University Paris V, René Descartes, Paris, France.
Neurosurgery. 2011 Dec;69(2 Suppl Operative):ons169-75; discussion ons175. doi: 10.1227/NEU.0b013e3182181e7d.
In cryptogenic epilepsy or when multifocal seizure onset is suspected, intracranial monitoring of the EEG is required.
To report on the adverse events related to electroencephalogram (EEG) intracranial recording in one of the largest pediatric series published and to discuss the avoidance of adverse events in our experience and with respect to a review of the literature.
A retrospective analysis of our department database and hospital charts of 95 children operated on between 1994 and 2009 was performed.
Invasive recording was uneventful in 51.1% of cases. Observed frequency of infection was 14.9%, cerebrospinal fluid leak was 10.6%, brain swelling was 6.4%, and hemorrhage was 17%. Brain swelling was more frequent in older patients, whereas the length of recording, number of electrode contacts used, and presence of depth electrodes were not relevant. Cerebrospinal fluid leakage was completely prevented by the routine introduction of dural graft substitutes in 2003.
Invasive recordings carry a noticeable rate of adverse events but provide invaluable information in delineating the epileptogenic zone. The low incidence of such events among younger children suggests that invasive recordings can be successfully performed with low morbidity in this age group.
在隐源性癫痫或怀疑多灶性癫痫发作时，需要进行颅内脑电图监测。
报告我们所在最大型儿科系列之一中颅内脑电图记录相关的不良事件，并讨论我们在实践中的不良事件的避免措施，以及文献复习的相关内容。
对我院 1994 年至 2009 年间手术的 95 名儿童的科室数据库和医院病历进行回顾性分析。
51.1%的病例颅内记录无不良事件。感染的发生率为 14.9%，脑脊液漏为 10.6%，脑水肿为 6.4%，出血为 17%。年龄较大的患者脑水肿更为常见，而记录的长度、使用的电极接触数量和深部电极的存在与不良事件无关。2003 年常规使用硬脑膜移植物替代品完全预防了脑脊液漏。
有创性记录会带来显著的不良事件发生率，但对于描绘致痫区提供了非常有价值的信息。年龄较小的儿童不良事件发生率较低，提示该年龄段可以成功进行低发病率的有创性记录。
