Optimized SEEG-guided three-dimensional radiofrequency thermocoagulation for insular epilepsy

Area of Science:

• Neurosurgery
• Epileptology
• Medical technology

Background:

• Drug-resistant epilepsy, particularly insular epilepsy, poses significant treatment challenges.
• Traditional resection surgery carries high risks, necessitating exploration of alternative therapies.

Purpose of the Study:

• To present the protocol for Stereo-electroencephalography-guided three-dimensional radiofrequency thermocoagulation (SEEG-3D RFTC).
• To investigate the efficacy and safety of SEEG-3D RFTC as a treatment for drug-resistant insular epilepsy.

Main Methods:

• Ten patients with insular epilepsy underwent SEEG electrode implantation targeting the insula.
• SEEG-3D RFTC was performed between electrode contacts to ablate epileptogenic foci.
• The study was a preliminary observational investigation.

Main Results:

• All surgical procedures were well tolerated with no long-term complications.
• Seven patients (70%) achieved seizure freedom (ILAE I-II).
• A 100% responder rate (ILAE I-IV) was observed across all participants.

Conclusions:

• Optimized SEEG-3D RFTC is an effective and safe treatment modality.
• This technique offers a promising alternative for managing drug-resistant insular epilepsy.