Comparison of Neuronavigation and Frame-Based Stereotactic Systems in Implanting Epileptic Depth Electrodes

To investigate the application of neuronavigation in the implantation of depth electrodes in patients with epilepsy.

Thirty-six patients with epilepsy who were implanted with depth electrodes using neuronavigation were assessed for accuracy of implantation and associated complications.

In the imaging navigation group, patients were implanted with 2-14 depth electrodes. The average number of implantations was 4.8 electrodes/case. The average implantation error was 2.03 ± 0.98 mm, exhibiting no significant difference compared to the frame-based stereotactic group. In the imaging group, an average of 19.4 min was required to implant each electrode, which was significantly shorter than the time required in the frame group (34.5 min). The temporal lobe was elucidated as the factor that affects electrode implantation accuracy. One patient in the imaging group exhibited a small amount of bleeding, and one suffered from cerebrospinal fluid leakage; however, the overall complication rate in the imaging group was lower than that in the frame group.

Imaging navigation provides better means of depth electrode implantation; its implantation accuracy is similar to that of the frame-based stereotactic method and it is less time consuming and causes less complications, and is especially suitable for stereoelectroencephalography, which requires multiple depth electrodes.