Mapping the Central Sulcus Extraoperatively Using Stereoelectroencephalography: A New Application of an Established...

Area of Science:

• Neurosurgery
• Neurophysiology
• Pediatric Neurology

Background:

• Intraoperative central sulcus localization is crucial for neurosurgical procedures.
• Current methods often rely on intraoperative techniques with subdural electrodes.
• Extraoperative localization using stereoelectroencephalography (SEEG) has not been previously documented.

Purpose of the Study:

• To describe a novel extraoperative method for central sulcus localization.
• To utilize stereoelectroencephalography (SEEG) for mapping sensorimotor cortices.
• To establish a new technique for pre-surgical planning in pediatric epilepsy.

Main Methods:

• Investigated six pediatric patients (aged 12-18 years) using SEEG.
• Performed peripheral median and posterior tibial nerve stimulation.
• Recorded somatosensory evoked potentials (SEPs) from SEEG electrodes.

Main Results:

• Successfully localized the central sulcus using SEEG-derived SEPs.
• The localization was validated and supplemented by cortical stimulation data.
• Demonstrated the feasibility of SEEG for mapping the central sulcus in pediatric patients.

Conclusions:

• This is the first report of SEEG-derived SEPs in primary motor and sensory cortices.
• The novel method provides valuable data for safe surgical resection in eloquent cortex.
• SEEG offers a promising tool for precise pre-surgical mapping and planning.