Journal
CLINICAL NEUROPHYSIOLOGY
Volume 132, Issue 5, Pages 1033-1040Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.clinph.2020.12.022
Keywords
Cortico-cortical evoked potential; Single-pulse electrical stimulation; Afterdischarge; Clinical seizure
Categories
Funding
- JSPS KAKENHI [15H05874, 17H05907, 17K16120, 18H02709, 18K19514]
- Japan Epilepsy Research Foundation
- Eisai Co., Ltd.
- NIHON KOHDEN CORPORATION
- Otsuka Pharmaceutical Co.
- UCB Japan Co., Ltd.
- Grants-in-Aid for Scientific Research [18K19514, 18H02709, 17K16120, 17H05907] Funding Source: KAKEN
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The study on 29 patients with intractable partial epilepsy undergoing CCEP recording showed that CCEP is a safe procedure, especially when used under the established protocol. The incidence of clinical seizures varied significantly between stimulation of seizure onset zone and non-seizure onset zone, highlighting the importance of caution in stimulating SOZ.
Objective: Cortico-cortical evoked potential (CCEP) by single-pulse electrical stimulation (SPES) is useful to investigate effective connectivity and cortical excitability. We aimed to clarify the safety of CCEPs. Methods: We retrospectively analyzed 29 consecutive patients with intractable partial epilepsy undergoing chronic subdural grid implantation and CCEP recording. Repetitive SPES (1 Hz) was systematically applied to a pair of adjacent electrodes over almost all electrodes. We evaluated the incidences of after discharges (ADs) and clinical seizures. Results: Out of 1283 electrode pairs, ADs and clinical seizures were observed in 12 and 5 pairs (0.94% and 0.39%, per electrode pair) in 7 and 3 patients (23.3% and 10.0%, per patient), respectively. Of the 18-82 pairs per patient, ADs and clinical seizures were induced in 0-4 and 0-3 pairs, respectively. Stimulating 4 SOZ (seizure onset zone) (2.5%) and 8 non-SOZ pairs (0.75%) resulted in ADs. We observed clinical seizures in stimulating 4 SOZ (2.5%) and 1 non-SOZ pair (0.09%). The incidence of clinical seizures varied significantly between SOZ and non-SOZ stimulations (p = 0.001), while the difference in AD incidence tended towards significance (p = 0.058). Conclusion: Although caution should be taken in stimulating SOZ, CCEP is a safe procedure for presurgical evaluation. Significance: CCEP is safe under the established protocol. (c) 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.
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