J Korean Neurosurg Soc.  2019 May;62(3):302-312. 10.3340/jkns.2019.0015.

Stereoelectroencephalography in Pediatric Epilepsy Surgery

• Tomlinson
• Buch VP
• Armstrong
• Kennedy BC

• KMID: 2453235
• DOI: http://doi.org/10.3340/jkns.2019.0015

Abstract

Stereoelectroencephalography (SEEG) is an invasive technique used during the surgical management of medically refractory epilepsy. The utility of SEEG rests in its ability to survey the three-dimensional organization of the epileptogenic zone as well as nearby eloquent cortices. Once concentrated to specialized centers in Europe and Canada, the SEEG methodology has gained worldwide popularity due to its favorable morbidity profile, superior coverage of deep structures, and ability to perform multilobar explorations without the need for craniotomy. This rapid shift in practice represents both a challenge and an opportunity for pediatric neurosurgeons familiar with the subdural grid approach. The purpose of this review is to discuss the indications, technique, and safety of long-term SEEG monitoring in children. In addition to reviewing the conceptual and technical points of the diagnostic evaluation, attention will also be given to SEEG-based interventions (e.g., radiofrequency thermo-coagulation).

Keyword

Stereoelectroencephalography; Invasive monitoring; Epilepsy surgery; Pediatrics

MeSH Terms

Canada
Child
Craniotomy
Epilepsy*
Europe
Humans
Neurosurgeons
Pediatrics

Figure

• 

  Fig. 1. Stereoelectroencephalography (SEEG) procedure. A : The Robotic Stereotactic Assistant planning software (Zimmer Biomet, Warsaw, IN, USA), demonstrating a bitemporal SEEG plan in a patient for whom bitemporal subdural strips failed to adequately localize seizure onset. B : The robot arm moves into position for each electrode, and instruments are placed through an instrument holder on the robot arm to each stereotactic target. C : Intraoperative photograph of secured electrodes after implantation.

Reference

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