Brna Paula, Duchowny Michael, Resnick Trevor, Dunoyer Catalina, Bhatia Sanjiv, Jayakar Prasanna
IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
Brain Institute, Miami Children's Hospital, Miami, Florida, U.S.A.
Epilepsia. 2015 Jul;56(7):1065-70. doi: 10.1111/epi.12983. Epub 2015 May 9.
There are limited data on the indications for the use of chronic invasive electroencephalography (EEG) monitoring (IEM) for pediatric epilepsy surgery.
We retrospectively studied 102 children who underwent intracranial monitoring to map critical cortex, localize the epileptogenic region, or resolve divergent findings. We assessed IEM utility based on changes to the resection plan following analysis of noninvasive data.
IEM was judged useful in 87% of cases and had greatest utility for resolving discordant data and localizing extratemporal and multilobar epileptogenic zones. IEM data were least useful for seizure onset in the temporal lobe and had little utility for direct cortical stimulation mapping unless functional magnetic resonance imaging (fMRI) revealed atypical language representation or the epileptogenic zone was in proximity to critical cortex.
IEM utility was demonstrated for a majority of cases with well-defined indications. The method of assessing utility will facilitate multicentric studies toward developing future consensus and practice guidelines.
关于慢性侵入性脑电图（EEG）监测（IEM）用于小儿癫痫手术的适应证数据有限。
我们回顾性研究了102例接受颅内监测以绘制关键皮质、定位致痫区或解决分歧结果的儿童。我们根据对非侵入性数据进行分析后切除计划的变化来评估IEM的效用。
IEM在87%的病例中被判定为有用，对于解决不一致的数据以及定位颞叶外和多叶致痫区具有最大效用。IEM数据对于颞叶癫痫发作的起始最无用，对于直接皮质刺激图谱的效用也很小，除非功能磁共振成像（fMRI）显示非典型语言表征或致痫区靠近关键皮质。
在大多数适应证明确的病例中证明了IEM的效用。评估效用的方法将有助于开展多中心研究，以制定未来的共识和实践指南。
