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Depth Electrodes: Approaches and Complications 

Depth Electrodes: Approaches and Complications
Depth Electrodes: Approaches and Complications

Thomas Ostergard

, and Jonathan P. Miller

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date: 05 July 2020

Depth electrode placement is an invaluable technique in treating patients with refractory epilepsy. Like any neurosurgical operation, planning is the most important phase of the procedure. The seizure focus should first be grossly localized using data from scalp electrodes and seizure semiology. This gross localization will guide placement of invasive electrophysiological hardware. All electrode implantation methods rely on Talairach’s principles of stereotaxis. Traditional electrode implantation is performed with a stereotactic frame. Evolving techniques use frameless stereotaxy or neuroendoscopy for implantation. The most worrisome complication of electrode placement is electrode-associated intracranial haemorrhage. Electrode deviation is a much more common complication, which can be minimized by avoiding extreme insertion angles, minimizing intracranial electrode length, and maximizing entry point accuracy.

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