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Related Experiment Videos

Stereo-EEG-guided radiofrequency thermocoagulations.

Massimo Cossu1, Francesco Cardinale1, Giuseppe Casaceli1

  • 1"Claudio Munari" Centre for Epilepsy Surgery, Department of Neuroscience, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

Epilepsia
|April 8, 2017
PubMed
Summary

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Stereo-electroencephalography (SEEG)-guided radiofrequency thermocoagulation (RF-TC) offers a new therapeutic option for difficult-to-treat focal epilepsy. This technique precisely targets the epileptogenic zone, providing an alternative for patients ineligible for resective surgery.

Area of Science:

  • Neurosurgery
  • Epileptology
  • Medical Technology

Background:

  • Stereotactic ablative procedures using radiofrequency thermocoagulation (RF-TC) have a long history in epilepsy treatment.
  • Modern imaging and stereo-electroencephalography (SEEG) have revitalized RF-TC by enabling precise targeting of the epileptogenic zone (EZ).
  • Focal epilepsy that is difficult to treat presents significant therapeutic challenges.

Purpose of the Study:

  • To describe the rationale and surgical technique of SEEG-guided RF-TC for treating the EZ in focal epilepsy.
  • To detail the application of this technique, particularly in pediatric patients.
  • To present SEEG-guided RF-TC as a viable therapeutic option.

Main Methods:

  • Utilizing SEEG for accurate identification and localization of the EZ through stereotactic implantation of intracerebral electrodes.
Keywords:
Drug-resistant epilepsyEpileptogenic zoneRadiofrequency thermocoagulationSeizure outcomeStereo-electroencephalographyStereotactic surgery

Related Experiment Videos

  • Employing the same SEEG electrodes for performing RF-TC lesions within the identified EZ.
  • Describing technical details of SEEG implantation and the RF-TC procedure, including pediatric considerations.

    • Main Results:

    • SEEG-guided RF-TC provides robust electroclinical evidence for treating the EZ.
    • The procedure offers an acceptable risk-benefit profile and cost-effectiveness.
    • It serves as a therapeutic option for patients unsuitable for resective surgery and an alternative for a subset of operable patients.

    Conclusions:

    • SEEG-guided RF-TC is a valuable therapeutic strategy for select patients with difficult-to-treat focal epilepsy.
    • The technique leverages advanced neuroimaging and electrophysiological monitoring for precise lesioning.
    • It expands treatment possibilities for refractory epilepsy, including in pediatric populations.