Complications of invasive video-EEG monitoring with subdural grid electrodes

作者：Hajo M. Hamer, Harold H. Morris, Edward J. Mascha, Matthew Karafa, William E. Bingaman, Mark D. Bej, Richard C. Burgess, D. S. Dinner, N.R. Foldvary, Joseph F. Hahn, Prakash Kotagal, Imad Najm, Elaine Wyllie, Hans Otto Lüders · 发表于：Neurology · 年份：2002 · DOI：10.1212/wnl.58.1.97 · 被引用次数：291 · 研究领域：Neurosurgical Procedures and Complications、Epilepsy research and treatment、Cerebrospinal fluid and hydrocephalus

OBJECTIVE: To evaluate the risk factors, type, and frequency of complications during video-EEG monitoring with subdural grid electrodes. METHODS: The authors retrospectively reviewed the records of all patients who underwent invasive monitoring with subdural grid electrodes (n = 198 monitoring sessions on 187 patients; median age: 24 years; range: 1 to 50 years) at the Cleveland Clinic Foundation from 1980 to 1997. RESULTS: From 1980 to 1997, the complication rate decreased (p = 0.003). In the last 5 years, 19/99 patients (19%) had complications, including two patients (2%) with permanent sequelae. In the last 3 years, the complication rate was 13.5% (n = 5/37) without permanent deficits. Overall, complications occurred during 52 monitoring sessions (26.3%): infection (n = 24; 12.1%), transient neurologic deficit (n = 22; 11.1%), epidural hematoma (n = 5; 2.5%), increased intracranial pressure (n = 5; 2.5%), and infarction (n = 3; 1.5%). One patient (0.5%) died during grid insertion. Complication occurrence was associated with greater number of grids/electrodes (p = 0.021/p = 0.052; especially >60 electrodes), longer duration of monitoring (p = 0.004; especially >10 days), older age of the patient (p = 0.005), left-sided grid insertion (p = 0.01), and burr holes in addition to the craniotomy (p = 0.022). No association with complications was found for number of seizures, IQ, anticonvulsants, or grid localization. CONCLUSIONS: Invasive monitoring with grid electrodes was assoc...