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Stereoelectroencephalography (SEEG) implantation using MRI-compatible electrodes is safe and effective for epilepsy surgery. This advanced technique aids in precise localization of the epileptogenic zone, even in MRI-negative cases.

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Area of Science:

  • Neurosurgery
  • Epileptology
  • Medical Imaging

Background:

  • Stereoelectroencephalography (SEEG) has been utilized at the Montreal Neurological Institute since 1972.
  • The SEEG technique has continuously evolved with advancements in imaging, robotics, and materials, including MRI-compatible electrodes (2007) and robotics (2011).

Purpose of the Study:

  • To report on the technique, safety, and advantages of the current SEEG implantation method.
  • To analyze technical, clinical, and radiological complications and postimplantation outcomes.

Main Methods:

  • Retrospective review of patients who underwent SEEG by the senior author.
  • Inclusion criteria: implantation with MRI-compatible electrodes.
  • Analysis of complications and outcomes, including MRI abnormalities with electrodes in situ.

Main Results:

  • 53 patients received 550 electrodes (average 10.4/patient) for 14.6 days.
  • No mortality, infection, or new neurologic deficits occurred.
  • Asymptomatic MRI abnormalities were observed in 7.54% of patients (0.72% per electrode); 2 patients had superficial screw issues without clinical impact.

Conclusions:

  • The described SEEG technique demonstrated no clinical morbidity, despite minor technical/radiological complications.
  • MRI-compatible electrodes facilitated neuronavigation, aiding resection tailoring and localization of MRI-negative lesions.
  • Continued refinement of SEEG is necessary to optimize electrode use for accurate epileptogenic zone identification.