Intraoperative Ultrasound-Assisted 3D-Electrocorticography for resection of type II focal cortical dysplasias

IF 3.4 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology Pub Date : 2026-01-01 Epub Date: 2025-11-17 DOI:10.1016/j.clinph.2025.2111443

Giuseppe Didato , Nicolò Castelli , Chiara Pastori , Paola Lanteri , Ambra Dominese , Michele Introna , Rita Garbelli , Fabio Martino Doniselli , Gianluca Marucci , Elena Freri , Angelo Del Sole , Valeria Cuccarini , Francesco Deleo , Andrea Stabile , Roberta Di Giacomo , Francesca Ragona , Laura Rossini , Carla Carozzi , Massimiliano Del Bene , Vittoria Nazzi , Michele Rizzi

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引用次数: 0

Abstract

Objective

Type II focal cortical dysplasias (FCDII) present a clear-cut anatomo-electro-clinical profile and are associated with optimal surgical outcome when completely resected. Alongside presurgical planning and neuroimaging, intraoperative electrocorticography (ECoG) can aid in delineating FCDII boundaries. We report outcomes from patients undergoing FCDII resection using 3D-ECoG with an intracerebral electrode guided by intraoperative ultrasound (ioUS).

Methods

Patients with suspected FCDII underwent 3D-ECoG during surgery to record intracerebral interictal epileptiform discharges (IEDs) classified as: 1) rhythmic spikes (RS), and 2) periodic bursts of polyspikes (PBOP).

Results

Ten patients (5 male, 5 female; median age 19.5 years, median epilepsy duration 16 years) were included. Bottom-of-sulcus dysplasia (BOSD) was found in 60 %. 3D-ECoG identified RS in 30 % and PBOP in 70 %. Total IED removal was achieved in 60 %. Histopathology revealed FCDII in 80 %, while 20 % had a diagnosis of “no definite FCD on histopathology”. After a median 24-month follow-up, 90 % achieved ILAE class 1 outcome (seizure free), 10 % had class 2 (only auras). No major complications occurred.

Conclusions

IoUS-assisted 3D-ECoG is a safe procedure for intraoperative delineation of FCDII, supporting complete resection.

Significance

Integrating IoUS with 3D-ECoG can offer substantial benefits for surgical management of FCDII-related epilepsy.

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术中超声辅助3d皮质电成像切除II型局灶性皮质发育不良

目的II型局灶性皮质发育不良（FCDII）具有明确的解剖-电-临床特征，并与完全切除后的最佳手术结果相关。除了术前计划和神经成像外，术中皮质电图（ECoG）可以帮助划定FCDII边界。我们报告了术中超声（iou）引导下脑内电极3D-ECoG切除FCDII患者的结果。方法疑似FCDII患者术中行3D-ECoG记录脑内癫痫样间期放电（IEDs），分为：1)节律性尖峰（RS）和2)多尖峰周期性爆发（PBOP）。结果纳入患者10例，男5例，女5例，中位年龄19.5岁，中位癫痫持续时间16年。沟底发育不良（BOSD）占60%。3D-ECoG鉴定RS为30%，PBOP为70%。总IED清除率为60%。组织病理学检查显示FCDII的占80%，而20%的组织病理学诊断为“没有明确的FCD”。中位随访24个月后，90%达到ILAE 1级结果（无癫痫发作），10%达到2级结果（仅有先兆）。无重大并发症发生。结论辅助3D-ECoG是术中描绘FCDII的安全方法，支持完全切除。意义将借据与3D-ECoG相结合可以为fcdii相关癫痫的手术治疗提供实质性的好处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.