'Cavernous sinus EEG': A new method for the preoperative evaluation of temporal lobe epilepsy

Nobuhiro Mikuni, Akio Ikeda, Kenichi Murao, Kiyohito Terada, Ichiro Nakahara, Waro Taki, Haruhiko Kikuchi, Hiroshi Shibasaki

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

Purpose: In presurgical evaluation of temporal lobe epilepsy (TLE), invasive methods are necessary if results of various noninvasive methods are not sufficiently convergent enough to identify the epileptogenic area accurately. To detect the epileptiform discharges originating specifically from the mesial temporal lobe, we applied the cavernous sinus catheterization technique. Methods: We placed Seeker Lite-10 guide wire electrodes into bilateral cavernous sinus through the internal jugular veins to record EEG (cavernous sinus EEG) in 6 patients with intractable TLE. Scalp EEG was simultaneously recorded in all 6 and electrocorticogram (ECoG) was also recorded in 4. Results: The cavernous sinus EEG demonstrated clear epileptiform discharges, sometimes even when they were absent on the simultaneously recorded scalp EEG. The epileptiform discharges recorded from the cavernous sinus electrodes were specifically associated with those in the mesial temporal region on ECoG. Ictal EEG pattern originating from mesial temporal lobe was also clearly documented on the cavernous sinus EEG. Conclusions: This new, semi-invasive method of identifying epileptogenic areas can detect the epileptiform discharges specifically arising from the mesial temporal lobe; it is as useful as or complements the invasive techniques such as foramen ovale or depth recording.

Original languageEnglish
Pages (from-to)472-482
Number of pages11
JournalEpilepsia
Volume38
Issue number4
DOIs
Publication statusPublished - 1997
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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