Beyond Stereo-EEG: Is It Worth Combining Stereo-EEG With Other Diagnostic Methods?

Area of Science:

• Neuroscience
• Epileptology
• Medical Imaging

Background:

• Stereo-electroencephalography (stereo-EEG) is crucial for presurgical epilepsy diagnosis.
• Its spatial coverage is limited, recording from less than 10% of brain activity.
• Understanding epileptic networks requires broader brain coverage.

Purpose of the Study:

• To explore how simultaneous recordings with other diagnostic methods enhance stereo-EEG.
• To overcome spatial limitations of stereo-EEG for improved diagnostic value.
• To better understand epileptic activity sources and network involvement.

Main Methods:

• Simultaneous recording of stereo-EEG with scalp EEG.
• Simultaneous recording of stereo-EEG with magnetoencephalography (MEG).
• Simultaneous recording of stereo-EEG with functional magnetic resonance imaging (fMRI).

Main Results:

• Scalp EEG aids in understanding large networks and seizure propagation.
• MEG offers precise source localization, including deep sources beyond stereo-EEG.
• fMRI reveals metabolic changes and widespread network alterations.

Conclusions:

• Integrating stereo-EEG with scalp EEG, MEG, and fMRI significantly improves diagnostic precision.
• Combined methods overcome stereo-EEG's spatial limitations for comprehensive epilepsy network analysis.
• This multimodal approach offers enhanced clinical and research applications for refractory epilepsy.