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Updated: Apr 25, 2026
Stereo-Electro-Encephalo-Graphy SEEG With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
Published on: June 13, 2016
A novel method for implementation of frameless StereoEEG in epilepsy surgery
Mark Nowell1, Roman Rodionov, Beate Diehl
1*Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom; ‡Epilepsy Society, MRI Unit, Chalfont St. Peter, United Kingdom; §Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom; ¶Centre of Medical Imaging and Computing, UCL, London, United Kingdom.
A new frameless stereoelectroencephalography (SEEG) technique offers a safe and effective method for epilepsy surgery planning. This approach accurately targets electrode placement, improving patient outcomes and surgical feasibility.
Area of Science:
- Neurosurgery
- Epileptology
- Medical Imaging
Background:
- Stereoelectroencephalography (SEEG) is a critical invasive diagnostic tool for epilepsy surgery.
- Traditional SEEG often relies on frame-based systems, which can be cumbersome.
Purpose of the Study:
- To introduce and evaluate a novel frameless SEEG technique.
- To report outcomes from a prospective single-center case series.
Main Methods:
- Preoperative planning involved specialized software for image integration and trajectory design.
- Electrode placement utilized frameless stereotaxy with percutaneous drilling and bolt insertion via a Medtronic S7 StealthStation.
Main Results:
- 187 electrodes were implanted in 22 patients, with 175 accurately reaching their neurophysiological targets.
- Four electrodes required repositioning due to extradural deflection; 8 had minor targeting deviations (mean 3.6 mm).
- The procedure was associated with one asymptomatic hemorrhage and no infections, enabling definitive resections in 16 patients.
Conclusions:
- Frameless SEEG represents a novel, safe, and clinically applicable method for SEEG implementation.
- This technique facilitates accurate electrode placement and is readily integrated into surgical practice.
