Clinical Application Of Stereo-electroencephalography Based On Neuro-navigation In Epilepsy Surgery

Objective:To evaluate the safety,efficacy and the application accuracy of the Stereo-electroencephalography(SEEG) based on the Brain-Lab neuro-navigation in the preoperative evaluation of intractable epilepsy.Method : Three-dimensional brain and Cortical vein model were established after the magnetic resonance imaging(MRI) and magnetic resonance venography(MRV) data of 14 patients with intractable epilepsy were imput into Brain-Lab nuero-navigation system in order to design the surgical path avoiding the Brain surface veins. SEEG operation was performed after obtaining target point and corrdinates. Quantitative analysis for target point and entry point localization error was performed and the safety,efficacy,complication were assessed.Result:Successful implantation were obtained in all cases and the patients’ epileptogenic zone were localized and removed(Deep brain stimulation in 1 case).Major complication was intracranial hemorrhage(1case), cerebrospinal fluid leakage(2 cases, one was secondary intracranial infection). Median entry point localization error was 1.64 mm(interquartile range, 1.17-3.07 mm).Median target point localization errors were 2.74mm(interquartile range, 1.85-3.89 mm) respectively.Conclusion:Stereoscopic brain cortex vein model effectively avoid electrodes implanted bleeding complications. As an invasive method of preoperation evaluation,SEEG is safe and effective especially for patients who had underwent inconclusive subdural grid placement treatment.