Evolution of SEEG Strategy: Stanford Experience

Area of Science:

• Neurology
• Neurosurgery
• Epileptology

Background:

• Stereoelectroencephalography (SEEG) presents a favorable risk profile and high patient tolerability.
• SEEG offers superior capability in investigating individualized 3-dimensional seizure onset activity compared to subdural electrodes.

Purpose of the Study:

• To highlight SEEG as the gold standard for phase II monitoring in epilepsy.
• To emphasize the role of SEEG in enabling advanced surgical approaches like multinuclear thalamic propagation mapping.
• To underscore the importance of SEEG for developing precision network-centric therapies for refractory epilepsy.

Main Methods:

• Utilizes stereoelectroencephalography (SEEG) for detailed intracranial EEG monitoring.
• Incorporates a novel surgical approach for multinuclear thalamic propagation mapping.
• Focuses on individualized 3-dimensional seizure onset localization.

Main Results:

• SEEG demonstrates a favorable risk profile and excellent patient tolerability.
• SEEG provides superior investigative capability for seizure onset activity compared to alternatives.
• Enables advanced mapping techniques crucial for complex epilepsy cases.

Conclusions:

• SEEG is established as the gold standard for phase II epilepsy monitoring at our institution.
• SEEG facilitates precision network-centric therapeutic approaches.
• SEEG is critical for managing medically refractory, multifocal, generalized, and surgically refractory epilepsy.