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Stereoelectroencephalography in Pediatric Epilepsy Surgery.
Samuel B Tomlinson1,2, Vivek P Buch3, Dallas Armstrong4
1Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Journal of Korean Neurosurgical Society
|May 16, 2019
Summary
Stereoelectroencephalography (SEEG) offers a safe and effective method for mapping epilepsy in children. This invasive technique provides detailed 3D views of the brain, aiding surgical decisions for refractory cases.
Area of Science:
- Neurosurgery
- Epileptology
- Medical Technology
Background:
- Medically refractory epilepsy requires precise localization of the epileptogenic zone.
- Stereoelectroencephalography (SEEG) is an invasive neurophysiological monitoring technique.
- SEEG offers advantages over traditional methods like subdural grids, including better coverage of deep brain structures and multilobar exploration.
Purpose of the Study:
- To review the indications, techniques, and safety of long-term SEEG monitoring in pediatric patients.
- To provide guidance for pediatric neurosurgeons transitioning to SEEG.
- To discuss SEEG-based interventions such as radiofrequency thermo-coagulation.
Main Methods:
- Review of current literature and clinical practices regarding SEEG in children.
- Discussion of the technical aspects of SEEG electrode placement and long-term monitoring.
- Analysis of safety data and morbidity profiles associated with pediatric SEEG.
Main Results:
- SEEG provides comprehensive 3D mapping of the epileptogenic zone and eloquent cortices.
- The technique has a favorable morbidity profile compared to other invasive methods.
- SEEG facilitates multilobar exploration without the need for craniotomy, improving deep structure coverage.
Conclusions:
- SEEG is a valuable tool for the surgical management of pediatric epilepsy.
- Understanding SEEG indications, techniques, and safety is crucial for pediatric neurosurgeons.
- SEEG enables precise pre-surgical evaluation and can guide therapeutic interventions.
