Sphenoidal electrode placement using biplane fluoroscopy and rotational flat panel CT imaging

Assessment of otherwise occult seizure foci arising from the anterior mesial temporal region occasionally necessitates placement of sphenoidal electrodes (SEs). This minimally invasive procedure is often performed without imaging guidance; however, more precise lead positioning with a reduced risk of complications has been described with fluoroscopic guidance. We describe the added value of rotational flat panel CT imaging for precise anatomic localization of the SE tip in relation to the foramen ovale.