Türk Nöroşirürji Dergisi 2002 , Vol 12 , Num 2
Gülnihal KUTLU1, Ayşe KARATAŞ3, Semiha KURT1, Şebnem SOYSAL2, Ayşe SERDAROĞLU2, Erhan BİLİR1, Atilla ERDEM3
1Gazi Üniversitesi Tıp Fakültesi Nöroloji, Anabilim Dalı, Ankara
2Gazi Üniversitesi Tıp Fakültesi Pediatri Anablim Dalı, Ankara
3Ankara Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı, Ankara
Purpose: Although scalp video/EEG monitorization plays a major role in the selection of the patients for temporal lobe epilepsy surgery, invasive ictal EEG regarding is sometimes necessary to delineate epileptogenic areas in patients with intractable epilepsy.

Methods and Patients: Seven patients with temporal lobe epilepsy who had inconclusive noninvasive lateralizaling and localizing data was monitorized by using subdural strip electrode. All patients had scalp telemetred EEG's and subdural electrodes were placed according to the scalp EEG monitorization data. Three or more seizures with subdural strip electrodes were recorded.

Results: In five of seven cases one epileptogenic focus was determined. After that these patients underwent an anterior temporal lobectomy +amygdalohippocampectomy operation and all of them were seizure free in their follow up. Hippocampal selerosis was confined pathologically in three of five, one patient had neocartical gliosis and the other had hamartoma. Multifocal epilepsy was considered in one patient in whom one epileptogenic focus couldn't be localized. We recommended monitorization by using depth electrode to other patient, but she didn't accept this procedure. During subdural strip electrode recording no complication was seen.

Conclusions: Video/EEG monitoring with subdural strip electrode correctly localizes and lateralizes the epileptogenic focus in selected patients with temporal lobe epilepsy. This procedure has tolerable morbidity because of the usefullness to the patients if the focus is determined correctly, anterior temporal lobectomy is a good chance for these patients. Anahtar Kelimeler : Invazive monitorization, Subdural strip electrode