Stereotactic Bony Trajectory Preservation for Responsive Neurostimulator Lead Placement Following Depth EEG Recording

Responsive neurostimulation (RNS) is rapidly gaining traction as a therapy for medically refractory epilepsy. Depth electrode placement for stimulation of a deep seizure focus may be indicated after the focus has been electrophysiologically localized using depth electroencephalography (depth EEG). We describe a simple technique whereby the bony trajectories created during initial stereotactic placement of depth EEG electrodes are preserved and reused for RNS with depth electrodes. This technique may help to improve targeting and maximize surgical efficiency.