Complications of Epilepsy Surgery

Pilcher, Webster H.; Rusyniak, W. George

doi:10.1016/s1042-3680(18)30597-7

Cited by 96 publications

(60 citation statements)

References 80 publications

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“…More importantly, most of the literature regarding the complication rates of intracranial electrodes and surgical approaches for epilepsy is in reviewed books, which have generally discussed the complications depending on multiple centers and/or multiple surgeons. 12,26,[33][34][35]54 Although the heterogeneity of these studies may cause bias in the complication rate, they have provided helpful statistics both for the evaluation of clinical practice and for counseling patients before surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Another larger series including 2000 intracranial electrode implantations for monitoring seizure from different centers found 1 case of hematoma that required evacuation. 3 In a literature review, Pilcher et al 34 reported a 2.5% rate of hemorrhage in 1582 patients evaluated with intracranial electrodes. Recent reports including small samples of patients assessed with intracranial electrodes 4,39,40,42 demonstrated almost similar rates of hemorrhage as larger series 3,4,7,9,26,30,48 or literature reviews.…”

Section: Complications Of Seegmentioning

confidence: 99%

“…Recent reports including small samples of patients assessed with intracranial electrodes 4,39,40,42 demonstrated almost similar rates of hemorrhage as larger series 3,4,7,9,26,30,48 or literature reviews. [33][34][35]54 Almost all authors agree that the incidence of intracerebral hemorrhage is low.…”

Section: Complications Of Seegmentioning

confidence: 99%

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Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution

Tanrıverdi¹,

Ajlan²,

Poulin³

et al. 2009

JNS

131

108

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Object. In this paper the authors aimed to provide information related to major and minor surgical and neurological complications encountered following stereoelectroencephalography and epilepsy surgery.Methods. The authors performed a retrospective review of 491 and 1905 patients who underwent intracranial electrode implantation and epilepsy surgery, respectively, between 1976 and 2006 at the Montreal Neurological Institute. All intracranial electrode implantations and surgical procedures were performed by 1 surgeon (A.O.).Results. A total of 6415 electrode implantations and 2449 surgical procedures were done. There were no deaths related to either procedure. There were no major complications after intracranial electrode implantation, and the risks of infection and intracranial hematoma were found to be 1.8 and 0.8%, respectively. The number of electrodes per lobe (p = 0.05) and number of lobes covered (p = 0.04) were significant risk factors for hematoma and infection. Regarding epilepsy surgery, there were no major surgical complications, and the overall minor complication rate was 2.9%. Infection was the most common complication (1.0%), followed by intracranial hematoma (0.7%). Significant risk factors associated with hematomas and infections were the number of reoperations (p = 0.001) and older patient age (p = 0.03). Minor and major neurological complication rates were 2.7 and 0.5%, respectively, and the rate of overall neurological morbidity was 3.3%. Hemiparesis was the most frequent neurological complication (1.5%).Conclusions. Based on the authors' experience, intracranial electrode implantation is an effective method with an extremely low morbidity rate. Moreover, epilepsy surgery is safe, especially in experienced hands. (DOI: 10.3171/2009.8.JNS08338) Key Words • complication • epilepsy • epilepsy surgery • intracranial electrode • morbidity 1111Abbreviations used in this paper: CAH = corticoamygdalohippocampectomy; DVT = deep vein thrombosis; EDH = epidural hematoma; IPH = intraparenchymal hematoma; MNI = Montreal Neurological Institute; PE = pulmonary embolism; QOL = quality of life; SDH = subdural hematoma; SEEG = stereoelectroencephalography; TLE = temporal lobe epilepsy; VFD = visual field defect.

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Section: Discussionmentioning

confidence: 99%

Section: Complications Of Seegmentioning

confidence: 99%

See 1 more Smart Citation

Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution

Tanrıverdi¹,

Ajlan²,

Poulin³

et al. 2009

JNS

131

108

View full text Add to dashboard Cite

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“…ECoG has higher spatial resolution than EEG (i.e., tenths of millimeters versus centimeters [8]), broader bandwidth (i.e., 0-200 Hz versus 0-40 Hz), higher amplitude (i.e., 50-100 µV maximum versus 10-20 µV), and far less vulnerability to artifacts such as EMG [8,9,15]. At the same time, because ECoG is recorded by subdural electrode arrays and thus does not require electrodes that penetrate into cortex, it is likely to have greater long-term stability and might also be safer than single-neuron recording [16,17].…”

Section: Introductionmentioning

confidence: 99%

A brain–computer interface using electrocorticographic signals in humans

et al. 2004

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Brain-computer interfaces (BCIs) enable users to control devices with electroencephalographic (EEG) activity from the scalp or with single-neuron activity from within the brain. Both methods have disadvantages: EEG has limited resolution and requires extensive training, while single-neuron recording entails significant clinical risks and has limited stability. We demonstrate here for the first time that electrocorticographic (ECoG) activity recorded from the surface of the brain can enable users to control a one-dimensional computer cursor rapidly and accurately. We first identified ECoG signals that were associated with different types of motor and speech imagery. Over brief training periods of 3-24 min, four patients then used these signals to master closed-loop control and to achieve success rates of 74-100% in a one-dimensional binary task. In additional open-loop experiments, we found that ECoG signals at frequencies up to 180 Hz encoded substantial information about the direction of two-dimensional joystick movements. Our results suggest that an ECoG-based BCI could provide for people with severe motor disabilities a non-muscular communication and control option that is more powerful than EEG-based BCIs and is potentially more stable and less traumatic than BCIs that use electrodes penetrating the brain. M This article features online multimedia enhancements

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“…Perirhinal and entorhinal cortex play a major role in memory processing [50]. Globally, it is estimated that 40 % of patients with MTLE operated on microsurgically on the dominant side have a significant postoperative short-term verbal memory deficit [51,52]. Clusmann et al [53] have shown, in their series of 285 patients, that this deficit was slightly more common (43.4 % vs 30.9 %) when an anterior temporal lobectomy was performed instead of an amygdalohippocampectomy.…”

Section: Epilepsymentioning

confidence: 99%

Gamma Knife for Functional Diseases

Régis

2014

Neurotherapeutics

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Complications of Epilepsy Surgery

Cited by 96 publications

References 80 publications

Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution

Morbidity in epilepsy surgery: an experience based on 2449 epilepsy surgery procedures from a single institution

A brain–computer interface using electrocorticographic signals in humans

Gamma Knife for Functional Diseases

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