Preoperative MRI findings and prediction of diagnostic utility of foramen ovale electrodes
OBJECTIVE
Foramen ovale electrodes (FOEs) are a minimally invasive method to localize mesial temporal seizures in cases in which noninvasive methods are inconclusive. The objective of this study was to identify factors predicting the ability of FOEs to yield a diagnosis in order to determine optimal candidates for this procedure.
METHODS
All cases of diagnostic investigations performed with FOEs at the authors’ institution between 2005 and 2017 were reviewed. FOE investigation was defined as diagnostic if it led to a treatment decision. Demographic and clinical variables for diagnostic and nondiagnostic investigations were compared using a Wilcoxon rank-sum test for continuous variables and Fisher’s exact test for categorical variables.
RESULTS
Ninety-three patients underwent investigations performed with FOEs during the study period and were included in the study. FOE investigation was diagnostic in 75.3% of cases. Of patients who underwent anterior temporal lobectomy following diagnostic FOE evaluation, 75.9% were Engel class I at last follow-up (average 40.1 months). When the diagnostic and nondiagnostic FOE groups were compared, patients who had diagnostic investigations were more likely to be male (57.1% male vs 26.1% in the nondiagnostic group, p = 0.015). They were also more likely to have temporal lesions on preoperative MRI (p = 0.018).
CONCLUSIONS
FOEs are a useful, minimally invasive diagnostic modality resulting in a treatment decision in 75% of cases. Male patients and patients with temporal lesions on MRI may be most likely to benefit from FOE investigation.
ABBREVIATIONS
ATL = anterior temporal lobectomy; FOE = foramen ovale electrode.An artists depiction of a proposed method to deliver endovascular care via a teleoperated robot in space. A patient located on a satellite orbiting the Earth is undergoing a telesurgical endovascular intervention via the CorPath device. Real-time angiography images are beamed back to Earth, where an operator (in this case, a humanoid robot) is controlling the robot over a long distance. Copyright Gavin W. Britz. Published with permission. See the article by Panesar et al. (pp 971–978).
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