Efficacy and safety of a new robot‑assisted stereotactic system for radiofrequency thermocoagulation in patients with temporal lobe epilepsy

Wu,Zhaohui; Zhao,Quanjun; Tian,Zengmin; Zhang,Jianning; Xiao,Xia; Lin,Hong; Wang,Hong; Wang,Fuli

doi:10.3892/etm.2014.1620

Efficacy and safety of a new robot‑assisted stereotactic system for radiofrequency thermocoagulation in patients with temporal lobe epilepsy

Authors:
- Zhaohui Wu
- Quanjun Zhao
- Zengmin Tian
- Jianning Zhang
- Xia Xiao
- Hong Lin
- Hong Wang
- Fuli Wang
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Affiliations: Department of Neurosurgery, Navy General Hospital of People's Liberation Army, Beijing 100048, P.R. China
Published online on: March 12, 2014 https://doi.org/10.3892/etm.2014.1620
Pages: 1728-1732

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Abstract

The aim of the present study was to evaluate the efficacy and safety of a newly developed robot‑assisted frameless stereotactic system for deep electrode implantation and radiofrequency thermocoagulation (RFTC). Deep‑electrode implantation was performed in the bilateral mesial temporal lobes of seven patients. Following the implantation of the deep electrodes through the monitored designed path, the epileptogenic zones were determined with the assistance of a robot system. Deep electrode electroencephalograms were recorded prior to and following RFTC. Treatment outcomes were evaluated by computed tomography scans and Engel classification criteria. The procedure was well tolerated by all patients with no patients suffered from severe permanent complications. After follow‑ups for 34‑62 months, four patients achieved Engel class I, including three patients with Ia classification, two patients were classified as Engel class IVa and one patient was classified as Engel class IVc. Therefore, robot‑assisted frameless stereotaxy for deep electrode implantation and RFTC is indicated to be a safe and effective method that may be used effectively in clinical practice.

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1	DuanYu N, GuoJun Z, Liang Q, LiXin C, Tao Y and YongJie L: Surgery for perirolandic epilepsy: Epileptogenic cortex resection guided by chronic intracranial electroencephalography and electric cortical stimulation mapping. Clin Neurol Neurosurg. 112:110–117. 2010. View Article : Google Scholar
2	Rosenow F and Lüders H: Presurgical evaluation of epilepsy. Brain. 124:1683–1700. 2001. View Article : Google Scholar : PubMed/NCBI
3	Koizuka S, Saito S, Tobe M, Sekimoto K, Obata H and Koyama Y: Technical communication: percutaneous radiofrequency mandibular nerve rhizotomy guided by high-speed real-time computed tomography fluoroscopy. Anesth Analg. 111:763–767. 2010. View Article : Google Scholar
4	Nakajima K, Koizuka S, Yanagisawa A and Saito S: Radiofrequency thermocoagulation of the thoracic nerve root guided by high-speed real-time computed tomography fluoroscopy. Anaesthesia. 67:675–676. 2012. View Article : Google Scholar : PubMed/NCBI
5	Malikova H, Liscak R, Vojtech Z, et al: Stereotactic radiofrequency amygdalohippocampectomy: does reduction of entorhinal and perirhinal cortices influence good clinical seizure outcome? Epilepsia. 52:932–940. 2011. View Article : Google Scholar
6	Allen SJ and Sidebotham DA: Seizures and shock after radiofrequency ablation for atrial fibrillation. J Cardiothorac Vasc Anesth. 24:716–718. 2010. View Article : Google Scholar : PubMed/NCBI
7	Bancaud J and Talairach J: Methodology of stereo EEG exploration and surgical intervention in epilepsy. Rev Otoneuroophtalmol. 45:315–328. 1973.(In French).
8	Guénot M, Isnard J, Ryvlin P, Fischer C, Mauguière F and Sindou M: SEEG-guided RF thermocoagulation of epileptic foci: feasibility, safety, and preliminary results. Epilepsia. 45:1368–1374. 2004.PubMed/NCBI
9	Catenoix H, Mauguière F, Guénot M, et al: SEEG-guided thermocoagulations: a palliative treatment of nonoperable partial epilepsies. Neurology. 71:1719–1726. 2008. View Article : Google Scholar : PubMed/NCBI
10	Engel J Jr: Clinical neurophysiology, neuroimaging, and the surgical treatment of epilepsy. Curr Opin Neurol Neurosurg. 6:240–249. 1993.PubMed/NCBI
11	Eljamel MS: Robotic application in epilepsy surgery. Int J Med Robot. 2:233–237. 2006. View Article : Google Scholar
12	Spire WJ, Jobst BC, Thadani VM, Williamson PD, Darcey TM and Roberts DW: Robotic image-guided depth electrode implantation in the evaluation of medically intractable epilepsy. Neurosurg Focus. 25:E192008. View Article : Google Scholar : PubMed/NCBI
13	Centeno RS, Yacubian EM, Caboclo LO, Júnior HC and Cavalheiro S: Intracranial depth electrodes implantation in the era of image-guided surgery. Arq Neuropsiquiatr. 69:693–698. 2011. View Article : Google Scholar : PubMed/NCBI
14	Bell B, Gerber N, Williamson T, et al: In vitro accuracy evaluation of image-guided robot system for direct cochlear access. Otol Neurotol. 34:1284–1290. 2013. View Article : Google Scholar : PubMed/NCBI
15	Alarcon G, Binnie CD, Elwes RD and Polkey CE: Power spectrum and intracranial EEG patterns at seizure onset in partial epilepsy. Electroencephalogr Clin Neurophysiol. 94:326–337. 1995. View Article : Google Scholar : PubMed/NCBI
16	Park YD, Murro AM, King DW, Gallagher BB, Smith JR and Yaghmai F: The significance of ictal depth EEG patterns in patients with temporal lobe epilepsy. Electroencephalogr Clin Neurophysiol. 99:412–415. 1996. View Article : Google Scholar : PubMed/NCBI
17	Guénot M, Isnard J, Ryvlin P, et al: Neurophysiological monitoring for epilepsy surgery: the Talairach SEEG method. Stereoelectroencephalography Indications, results, complications and therapeutic applications in a series of 100 consecutive cases. Stereotact Funct Neurosurg. 77:29–32. 2001.
18	Guenot M and Isnard J: Multiple SEEG-guided RF-thermolesions of epileptogenic foci. Neurochirurgie. 54:441–447. 2008.(In French).
19	Elliott RE, Morsi A, Geller EB, Carlson CC, Devinsky O and Doyle WK: Impact of failed intracranial epilepsy surgery on the effectiveness of subsequent vagus nerve stimulation. Neurosurgery. 69:1210–1217. 2011. View Article : Google Scholar : PubMed/NCBI
20	Malikova H, Vojtech Z, Liscak R, et al: Stereotactic radiofrequency amygdalohippocampectomy for the treatment of mesial temporal lobe epilepsy: correlation of MRI with clinical seizure outcome. Epilepsy Res. 83:235–242. 2009. View Article : Google Scholar
21	Kameyama S, Murakami H, Masuda H and Sugiyama I: Minimally invasive magnetic resonance imaging-guided stereotactic radiofrequency thermocoagulation for epileptogenic hypothalamic hamartomas. Neurosurgery. 65:438–449. 2009. View Article : Google Scholar
22	Schmitt FC, Voges J, Buentjen L, et al: Radiofrequency lesioning for epileptogenic periventricular nodular heterotopia: a rational approach. Epilepsia. 52:e101–e105. 2011. View Article : Google Scholar : PubMed/NCBI