Authors :
Presenting Author: Yosuke Masuda, MD, PhD – University of Tsukuba
Hisayuki Hosoo, MD, PhD – University of Tsukuba
Kota Araki, MD – University of Tsukuba Hospital
Hiroki Ishida, PhD – EP Medical Inc
Mitsuyo Nishimura, MT – University of Tsukuba Hospital
Aiki Marushima, MD, PhD – University of Tsukuba
Ayataka Fujimoto, MD, PhD – Seirei Hamamatsu General Hospital
Eiichi Ishikawa, MD, PhD – University of Tsukuba
Yuji Matsumaru, MD, PhD – University of Tsukuba
Rationale: Focal epilepsy can be effectively treated by focal ablation. However, epileptic foci are not always visible on imaging studies, necessitating the use of different diagnostic methods, including invasive techniques. Intravascular EEG (eEEG) has been developed as a less invasive method for recording intracranial EEG. Identification of epileptic foci requires the placement of multiple electrodes in the brain, but previous studies have only been able to place one electrode per cerebral hemisphere.
Methods: We have developed a new endovascular electroencephalograph, named EP01, which allows multiple electrodes to be placed in the brain. This study is the first human trial of bilateral multiple EEG electrode insertion and subsequent EEG recording. A case of a patient with temporal lobe epilepsy with a scar of cerebral contusion in the anterior right temporal lobe is reported.
Results:
During Wada testing, five eEEG electrodes were successfully implanted via the bilateral jugular veins, reaching the bilateral superior sagittal sinus, transverse sinus, and cavernous sinus. Simultaneous recordings were obtained with both eEEG and scalp EEG. The eEEG recordings demonstrated changes that were synchronized with the scalp EEG, influenced by anesthetic administration and the patient’s eye state (open/closed). Notably, the eEEG recorded potentials that were three to four times larger than those captured by the scalp EEG. All EP01 and SL10 devices were safely removed following the Wada test and EEG recordings, with no complications observed.
Conclusions:
The EP01 device enables the placement of multiple cerebrovascular electrodes within a single hemisphere, facilitating comprehensive EEG measurements. This advancement is anticipated to provide a less-invasive option for pinpointing epileptic foci, potentially improving the management and treatment of focal epilepsy.
Funding:
This research was funded test equipment was provided by Epsilon Medical Inc.