Accuracy Of Electrodes Implantation Sites During SINO-Robot Guided SEEG Electrodes Implantation

Objectives:The latest epidemiological study indicates that the prevalence of epilepsy in Chinese population is about 3-10‰,among which about 30% to 40% of the patients are drug-resistant epilepsy.Accurate locating and destroying epileptogenic foci are the main methods to treat drug-resistant epilepsy.Previously,non-invasive methods such as clinical manifestations,neuroimaging examination and scalp electroencephalogram can be used to locate the intracranial epileptic foci in epileptic.According to literatures,the non-invasive localization method can only preliminarily locate the epileptic lesions in about 70% of patients,and cannot accurately locate the anatomical location of the epileptic lesions,let alone accurately locate it in 3-D.So SEEG(stereoelectroencephalogram)is used to further positioning intracranial epileptic foci in recent years.SEEG can provide enough EEG information to accurately locate epileptogenic foci in three 3-D.Therefore,a reasonable " Clinical symptoms-brain electrophysiology-brain anatomy " model can be constructed according to the epileptic foci and its transmission pathway of epileptic seizures.A variety of stereotactic devices can guide SEEG electrode implantation safely and accurately.SINO-robot as a new clinical stereotactic navigation device,there is no research at home and abroad to summarize the accuracy and safety of SINO-robot guided SEEG electrode implantation sites in drug resistance epileptic.Contents:This study retrospectively studied the results of single center SEEG electrodes implantation in drug resistance epileptic under the guidance of SINO-robot.This study mainly analyzed and summarized the accuracy of the SEEG electrodes implantation sites guided by SINO-robot in our center.Methods:From June 2018 to January 2020,20 consecutive patients with drug-resistant epilepsy were selected.Twenty SEEG electrode implantation operations were successfully performed under the guidance of SINO-robot.Demographic data,clinical history,imaging data,preoperative electrode trajectory plan,and postoperative imaging review results were collected.Images fusion are performed between the preoperative planned trajectories of the electrodes and the actual postoperative position of the electrodes.The Euclidean distance between the planned entry points or the planned target points and the actual entry points or the actual target points are calculated as the error value of the implantation site.After successful localizing epileptogenic foci based on SEEG results,the foci were surgically removed or treated with radiofrequency thermocoagulation.Patients were followed up to observe the status of seizures.Results:A total of 209 SEEG electrodes were implanted in 20 patients from June 2018 to January 2020 with an average of 10.45(range: 6-16)leads per patient.The mean operating time per lead is 11.37±2.23 min(range:7.04-21.36min).Mean error(Euclidean distance):the entry point localization errors is 1.04 mm ±0.240mm(range:0.32-1.63 mm)and the target point localization errors is 1.62±0.40mm(range:0.83-2.61min).In our series,all patients have positive feedback,and75.00%(15/20)of patients achieving an Engel class I of seizure freedom with Follow-up was at least 3 months.One patient developed an acute epidural hematoma after surgery.The patient had no obvious clinical manifestations and the hematoma absorbed by itself.No late complications or mortality were reported in this cohort.Conclusions:In this study,the SINO-robot can accurately guide the SEEG electrode implantation site localization.