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MR findings after depth electrode implantation for medically refractory epilepsy
M A Merriam1, R A Bronen, D D Spencer
1Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06510.
AJNR. American Journal of Neuroradiology
|November 1, 1993
Summary
Magnetic resonance (MR) imaging reveals minimal chronic brain changes after electroencephalography (EEG) depth electrode placement for epilepsy. These subtle MR findings, often gliosis, should not be mistaken for seizure activity.
Area of Science:
- Neuroimaging
- Epilepsy Research
- Neurosurgery
Background:
- Stereotactic electroencephalography (EEG) depth electrode placement is crucial for managing medically refractory epilepsy.
- Assessing long-term effects of these electrodes on brain parenchyma is essential for patient safety and accurate interpretation of neuroimaging.
Purpose of the Study:
- To evaluate chronic changes in brain parenchyma using MR imaging after electroencephalography (EEG) depth electrode placement.
- To determine the incidence and nature of gliosis, hemorrhage, or infection along probe tracts.
Main Methods:
- Retrospective review of MR scans from 57 patients with 210 stereotactically placed depth electrodes.
- Evaluation of MR images for signal abnormalities, including gliosis, hemorrhage, or infection along electrode tracts.
Main Results:
- MR signal abnormalities were observed in 67% of patients along probe tracts.
- Punctate hyperintensity, likely gliosis, was seen in 41% of tracts on long-repetition-time images.
- Significant hemorrhage occurred in one case; infection was not reported.
Conclusions:
- Depth electrode implantation for EEG monitoring causes minimal chronic MR changes in most patients.
- Punctate hypersensitivity on MR should be attributed to gliosis, not seizure focus.
- Hemorrhage and infection are rare complications; MR angiography may further reduce risks.