furthermore, this result was similar to other studies.

Downloads

Download data is not yet available.

References

Bell GS, Sander JW. The epidemiology of epilepsy: the size of the problem. Seizure 2001;10:306–16.

Ekman M, Forsgren L. Economic evidence in epilepsy: a review. Eur J Health Econ 2004;5:36–42.

Strzelczyk A, Reese JP, Dodel R, Hamer HM. Cost of epilepsy: a systematic review. Pharmacoeconomics 2008;26:463–76.

Banerjee PN, Filippi D, Allen Hauser W. The descriptive epidemiology of epilepsy-a review. Epilepsy Res 2009;85:31–45.

Marson A, Jacoby A, Johnson A, Kim L, Gamble C, Chadwick D. Immediate versus deferred antiepileptic drug treatment for early epilepsy and single seizures: a ran- domised controlled trial. Lancet 2005;365:2007-13.

Mula M,Cock HR. More than seizures: improving the lives of people with refractory epilepsy. Eur J Neurol 2015;22:24–30.

Remy S, Beck H. Molecular and cellular mechanisms of pharmacoresistance in epilepsy. Brain 2006;129:18-35.

Taussig D, Montavont A, Isnard J. Invasive EEG explorations. Neurophysiol Clin 2015;45:113–9.

Sperling MR, Shewmon DA. General principles for presur- gical evaluation. In: Engel, J.J., Pedley, T.A. (Eds.), Epilepsy: A Comprehensive Textbook. Lippincott-Raven, Philadelphia; 1997. p. 1697-1705.

Enatsu R, Bulacio J, Najm I, Wyllie E, So NK, Nair DR, Foldvary-Schaefer N, Bingaman W, GonzalezMartinez J: Combining stereo-elec- troencephalography and subdural electrodes in the diagnosis and treatment of medically intractable epilepsy. J Clin Neurosci 2014;21:1441-5.

Delev D, Send K, Malter M, Ormond DR, Par- paley Y, von Lehe M, Schramm J, Grote A: Role of subdural interhemispheric electrodes in presurgical evaluation of epilepsy patients. World Neurosurg 2015;84:1719. e1–1725.e1.

Mehta AD, Labar D, Dean A, Harden C, Ho- sain S, Pak J, Marks D, Schwartz TH: Frame- less stereotactic placement of depth electrodes in epilepsy surgery. J Neurosurg 2005;102:1040-5.

Yang M, Ma Y, Li W, Shi X, Hou Z, An N, Zhang C, Liu L, Yang H, Zhang D, Yang Q, Liu S. A Retrospective Analysis of Stereoelectroencephalography and Subdural Electroencephalography for Preoperative Evaluation of Intractable Epilepsy. Stereotact Funct Neurosurg. 2017;95(1):13-20. doi: 10.1159/000453275. Epub 2017 Jan 14. Erratum in: Stereotact Funct Neurosurg. 2017;95(1):69.

MacDougall KW, Burneo JG, McLachlan RS, Steven DA. Outcome of epilepsy surgery in patients investigated with subdural electrodes. Epilepsy Res. 2009 Aug;85(2-3):235-42.

Gonzalez-Martinez J, Mullin J, Vadera S, Bulacio J, Hughes G, Jones S, Enatsu R, Najm I. Stereotactic placement of depth electrodes in medically intractable epilepsy. J Neurosurg. 2014 Mar;120(3):639-44.

Dzhafarov VM, Guzeeva AS, Amelina EV, et al. [Invasive EEG for temporal lobe epilepsy: selection of technique]. Zhurnal Voprosy Neirokhirurgii Imeni N. N. Burdenko. 2021 ;85(5):23-9.

Toth M, Papp KS, Gede N, Farkas K, Kovacs S, Isnard J, Hagiwara K, Gyimesi C, Kuperczko D, Doczi T, Janszky J. Surgical outcomes related to invasive EEG monitoring with subdural grids or depth electrodes in adults: A systematic review and meta-analysis. Seizure. 2019 Aug;70:12-9.

Downloads

Published

2025-10-03

How to Cite

Chandensang, P., & Bunyaratavej, K. (2025). Surgical outcomes related to invasive EEG monitoring with subdural grids or depth electrodes in epilepsy patients. Thai Journal of Neurological Surgery, 14(3), 82–92. retrieved from https://he05.tci-thaijo.org/index.php/TJNS/article/view/6716

Issue

Vol. 14 No. 3 (2023): July-September 2023

Section

Original articles

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Articles in this journal are copyrighted by the x may be read and used for academic purposes, such as teaching, research, or citation, with proper credit given to the author and the journal.
use or modification of the articles is prohibited without permission.
statements expressed in the articles are solely the opinions of the authors.
authors are fully responsible for the content and accuracy of their articles.
other reuse or republication requires permission from the journal."