Çetin OKUYAZ, Semiha KURT, Ayşe SERDAROĞLU, Atilla ERDEM, Ayşe KARATAŞ, Erhan BİLİR, Kürşad AYDIN, Gülnihal KUTLU

Invasive EEG monitoring in children: A report of three cases

Çocukluk çağının ilaç tedavisine dirençli parsiyel epilepsilerinin tedavisinde cerrahi tavsiye edilmektedir. Ancak cerrahinin başarılı sonuçlar verebilmesi için epilepto/enik korteksin yeri tam olarak belirlenmelidir. Bu amaç için çeşitli tanı yöntemleri kullanılmaktadır, ancak EEG hala ana metoddur. Bazı olgularda skalp EEG epileptojenik korteksin yerini belirlemede yetersiz kalabilir ya da diğer tanı metodlarının sonuçları ile uyumlu olmayabilir. Bu tür olgularda invaziv EEG monitörizasyonu yapılmalıdır. Bu yazıda ilaç tedavisine dirençli parsiyel epilepsili üç olgu nedeniyle invaziv EEG monitörizasyonunun önemini vurguladık. Bizim bilgilerimize göre olgularımız Türkiye'de bir üniversite hastanesinde invaziv EEG monitörizasyonu uygulanan ilk çocuk olgulardır.

Çocuklarda invaziv EEG monitörizasyonu:Üç olgu raporu

Surgery is recommended for children with localization related epilepsy that is intractable to drug therapy. For a successful surgical outcome, the precise localization of the epileptogenic cortex should be determined. Several diagnostic techniques may be used in order to achieve this goal; however, EEG is still the main method. In some patients scalp EEG is not capable of localizing epileptogenic focus or it is discordant with other diagnostic measures. In such patients, invasive EEG monitoring should be performed. In this article, we emphasize the importance of invasive EEG monitoring in three patients with medically refractory epilepsy. To our knowledge, these cases are the first children evaluated by invasive EEG monitoring in a university hospital in Turkey.

PDF

___

1. Snead OC. Surgical treatment of medically refractory epilepsy in childhood. Brain Dev 2001; 23: 199-207.
2. Jayakar P. Invasive EEG monitoring in children: when, where, and what?. J Clin Neurophysiol 1999; 16: 408-418.
3. Blume WT. Current trends in electroencephalography. Curr Opin Neurol 2001; 14: 193-197.
4. Weil S. Noachtar S, Arnold S, Yousry TA, Winkler PA Tatsch K Ictal SPECT differentiates between temporal and extratemporal epilepsy: confirmation by excellent postoperative seizure control. Nucl Med Commun 2001: 22: 233-237,
5. Minassian BA, Otsubo H, Weiss S, Elliot I, Rutka JT, Knead OC. Magnetoencephatographic localization in epilepsy surgery: comparison with invasive intracranial electroencephalography. Ann Neurol 1999; 46: 627-633.
6. Zupanc ML. Neuroimaging in the evaluation of children and adolescents with intractable epilepsy. Pediatr Neurol 1997: 17: 111-121.
7. Zumsteg D, Wieser HG. Presurgical evaluation: current role of invasive EEG. Epilepsia 2000; 41: 55-60.
8. Sperling MR. Clinical challenges in invasive monitoring in epilepsy surgery Epilepsia 1997; 38: 6-12.
9. Diehl B, Luders HO. Temporal lobe epilepsy: When are invasive recordings needed? Epilepsia 2000; 41: 61-74.
10 Blume WT, Hwang PA. Pediatric candidates for temporal lobe epilepsy surgery. Can J Neurol Sci 2000: 27: 14-19.
İL. Kim SK, Wang KC, Hwang YS, Kim KJ, Kim 10, Lee DS, Yi Y, Cho BK. Pediatric intractable epilepsy: the role of presuqjical evaluation and seizure outcome. Childs Nen* Syst 2000; 16: 278-285.
12. Lee SK, Kim N, Hong KS, Nam HW, Park SH, Chung CK. The clinical usefulness of ictal surface EEG in neocortical epilepsy. Epilepsia 2000; 41: 1450-1455.