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Journal of Neurology

, Volume 262, Issue 12, pp 2699–2712 | Cite as

Safety profile of intracranial electrode implantation for video-EEG recordings in drug-resistant focal epilepsy

  • Bertrand Mathon
  • Stéphane Clemenceau
  • Dominique Hasboun
  • Marie-Odile Habert
  • Hayat Belaid
  • Vi-Huong Nguyen-Michel
  • Virginie Lambrecq
  • Vincent Navarro
  • Sophie Dupont
  • Michel Baulac
  • Philippe Cornu
  • Claude Adam
Original Communication

Abstract

Invasive electroencephalography recordings with depth or subdural electrodes are necessary to identify the ictogenic area in some drug-resistant focal epilepsies. We aimed to analyze the safety profile of intracranial electrode implantation in a tertiary center and the factors associated with its complications. We retrospectively examined complications in 163 intracranial procedures performed in adult patients. Implantation methods included oblique depth stereotactic approach (n = 128) and medial–temporal depth stereotactic approach in combination with subdural strip placement (n = 35). 1201 depth macroelectrodes, 59 bundles of microelectrodes (in 30 patients) and 148 subdural electrodes were implanted. Complications were classified as major (requiring treatment or leading to neurological impairment) or minor. The rate of overall complications was 4.9 % (n = 8), with 3.1 % (n = 5) of major complications, though no permanent morbidity or mortality was recorded. Infection occurred in 1.2 % and hemorrhage in 3.7 % of patients. One hemorrhage occurred for every 225 electrodes implanted (4.4 ‰). Microelectrodes were not responsible for any complications. Overall and hemorrhagic complications were significantly associated with MRI-negative cases (7.3 and 6.3 % versus 0 %, p = 0.04). We believe that intracranial electrode implantation has a favorable safety profile, without permanent deficit. These risks should be balanced with the benefits of invasive exploration prior to surgery. Furthermore, this study provides preliminary evidence regarding the safety of micro-macroelectrodes.

Keywords

SEEG (Stereoelectroencephalography) Invasive EEG Depth electrodes Complications Adverse events Epilepsy surgery 

Notes

Acknowledgments

This work received support from the program “Investissements d’avenir” ANR-10-IAIHU-06. The authors thank Prof. Pierre Levy and Dr. Alister Rogers for advice and discussion concerning the manuscript.

Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Bertrand Mathon
    • 1
    • 7
  • Stéphane Clemenceau
    • 1
  • Dominique Hasboun
    • 2
    • 7
  • Marie-Odile Habert
    • 4
    • 7
  • Hayat Belaid
    • 1
    • 6
  • Vi-Huong Nguyen-Michel
    • 3
  • Virginie Lambrecq
    • 3
    • 6
  • Vincent Navarro
    • 3
    • 6
    • 7
  • Sophie Dupont
    • 3
    • 5
    • 6
    • 7
  • Michel Baulac
    • 3
    • 6
    • 7
  • Philippe Cornu
    • 1
    • 7
  • Claude Adam
    • 3
    • 6
  1. 1.Department of NeurosurgeryLa Pitié-Salpêtrière Hospital, AP-HPParisFrance
  2. 2.Department of NeuroradiologyLa Pitié-Salpêtrière Hospital, AP-HPParisFrance
  3. 3.Department of NeurologyEpileptology Unit, La Pitié-Salpêtrière Hospital, AP-HPParisFrance
  4. 4.Department of Nuclear MedicineLa Pitié-Salpêtrière Hospital, AP-HPParisFrance
  5. 5.Department of RehabilitationLa Pitié-Salpêtrière Hospital, AP-HPParisFrance
  6. 6.Brain and Spine Institute (CRICM-ICM; INSERM, UMRS 1127; CNRS, UMR 7225)ParisFrance
  7. 7.Sorbonne UniversityUPMC, Univ Paris 06ParisFrance

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