Temporal Patterns of Skin-Fixed Depth Electrodes During Stereotactic Electroencephalography Recording

Area of Science:

• Neurosurgery
• Epileptology
• Medical Devices

Background:

• Stereotactic electroencephalography (SEEG) is vital for refractory epilepsy evaluation.
• Anchor bolts are standard for SEEG electrode fixation, but cost and technical issues prompt alternatives like skin fixation.
• Limited data exists on how fixation methods impact electrode stability during SEEG recordings.

Purpose of the Study:

• To investigate the temporal pattern of depth electrode dislocation with skin fixation compared to anchor bolt fixation.
• To quantify electrode migration in both fixation groups during SEEG monitoring.

Main Methods:

• A comparative study evaluating electrode dislocation in SEEG procedures.
• Analyzed 41 electrodes (anchor bolt group) and 66 electrodes (skin fixation group) across nine patients.
• Measured longitudinal and lateral electrode displacement over time.

Main Results:

• Skin fixation resulted in significantly greater mean cumulative longitudinal migration (4.34 mm) versus anchor bolts (0.16 mm) (p < 0.0001).
• Most migration occurred during the bilateral implantation procedure in the skin fixation group.
• Mean lateral shift was 0.87 mm in the skin fixation group; no migration-related complications were reported.

Conclusions:

• Skin fixation of SEEG electrodes presents a higher risk of dislocation compared to anchor bolts.
• While clinical complications are rare, careful attention to fixation is needed for accurate anatomo-electrophysiological interpretation in epilepsy patients.
• This study highlights the importance of monitoring electrode stability with different fixation methods.