(These patterns might vary, and can be affected by multiple extrinsic factors, i.e. The system is based on the relationship between the location of an electrode and the underlying area of the brain, specifically the cerebral cortex.ĭuring sleep and wake cycles, the brain produces different, objectively recognized and distinguishable electrical patterns, which can be detected by electrodes on the skin. This method was developed to maintain standardized testing methods ensuring that a subject's study outcomes (clinical or research) could be compiled, reproduced, and effectively analyzed and compared using the scientific method. The 10–20 system or International 10–20 system is an internationally recognized method to describe and apply the location of scalp electrodes in the context of an EEG exam, polysomnograph sleep study, or voluntary lab research. Accessed December 7, 2015.Electrode locations of International 10-20 system for EEG (electroencephalography) recording
Pre-surgery Intracranial Monitoring: Stereo-EEG Versus Subdural Electrodes. Session: Surgery: Battle Royale: Stereo EEG vs. The AES 2015 Annual Meeting was held December 4-8 in Philadelphia. Data generated by each type of electrodes produce different results and the methods are not a catch-all approach to epilepsy care. The overall consensus among the speakers was that the decision to use sEEG over subdural electrodes and vice versa must be made on a case-by-case basis.
Both methods also helped ensure that the patient’s seizure focus was surgically removed without causing damage to important nearby brain regions. Steven said the use of both types of electrodes was necessary because the precise location of the seizure focus was uncertain. By doing so, he was able to determine that the lesion was primarily responsible for her seizures and ultimately performed a lesionectomy on the patient. Steven placed 1 sEEG electrode within the lesion and 10 strip and grid electrodes surrounding the area. After a magnetic resonance image revealed a lesion on the patient’s brain, Dr. Steven said he was originally unable to determine where her seizures originated within the brain using a scalp EEG, but thought that they appeared to be frontal lobe seizures. Her auras included heart palpitations, tingling sensations, and numbness in her left arm, face, and leg-mostly in the arm and face.Īlthough anti-seizure medications can successfully treat seizures in two-thirds of all people with epilepsy, surgical evaluation is recommended in the remaining one-third of people, like this patient, who continue to have seizures regardless of medications. Steven, MD, a neurosurgeon at the University of Western Ontario, shared a complex case of his patient, a 27-year-old woman, who experienced hypermotor seizures several times per day since the age of 2. In both procedures, patients are observed in the electroencephalogram (EEG) video monitoring unit to locate the exact origin of the seizures.ĭavid A. If the seizure focus is believed to be deep-such as within a lesion-invasive monitoring is done using sEEG depth electrodes. Subdural electrodes are typically used if the seizure focus is believed to be on the surface of the brain. Presenters from prestigious medical institutions across the United States and Canada outlined some of their most challenging cases for which they were charged with analyzing patients’ seizures using stereo electroencephalogram (sEEG) depth electrodes, subdural strip and grid electrodes, or a combination of both.
The challenge, however, is often pinpointing seizure-producing areas of the brain, according to several neurosurgeons at the American Epilepsy Society (AES) 2015 Annual Meeting in Philadelphia. Brain surgery is increasingly being used to control seizures when they occur repeatedly, despite antiepileptic medications.
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