Cortico-cortical evoked potential by single-pulse electrical stimulation is a generally safe procedure |
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Affiliation: | 1. Department of Neurology, Kyoto University Graduate School of Medicine, Japan;2. Department of Epilepsy, Neurological Institute, Cleveland Clinic, USA;3. Division of Neurology, Kobe University Graduate School of Medicine, Japan;4. Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Japan;5. Department of Neurosurgery, Kyoto University Graduate School of Medicine, Japan;6. Department of Neurosurgery, Ehime University Graduate School of Medicine, Japan |
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Abstract: | ObjectiveCortico-cortical evoked potential (CCEP) by single-pulse electrical stimulation (SPES) is useful to investigate effective connectivity and cortical excitability. We aimed to clarify the safety of CCEPs.MethodsWe retrospectively analyzed 29 consecutive patients with intractable partial epilepsy undergoing chronic subdural grid implantation and CCEP recording. Repetitive SPES (1 Hz) was systematically applied to a pair of adjacent electrodes over almost all electrodes. We evaluated the incidences of afterdischarges (ADs) and clinical seizures.ResultsOut of 1283 electrode pairs, ADs and clinical seizures were observed in 12 and 5 pairs (0.94% and 0.39%, per electrode pair) in 7 and 3 patients (23.3% and 10.0%, per patient), respectively. Of the 18–82 pairs per patient, ADs and clinical seizures were induced in 0–4 and 0–3 pairs, respectively. Stimulating 4 SOZ (seizure onset zone) (2.5%) and 8 non-SOZ pairs (0.75%) resulted in ADs. We observed clinical seizures in stimulating 4 SOZ (2.5%) and 1 non-SOZ pair (0.09%). The incidence of clinical seizures varied significantly between SOZ and non-SOZ stimulations (p = 0.001), while the difference in AD incidence tended towards significance (p = 0.058).ConclusionAlthough caution should be taken in stimulating SOZ, CCEP is a safe procedure for presurgical evaluation.SignificanceCCEP is safe under the established protocol. |
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Keywords: | Cortico-cortical evoked potential Single-pulse electrical stimulation Afterdischarge Clinical seizure SPES" },{" #name" :" keyword" ," $" :{" id" :" k0030" }," $$" :[{" #name" :" text" ," _" :" single-pulse electrical stimulation CCEP" },{" #name" :" keyword" ," $" :{" id" :" k0040" }," $$" :[{" #name" :" text" ," _" :" cortico-cortical evoked potential SOZ" },{" #name" :" keyword" ," $" :{" id" :" k0050" }," $$" :[{" #name" :" text" ," _" :" seizure-onset zone AD" },{" #name" :" keyword" ," $" :{" id" :" k0060" }," $$" :[{" #name" :" text" ," _" :" afterdischarge |
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