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Depth Electrodes in Pediatric Epilepsy Surgery

Published online by Cambridge University Press:  23 September 2014

Janani Kassiri ,
Jeff Pugh ,
Sharon Carline ,
Laura Jurasek ,
Thomas Snyder ,
Matt Wheatley  and
D. Barry Sinclair
Janani Kassiri
Affiliation:
Comprehensive Epilepsy Program, University of Alberta Hospital, Edmonton, Alberta, Canada
Jeff Pugh
Affiliation:
Comprehensive Epilepsy Program, University of Alberta Hospital, Edmonton, Alberta, Canada
Sharon Carline
Affiliation:
Comprehensive Epilepsy Program, University of Alberta Hospital, Edmonton, Alberta, Canada
Laura Jurasek
Affiliation:
Comprehensive Epilepsy Program, University of Alberta Hospital, Edmonton, Alberta, Canada
Thomas Snyder
Affiliation:
Comprehensive Epilepsy Program, University of Alberta Hospital, Edmonton, Alberta, Canada
Matt Wheatley
Affiliation:
Comprehensive Epilepsy Program, University of Alberta Hospital, Edmonton, Alberta, Canada
D. Barry Sinclair*
Affiliation:
Comprehensive Epilepsy Program, University of Alberta Hospital, Edmonton, Alberta, Canada
*
Comprehensive Epilepsy Program, University of Alberta, 11402 University Avenue, Edmonton, Alberta, T6G 2J3, Canada Email: barry.Sinclair@albertahealthservices.ca
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Abstract:

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Background:

The surgical removal of the epileptogenic zone in medically intractable seizures depends on accurate localization to minimize the neurological sequelae and prevent future seizures. To date, few studies have demonstrated the use of depth electrodes in a pediatric epilepsy population. Here, we report our study of pediatric epilepsy patients at our epilepsy center who were successfully operated for medically intractable seizures following the use of intracranial depth electrodes. In addition, we detail three individuals with distinct clinical scenarios in which depth electrodes were helpful and describe our technical approach to implantation and surgery.

Methods:

We retrospectively reviewed 18 pediatric epilepsy patients requiring depth electrode studies who presented at the University of Alberta Comprehensive Epilepsy Program between 1999 and 2010 with medically intractable epilepsy. Patients underwent cortical resection following depth electrode placement according to the Comprehensive Epilepsy Program surgical protocols after failure of surface electroencephalogram and magnetic resonance imaging to localize ictal onset zone.

Result:

The ictal onset zone was successfully identified in all 18 patients. Treatment of all surgical patients resulted in successful seizure freedom (Engel class I) without neurological complications.

Conclusion:

Intracranial depth electrode use is safe and able to provide sufficient information for the identification of the epileptogenic zone in pediatric epilepsy patients previously not considered for epilepsy surgery.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 1 , January 2013 , pp. 48 - 55
Copyright
Copyright © The Canadian Journal of Neurological 2013

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