Utilizing neuronavigation for virtual electrode representation and safe resection following SEEG; a technical report.

Area of Science:

• Neurosurgery
• Epilepsy Management
• Medical Imaging

Background:

• Epilepsy resection is effective but underutilized.
• Stereoelectroencephalography (SEEG) offers a better risk profile than subdural grids for invasive monitoring.
• Planning delayed resections after SEEG electrode removal presents a challenge.

Observation:

• A novel technique utilizes neuronavigation for virtual visualization of previously removed SEEG electrodes.
• Co-registration of intraoperative monitoring imaging with post-explantation imaging allows for precise electrode localization.
• Accuracy of the virtual electrode representation was confirmed by physical examination of surgical scars.

Findings:

• The developed technique successfully enabled intraoperative neuronavigation for virtual SEEG electrode representation.
• This method provides a reliable way to guide cortical, non-lesional epilepsy resections following SEEG monitoring.
• The technique proved accurate and easily verifiable, facilitating anatomically guided resections.

Implications:

• This technique can serve as a valuable adjunct for epilepsy resections planned after SEEG.
• By simplifying post-SEEG resection planning, it may encourage wider adoption of SEEG in epilepsy centers.
• Improved planning and visualization can enhance the safety and efficacy of epilepsy surgery.