| The Influence of Calvarial Thickening in Epilepsy Patients on Deep Brain Stimulation |
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Min Seung Myung, Kyung Rae Cho, Jae Geon Jung, Young Min Shon, Jung-Il Lee |
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Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea Department of Neurology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea |
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| Abstract |
Objective
Deep brain stimulation (DBS) has been applied on the wide range of movement disorders. Recently, application of DBS to epilepsy has shown an acceptable outcome. In epilepsy patients, calvarial thickening is a well-known phenomenon. This phenomenon is a bothersome point in conducting DBS surgery due to its technical difficulty to drill a burr hole in the precise coaxial trajectory of the DBS lead and it often requires additional drilling. In this study we focus on the skull thickness of epilepsy patients, compared it to movement disorder patients to prognosticate technical difficulties of DBS on epilepsy patients.
Methods
21 patients who underwent DBS surgery from Nov. 2017 to Sep. 2018 in Samsung Medical Center were included. Direct measurement during operation with a Vernier caliper was used to obtain each individual patient's skull thickness. Patients were divided into two subgroups depending on the patient's disease entity. SPSS was used for statistical data analysis.
Results
Six epilepsy patients and 15 movement disorder patients were identified. The contrast of patient-related factors between two groups was not significant, except for skull thickness. The skull of the epilepsy patient group were significantly thicker than in the movement disorder patient group (p=0.049). Skull thickness was not affected by sex and age. The mean difference of skull thickness between the epilepsy and movement disorder group was 0.3cm. In the epilepsy patient group, there was a tendency in which the skull thickness increases in patients with longer duration of antiepileptic drug (AED) use.
Conclusions
Calvarial thickening is a known phenomenon frequently observed in epilepsy patients. Therefore, when DBS is performed in epilepsy patients, a thick skull should be considered prior to surgery to avoid additional surgical complications. |
| Key Words:
Deep brain stimulation, Skull thickness, Epilepsy. |
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