Xu Ran, Achberger Johannes, Wedel Dario von, Vajkoczy Peter, Onken Julia, Schneider Ulf C
Department of Neurosurgery, Charité-Universitätsmedizin Berlin, 13437 Berlin, Germany.
BIH Charité (Junior) (Digital) Clinician Scientist Program, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, Charitéplatz 1, 10117 Berlin, Germany.
Micromachines (Basel). 2022 Feb 28;13(3):397. doi: 10.3390/mi13030397.
The utilization of epidural electrodes in the preoperative evaluation of intractable epilepsy is a valuable but underrepresented tool. In recent years, we have adapted the use of cylindrical epidural 1-contact electrodes (1-CE) instead of Peg electrodes. 1-CEs are more versatile since their explantation is a possible bedside procedure. Here we report our experience with 1-CEs as well as associated technical nuances. This retrospective analysis included 56 patients with intractable epilepsy who underwent epidural electrode placement for presurgical evaluation at the Department of Neurosurgery at the Charité University Hospital from September 2011 to July 2021. The median age at surgery was 36.3 years (range: 18-87), with 30 (53.6%) female and 26 (46.4%) male patients. Overall, 507 electrodes were implanted: 93 Fo electrodes, 33 depth electrodes, and 381 epidural electrodes, with a mean total surgical time of 100.5 ± 38 min and 11.8 ± 5 min per electrode. There was a total number of 24 complications in 21 patients (8 Fo electrode dislocations, 6 CSF leaks, 6 epidural electrode dislocations or malfunction, 3 wound infections, and 2 hemorrhages); 11 of these required revision surgery. The relative electrode complication rates were 3/222 (1.4%) in Peg electrodes and 3/159 (1.9%) in 1-CE. In summary, epidural recording via 1-CE is technically feasible, harbours an acceptable complication rate, and adequately replaces Peg electrodes.
硬膜外电极在难治性癫痫术前评估中的应用是一种有价值但未得到充分利用的工具。近年来，我们采用了圆柱形硬膜外单触点电极（1-CE）而非钉状电极。1-CE更具通用性，因为其取出可在床边进行。在此，我们报告使用1-CE的经验以及相关技术细节。这项回顾性分析纳入了56例难治性癫痫患者，他们于2011年9月至2021年7月在夏里特大学医院神经外科接受硬膜外电极置入术以进行术前评估。手术时的中位年龄为36.3岁（范围：18 - 87岁），其中女性30例（53.6%），男性26例（46.4%）。总共植入了507根电极：93根皮层下电极、33根深部电极和381根硬膜外电极，平均总手术时间为100.5±38分钟，每根电极的手术时间为11.8±5分钟。21例患者共出现24种并发症（8例皮层下电极移位、6例脑脊液漏、6例硬膜外电极移位或故障、3例伤口感染和2例出血）；其中11例需要进行翻修手术。钉状电极的相对电极并发症发生率为3/222（1.4%），1-CE的相对电极并发症发生率为3/159（1.9%）。总之，通过1-CE进行硬膜外记录在技术上是可行的，并发症发生率可接受，并且能充分替代钉状电极。
