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Mean amplitude and standard error of sphenoidal (Sp1/ Sp2), peri-orbital (SOL and IOM), anterior temporal (F7/ F8), frontal (F3/ F4), frontopolar (Fp1/ Fp2), and ear electrodes (A1/ A2). Mean amplitude of sphenoidal electrode is greatest. There is no statistical difference between Sp1/2, F7/8, SOL, and IOM (*: P < 0.1, **: P < 0.05). Sp: sphenoidal electrode; SOL: superior orbital lateral electrode; IOM: inferior orbital medial electrode
Source publication
Objective: The feasibility of peri-orbital electrodes, which are not invasive and do not induce pain, as a supplemental electrode for detection of ictal discharges in medial temporal lobe epilepsy (MTLE) was examined. Methods: Patients with MTLE, who underwent video-EEG monitoring with simultaneous peri-orbital and sphenoidal electrodes and obtaine...
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Citations
... However, extracranial detection of electroencephalographic (EEG) activity from the mesial temporal lobe is sometimes difficult to detect with standard surface electrodes placed according to the international 10-20 EEG system, such as F7/F8 and A1/A2, because the conduction of deep brain activity is easily attenuated by the skull. [3,4,10] A sphenoidal (Sp) electrode technique has been developed and is widely used to monitor epileptiform discharges in the mesial temporal lobe through the foramen ovale. [3,4,10] e Sp electrode is inserted beneath the zygomatic arch, and the electrode tip is usually placed at an anteroventral position within the basal temporal region. ...
... [3,4,10] A sphenoidal (Sp) electrode technique has been developed and is widely used to monitor epileptiform discharges in the mesial temporal lobe through the foramen ovale. [3,4,10] e Sp electrode is inserted beneath the zygomatic arch, and the electrode tip is usually placed at an anteroventral position within the basal temporal region. e drawback is that the insertion of the Sp electrode is often associated with pain. ...
... e drawback is that the insertion of the Sp electrode is often associated with pain. [5] To overcome this, we [10] previously developed periorbital electrodes, which are noninvasive and do not induce pain, and demonstrated that periorbital electrode recording can detect the ictal discharges in the mesial temporal lobe as effectively as the Sp and standard temporal surface electrodes, including the T1/T2 electrodes of Silverman. [11] Although the periorbital electrode recordings are rarely obscured by muscle activity, unlike other standard temporal surface electrodes, they are disturbed by eye movement. ...
Background
We previously demonstrated the usefulness of periorbital electrodes in supplemental recording to detect epileptiform discharges in patients with mesial temporal lobe epilepsy (MTLE). However, eye movement may disturb periorbital electrode recording. To overcome this, we developed mandibular (MA) and chin (CH) electrodes and examined whether these electrodes could detect hippocampal epileptiform discharges.
Methods
This study included a patient with MTLE, who underwent insertion of bilateral hippocampal depth electrodes and video-electroencephalographic (EEG) monitoring with simultaneous recordings of extra- and intracranial EEG as part of a presurgical evaluation. We examined 100 consecutive interictal epileptiform discharges (IEDs) recorded from the hippocampus and two ictal discharges. We compared these IEDs from intracranial electrodes with those from extracranial electrodes such as MA and CH electrodes in addition to F7/8 and A1/2 of international EEG 10-20 system, T1/2 of Silverman, and periorbital electrodes. We analyzed the number, rate of laterality concordance, and mean amplitude of IEDs detected in extracranial EEG monitoring and characteristics of IEDs on the MA and CH electrodes.
Results
The MA and CH electrodes had nearly the same detection rate of hippocampal IEDs from other extracranial electrodes without contamination by eye movement. Three IEDs, not detected by A1/2 and T1/2, could be detected using the MA and CH electrodes. In two ictal events, the MA and CH electrodes detected the ictal discharges from the hippocampal onset as well as other extracranial electrodes.
Conclusion
The MA and CH electrodes could detect hippocampal epileptiform discharges as well as A1/A2, T1/T2, and peri-orbital electrodes. These electrodes could serve as supplementary recording tools for detecting epileptiform discharges in MTLE.
