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O-036 Endovascular EEG: a new method for evaluation of intractable epilepsy using endovascular technique
  1. T Kodama,
  2. N Kaito,
  3. Y Murayama
  1. Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan


Introduction To evaluate epilepsy and syncope, detecting ictal EEG pattern is necessary. Prolonged video/EEG monitoring is required to identify the epileptogenic focus, but it often could not be detected In addition,surgical treatment for intractable epilepsy, especially temporal lobe epilepsy, has been well established and is therefore being applied frequently. However, clinicians remain reluctant to take this approach as the diagnostic process requires an invasive examination. In this research we developed a novel less invasive endovascular method, which could replace the invasive one.

Materials and methods 3 swine weighing 30–40 kg were used. General anesthesia was performed with 1%–2% isoflurane. After craniectomy, subdural electrodes were positioned, and endovascular electrodes were inserted from the femoral vein and advanced into the jugular vein under fluoroscopic guidance. Simultaneous recording with the subdural and endovascular electrodes was then performed.

Results ECoG could be recorded by the subdural electrodes. After the intravascular catheter was advanced to the mid portion of jugular vein, the intravenous endovascular EEG was very closely with the subdural one. In addition, the movement artifacts could be almost eliminated, and the background activity could also be determined.

Discussion Endovascular EEG varied according to the distance of the heart. ECG has a great influence on the measurement of endovascular EEG. It was assumed that a higher quality EEG could be obtained due to the distance of the heart. On the other hand, it was confirmed that by recording using monopolar derivation and a filter of ECG, intravenous endovascular EEG could be interpreted.

Conclusion By conducting intravenous endovascular electroencephalography in swine, it was possible to obtain high quality electroencephalograms equivalent to those recorded by subdural electrodes. Endovascular EEG could become a less invasive and more effective technique.

Disclosures T. Kodama: None. N. Kaito: None. Y. Murayama: None.

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