August 20, 2019

SMC Finds Method to Eliminate Certain Complications During Temporal Lobe Epilepsy Surgery

Researchers at Samsung Medical Center (SMC) have discovered that intraoperative motor-evoked potential (MEP) monitoring can eliminate the risk of postoperative motor deficits during temporal lobe epilepsy (TLE) surgery, the hospital said Friday.

Temporal lobe epilepsy surgery is an essential treatment for patients with refractory epilepsy, offering the opportunity to maximize seizure freedom as well as prevent untimely death. Although the temporal lobectomy is far from the motor nerve system, the operation can cause complications such as hemiplegia in 1 to 3 percent of patients who undergo surgery.

The SMC team, led by Professor Seo Dae-won, aimed to analyze whether MEP was effective in preventing complications.

The team compared postoperative neurological deficits in patients who underwent TLE surgery with or without transcranial MEPs combined with somatosensory evoked potential (SSEP) monitoring between January 1995 and June 2018.

The team performed the transcranial motor stimulation using subdermal electrodes and recorded the MEP responses in the four extremity muscles. Professor Seo made a decrease of more than 50 percent in the MEP or the SSEP amplitudes compared with baseline a warning criterion.

As a result, in the TLE surgery group without MEP monitoring, postoperative permanent motor deficits newly developed in seven of 613 patients, while no permanent motor deficit occurred in 279 patients who received transcranial MEP and SSEP monitoring.

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