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Robot‐assisted stereoencephalography vs subdural electrodes in the evaluation of temporal lobe epilepsy
OBJECTIVE: Invasive video‐electroencephalography (iVEEG) is the gold standard for evaluation of refractory temporal lobe epilepsy before second stage resective surgery (SSRS). Traditionally, the presumed seizure onset zone (SOZ) has been covered with subdural electrodes (SDE), a very invasive proced...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472365/ https://www.ncbi.nlm.nih.gov/pubmed/37149851 http://dx.doi.org/10.1002/epi4.12756 |
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author | Gorbachuk, Mykola Machetanz, Kathrin Weinbrenner, Eliane Grimm, Florian Wuttke, Thomas V. Wang, Sophie Ethofer, Silke Tatagiba, Marcos Rona, Sabine Honegger, Jürgen Naros, Georgios |
author_facet | Gorbachuk, Mykola Machetanz, Kathrin Weinbrenner, Eliane Grimm, Florian Wuttke, Thomas V. Wang, Sophie Ethofer, Silke Tatagiba, Marcos Rona, Sabine Honegger, Jürgen Naros, Georgios |
author_sort | Gorbachuk, Mykola |
collection | PubMed |
description | OBJECTIVE: Invasive video‐electroencephalography (iVEEG) is the gold standard for evaluation of refractory temporal lobe epilepsy before second stage resective surgery (SSRS). Traditionally, the presumed seizure onset zone (SOZ) has been covered with subdural electrodes (SDE), a very invasive procedure prone to complications. Temporal stereoelectroencephalography (SEEG) with conventional frame‐based stereotaxy is time‐consuming and impeded by the geometry of the frame. The introduction of robotic assistance promised a simplification of temporal SEEG implantation. However, the efficacy of temporal SEEG in iVEEG remains unclear. The aim of this study was therefore to describe the efficiency and efficacy of SEEG in iVEEG of temporal lobe epilepsy. METHODS: This retrospective study enrolled 60 consecutive patients with medically intractable epilepsy who underwent iVEEG of a potential temporal SOZ by SDE (n = 40) or SEEG (n = 20). Surgical time efficiency was analyzed by the skin‐to‐skin time (STS) and the total procedure time (TPT) and compared between groups (SDE vs SEEG). Surgical risk was depicted by the 90‐day complication rate. Temporal SOZ were treated by SSRS. Favorable outcome (Engel°1) was assessed after 1 year of follow‐up. RESULTS: Robot‐assisted SEEG significantly reduced the duration of surgery (STS and TPT) compared to SDE implantations. There was no significant difference in complication rates. Notably, all surgical revisions in this study were attributed to SDE. Unilateral temporal SOZ was detected in 34/60 cases. Of the 34 patients, 30 underwent second stage SSRS. Both SDE and SEEG had a good predictive value for the outcome of temporal SSRS with no significant group difference. SIGNIFICANCE: Robot‐assisted SEEG improves the accessibility of the temporal lobe for iVEEG by increasing surgical time efficiency and by simplifying trajectory selection without losing its predictive value for SSRS. |
format | Online Article Text |
id | pubmed-10472365 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104723652023-09-02 Robot‐assisted stereoencephalography vs subdural electrodes in the evaluation of temporal lobe epilepsy Gorbachuk, Mykola Machetanz, Kathrin Weinbrenner, Eliane Grimm, Florian Wuttke, Thomas V. Wang, Sophie Ethofer, Silke Tatagiba, Marcos Rona, Sabine Honegger, Jürgen Naros, Georgios Epilepsia Open Original Articles OBJECTIVE: Invasive video‐electroencephalography (iVEEG) is the gold standard for evaluation of refractory temporal lobe epilepsy before second stage resective surgery (SSRS). Traditionally, the presumed seizure onset zone (SOZ) has been covered with subdural electrodes (SDE), a very invasive procedure prone to complications. Temporal stereoelectroencephalography (SEEG) with conventional frame‐based stereotaxy is time‐consuming and impeded by the geometry of the frame. The introduction of robotic assistance promised a simplification of temporal SEEG implantation. However, the efficacy of temporal SEEG in iVEEG remains unclear. The aim of this study was therefore to describe the efficiency and efficacy of SEEG in iVEEG of temporal lobe epilepsy. METHODS: This retrospective study enrolled 60 consecutive patients with medically intractable epilepsy who underwent iVEEG of a potential temporal SOZ by SDE (n = 40) or SEEG (n = 20). Surgical time efficiency was analyzed by the skin‐to‐skin time (STS) and the total procedure time (TPT) and compared between groups (SDE vs SEEG). Surgical risk was depicted by the 90‐day complication rate. Temporal SOZ were treated by SSRS. Favorable outcome (Engel°1) was assessed after 1 year of follow‐up. RESULTS: Robot‐assisted SEEG significantly reduced the duration of surgery (STS and TPT) compared to SDE implantations. There was no significant difference in complication rates. Notably, all surgical revisions in this study were attributed to SDE. Unilateral temporal SOZ was detected in 34/60 cases. Of the 34 patients, 30 underwent second stage SSRS. Both SDE and SEEG had a good predictive value for the outcome of temporal SSRS with no significant group difference. SIGNIFICANCE: Robot‐assisted SEEG improves the accessibility of the temporal lobe for iVEEG by increasing surgical time efficiency and by simplifying trajectory selection without losing its predictive value for SSRS. John Wiley and Sons Inc. 2023-05-14 /pmc/articles/PMC10472365/ /pubmed/37149851 http://dx.doi.org/10.1002/epi4.12756 Text en © 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Gorbachuk, Mykola Machetanz, Kathrin Weinbrenner, Eliane Grimm, Florian Wuttke, Thomas V. Wang, Sophie Ethofer, Silke Tatagiba, Marcos Rona, Sabine Honegger, Jürgen Naros, Georgios Robot‐assisted stereoencephalography vs subdural electrodes in the evaluation of temporal lobe epilepsy |
title | Robot‐assisted stereoencephalography vs subdural electrodes in the evaluation of temporal lobe epilepsy |
title_full | Robot‐assisted stereoencephalography vs subdural electrodes in the evaluation of temporal lobe epilepsy |
title_fullStr | Robot‐assisted stereoencephalography vs subdural electrodes in the evaluation of temporal lobe epilepsy |
title_full_unstemmed | Robot‐assisted stereoencephalography vs subdural electrodes in the evaluation of temporal lobe epilepsy |
title_short | Robot‐assisted stereoencephalography vs subdural electrodes in the evaluation of temporal lobe epilepsy |
title_sort | robot‐assisted stereoencephalography vs subdural electrodes in the evaluation of temporal lobe epilepsy |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10472365/ https://www.ncbi.nlm.nih.gov/pubmed/37149851 http://dx.doi.org/10.1002/epi4.12756 |
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