Lumbar cerebral spinal fluid drainage during long-term electrocorticographic monitoring with subdural strip electrodes: elimination of cerebral spinal fluid leak.

We performed this study to determine the efficacy of continuous lumbar cerebral spinal fluid (CSF) drainage in controlling CSF leak during subdural strip electrode monitoring of epilepsy patients. Subdural strip electrodes were placed in 14 patients. In seven patients, a lumbar sub-arachnoid catheter was placed for continuous CSF drainage. In seven patients, no lumbar drain was placed. The duration of scalp CSF leak during strip electrode monitoring was significantly reduced in patients undergoing lumbar CSF drainage compared to those without lumbar drains (chi 2 = 40.9, P < 0.05). In one patient spinal headache developed which resolved with lumbar drain removal. Lumbar drainage eliminates scalp CSF leakage and can improve patient comfort. This technique should be further studied to determine if it reduces infection risk during long-term invasive monitoring.