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Iatrogenic seizures during intracranial EEG monitoring
Author(s) -
Khoury Julie A.,
Noe Katherine H.,
Drazkowski Joseph F.,
Sirven Joseph I.,
Zimmerman Richard S.
Publication year - 2011
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2011.03161.x
Subject(s) - subclinical infection , medicine , electroencephalography , edema , epilepsy , cerebral edema , magnetic resonance imaging , epilepsy surgery , anesthesia , complication , surgery , radiology , psychiatry
Summary Cerebral edema with declining neurologic status is a known complication of intracranial electroencephalography (EEG) monitoring. The frequency and consequences of iatrogenic edema that is not clinically evident are presently poorly defined. We investigated the potential for intracranial electrodes to cause subclinical cerebral edema, and for such edema to cause iatrogenic seizures. In a retrospective review of 33 adults who had head magnetic resonance imaging (MRI) while undergoing epilepsy surgery evaluation with intracranial EEG, 28% (6 of 21) depth electrode implantations had subclinical vasogenic edema. Of these, 50% (3 of 6) had nonhabitual electrographic seizures that appear to result from iatrogenic edema. No long‐term adverse sequelae were noted, however, if unrecognized, iatrogenic seizures could lead to unnecessary exclusion from definitive surgical intervention for refractory epilepsy.