The role of ROSA navigated intracranial electrode implantation technique on precise epileptogenic zone localization

Objective To evaluate the application of robotized stereotactic assistant(ROSA) navigated intracranial electrode implantation in precise epileptogenic zone localization. Methods The data of 40 patients with drug-resistant epilepsy in Beijing Sanbo Brain Hospital from March 2012 to September 2013 who underwent ROSA navigated implantation of intracranial electrode for localization of epileptogenic zone were collected. The demographics, noninvasive clinical data, complications and seizure outcomes after surgical resection were prospectively collected and analyzed. Results Thirty-nine patients proceeded video-electroencephalography (V-EEG) without distraction. 1 patient experienced intracranial hemorrhage caused by the implantation. The electrodes were preserved for 4-34 days (mean 11.4 days), and 2-38 clinical seizures were observed with a mean of 9.9. There was no cerebrospinal fluid leak, intracranial hematoma, electrodes fracture or patient death. There was 1 scalp infection. From the studied group of 39 patients, the area of seizure onset could be localized in 37 patients. 32 patients underwent surgical resection following stereo-electroencephalography (SEEG) evaluation and were followed-up for more than 6 months. In the group of 32 patients, 27 patients were reached EngelⅠclass, 2 EngelⅡ, 1 Engel Ⅲ and 2 Engel Ⅳ. Conclusions For intractable epilepsy, when non-invasive assessments couldn′t find the epileptogenic foci, intracranial electrode implantation combined with long-term V-EEG was an effective method to localize the epileptogenic foci, especially the ROSA navigated stereotactic electrode implantation, which was a microinvasive, short-time, less-complication, safe-guaranteed and precise technique. Key words: Epilepsy; Intracranial electrode; Electroencephalography; Robotized stereotactic assistant