The Impact of Increasing Depth Electrodes Transversing the Temporalis Muscle on Seizure Monitoring
Abstract number :
2.11
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2024
Submission ID :
961
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Keaton Piper, MD – University of South Florida
Elliot Neal, MD – University of South Florida
Emma Dunn, BS – University of South Florida
Adam Alayli, BS – University of South Florida
Zeegan George, MD – University of South Florida
Jay kumar, MD – University of South Florida Neurosurgery
Yarema Bezchlibnyk, MD PhD – University of South Florida
Rationale: Seizure monitoring through depth electrodes is a vital tool in evaluating and managing epilepsy, often termed Long Term Monitoring (LTM). However, to achieve adequate coverage of the epileptic network, which often involves the temporal lobes, electrodes are placed traversing the temporalis muscle. Increased density of depth electrodes in the temporalis has been hypothesized to be related to increased pain scores due to the pain associated with mastication during long-term epilepsy monitoring. This study explores the repercussions of increasing electrode density in the temporalis on patient outcomes.
Methods: Between 2018 and 2022, sixty patients underwent long-term epilepsy monitoring with depth electrodes, with an average of 15 days implanted (range: 4-60). These patients were retrospectively queried for visual analogue scale (VAS) pain scores, patient-reported satisfaction, seizure capture, outcome of LTM, early termination of LTM, and ultimately seizure freedom.
Results: In this study, five patients were terminated early, two of whom reported excruciating pain over the temporalis. Among the patients who were terminated early, there was an average of 14 electrodes traversing the temporalis compared to 11 temporalis-transversing electrodes in those who completed their full LTM. While further data is being collected, visual analogue scale pain scores were significantly higher in those patients who terminated LTM early. All patients who had early termination of LTM were further managed with antiseizure medications or had a vagus nerve stimulator placed; none were candidates for intracranial ablative, resection, or neuromodulation surgery.
Conclusions: These findings underscore the importance of carefully considering electrode density in temporalis muscle implantations to optimize both short-term safety and long-term efficacy in seizure evaluation.
Funding: none
Neurophysiology