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Updated: May 8, 2026

Stereo-Electro-Encephalo-Graphy (SEEG) With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
05:54

Stereo-Electro-Encephalo-Graphy (SEEG) With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note

Published on: June 13, 2016

Surgical treatment of refractory status epilepticus in children: clinical article

Sanjiv Bhatia1, Faiz Ahmad, Ian Miller

  • 1Departments of Neurological Surgery and.

Journal of Neurosurgery. Pediatrics
|August 27, 2013
PubMed

Insights

Surgery effectively controlled refractory status epilepticus (RSE) in patients, preventing complications and reducing intensive care needs. Imaging guided the surgical resection, leading to positive outcomes.

Area of Science:

  • Neurology
  • Neurosurgery
  • Epileptology

Background:

  • Refractory status epilepticus (RSE) presents a critical neurological emergency with significant morbidity and mortality.
  • Patients with RSE often require prolonged intensive care, increasing the risk of complications.
  • Surgical intervention offers a potential alternative to mitigate risks associated with prolonged seizures and intensive care.

Purpose of the Study:

  • To analyze the experience and outcomes of surgical management for patients with refractory status epilepticus.
  • To evaluate the efficacy of surgical intervention in controlling seizures and reducing intensive care unit (ICU) stay.
  • To assess the role of advanced imaging techniques in guiding surgical resection for RSE.

Main Methods:

  • A retrospective review of the Epilepsy Surgery Database at Miami Children's Hospital was conducted.
  • Data analyzed included clinical presentation, electrophysiological findings, radiological data, surgical details, and postoperative course for 15 patients.
  • Ictal SPECT and FDG-PET imaging were utilized in conjunction with intraoperative electrophysiological studies.

Main Results:

  • Fifteen patients underwent surgery for RSE, with a mean preoperative duration of 8 weeks.
  • Seizures were controlled in all patients post-surgery, facilitating ICU discharge.
  • While no operative mortality occurred, four patients experienced worsened neurological function (hemiparesis, dysphasia); sepsis and respiratory issues were noted ICU complications.

Conclusions:

  • Surgical intervention is an effective strategy for controlling refractory partial status epilepticus and reducing associated morbidity.
  • Surgery can decrease the duration of intensive care unit stays for RSE patients.
  • Ictal SPECT and PET imaging are valuable tools for guiding surgical resection in RSE management.
Abstract

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