Abstract
Assessment of otherwise occult seizure foci arising from the anterior mesial temporal region occasionally necessitates placement of sphenoidal electrodes (SEs). This minimally invasive procedure is often performed without imaging guidance; however, more precise lead positioning with a reduced risk of complications has been described with fluoroscopic guidance. We describe the added value of rotational flat panel CT imaging for precise anatomic localization of the SE tip in relation to the foramen ovale.
Highlights
Conventional scalp electroencephalogram (EEG) electrode placement alone may be unable to detect basal temporal lobe ictal foci in 5%–10% of patients with temporal lobe epilepsy.[1]
We describe the use of rotational flat panel CT (RFPCT) for precise anatomic depiction of the sphenoidal electrodes (SEs) tip position
After obtaining informed consent and ensuring no history of coagulopathy, we placed each patient on the Axiom Artis biplane fluoroscopy table (Siemens, Erlangen, Germany) in the supine position
Summary
Conventional scalp electroencephalogram (EEG) electrode placement alone may be unable to detect basal temporal lobe ictal foci in 5%–10% of patients with temporal lobe epilepsy.[1] extended EEG monitoring of patients with refractory complex partial epilepsy occasionally necessitates the minimally invasive placement of sphenoidal electrodes (SEs).[2,3,4] Ideal positioning of the electrode tip is slightly anterior and lateral to foramen ovale (FO).[3,4] Whether electrodes are placed blindly or under fluoroscopic guidance, submentovertex radiographs are generally obtained to document tip position
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