title: Treatment of epilepsy with bipolar electro-coagulation: an analysis of cortical blood flow and histological change in temporal lobe.
abstract: BACKGROUND
  Bipolar electro-coagulation has a reported efficacy in treating epilepsy involving functional cortex by pure electro-coagulation or combination with resection. However, the mechanisms of bipolar electro-coagulation are not completely known. We studied the acute cortical blood flow and histological changes after bipolar electro-coagulation in 24 patients with intractable temporal lobe epilepsy.
  
  
  METHODS
  Twenty-four patients were consecutively enrolled, and divided into three groups according to the date of admission. The regional cortical blood flow (rCBF), electrocorticography, the depth of cortex damage, and acute histological changes (H and E staining, neuronal staining and neurofilament (NF) staining) were analyzed before and after the operation. The t-test analysis was used to compare the rCBF before and after the operation.
  
  
  RESULTS
  The rCBF after coagulation was significantly reduced (P < 0.05). The spikes were significantly reduced after electro-coagulation. For the temporal cortex, the depth of cortical damage with output power of 2-9 W after electro-coagulation was 0.34 ± 0.03, 0.48 ± 0.06, 0.69 ± 0.06, 0.84 ± 0.09, 0.98 ± 0.08, 1.10 ± 0.11, 1.11 ± 0.09, and 1.22 ± 0.11 mm, respectively. Coagulation with output power of 4-5 W completely damaged the neurons and NF protein in the molecular layer, external granular layer, and external pyramidal layer.
  
  
  CONCLUSIONS
  The electro-coagulation not only destroyed the neurons and NF protein, but also reduced the rCBF. We concluded that the injuries caused by electro-coagulation would prevent horizontal synchronization and spread of epileptic discharges, and partially destroy the epileptic focus.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Cui
authors.affiliation: Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China.
authors.forename: Guo-Ming
authors.initials: GM
authors.lastname: Luan
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.forename: Feng
authors.initials: F
authors.lastname: Zhai
authors.forename: Yu-Guang
authors.initials: YG
authors.lastname: Guan
authors.forename: Min
authors.initials: M
authors.lastname: Bao
mesh_terms: D000328:Adult; D004564:Electrocoagulation / Q000379:methods*; D004827:Epilepsy / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D013702:Temporal Lobe / Q000601:surgery*; D055815:Young Adult