Robotic image-guided depth electrode implantation in the evaluation of medically intractable epilepsy.
OBJECTIVE
The authors describe their experience with a technique for robotic implantation of depth electrodes in patients concurrently undergoing craniotomy and placement of subdural monitoring electrodes for the evaluation of intractable epilepsy.


METHODS
Patients included in this study underwent evaluation in the Dartmouth Surgical Epilepsy Program and were recommended for invasive seizure monitoring with depth electrodes between 2006 and the present. In all cases an image-guided robotic system was used during craniotomy for concurrent subdural grid electrode placement. A total of 7 electrodes were placed in 4 patients within the time period.


RESULTS
Three of 4 patients had successful localization of seizure onset, and 2 underwent subsequent resection. Of the patients who underwent resection, 1 is now seizure free, and the second has only auras. There was 1 complication after subpial grid placement but no complications related to the depth electrodes.


CONCLUSIONS
Robotic image-guided placement of depth electrodes with concurrent craniotomy is feasible, and the technique is safe, accurate, and efficient.
Spire
William J
WJ
Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, One MedicalCenter Drive, Lebanon, New Hampshire 03756, USA. William.Spire@Hitchcock.org
Jobst
Barbara C
BC
Thadani
Vijay M
VM
Williamson
Peter D
PD
Darcey
Terrance M
TM
Roberts
David W
DW