난치성 간질환자의 수술전 검사에서 뇌경막하 전극의 이용에 관한 임상연구
Chronic Subdural Strip Electrode Recordings as Preperative Evaluation for Epilpsy Surgery
손은익, 김일만, 이상도, 김지은, 이창영,
소속 상세정보
손은익 ( Son Eun-Ik )
계명대학교 의과대학 신경외과학교실
김일만 ( Kim Eal-Maan )
계명대학교 의과대학 신경외과학교실
이상도 ( Yi Sang-Doe )
계명대학교 의과대학 신경과학교실
김지은 ( Kim Ji-Eun )
계명대학교 의과대학 신경과학교실
이창영 ( Lee Chang-Young )
계명대학교 의과대학 신경외과학교실
KMID : 0877219980020010020
Abstract
One of the important factors in providing good results from epilepsy surgery is the accuracy of identifying the epileptogenic focus. We report a retrospective series of 50 consecutive patients who underwent chronic intracranial recordings with subdural strip electrodes. All patients had previously undergone chronic EEG/Video monitoring with scalp and sphenoidal electrodes. The mesial temporal subdural electrodes were easily introduced to the inner uppermost part of the parahippocampal gyrus and excellent recordings of interictal and ictal events were obtained. Postoperative CT scans and simple craniograms demonstrated correct positioning of the electrodes. All patients were monitored for 2 to 14 days (mean : 4.3 days) of implantation to obtain enough seizures (mean :5.9 seizures). The recordings enabled sufficiently accurate localization for focal resection in 34 (68%) of 50 cases with only one minor complication. Most electrodes were localized over the lateral and mesiobasal cortex of temporal lobe. However, additional strip electrodes were covered on the frontal, parietal and occipital lobe cortex in ten cases to prevent sampling error. This procedure is a relatively safe and effective method for resolving difficult diagnostic issues and a valuable alternative to placing intracerebral depth electrodes.
키워드
간질수술;뇌경막하 전극;두개강내 검사;측두엽 간질;합병증
Epilepsy surgery;Subdural strip electrode;Intracranial recording;Temporal lobe epilepsy;Complication
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