Stereotactic depth electrode placement for chronic subthreshold cortical stimulation: surgical technique video

Area of Science:

• Neurosurgery
• Epilepsy Treatment
• Neuromodulation

Background:

• Medically intractable epilepsy often requires advanced treatment options beyond medication.
• Established neurostimulation trials like SANTE and RNS System have shown limitations in achieving seizure-free outcomes.
• Drug-resistant epilepsy involving the eloquent cortex presents unique therapeutic challenges.

Purpose of the Study:

• To describe the surgical technique for Chronic Subthreshold Cortical Stimulation (CSCS) placement.
• To detail the stimulation programming parameters for CSCS.
• To facilitate wider adoption of CSCS as a treatment for drug-resistant epilepsy.

Main Methods:

• Detailed description of the surgical procedure for CSCS implantation.
• Explanation of the programming strategies for chronic subthreshold cortical stimulation.
• Focus on techniques applicable to epilepsy involving the eloquent cortex.

Main Results:

• CSCS has demonstrated safety and efficacy in treating adult drug-resistant epilepsy.
• The described surgical and programming techniques are designed for successful CSCS implementation.
• This approach offers a viable alternative for patients unresponsive to other neurostimulation paradigms.

Conclusions:

• Chronic Subthreshold Cortical Stimulation (CSCS) is a safe and effective treatment for specific epilepsy cases.
• The detailed surgical and programming guidelines presented can aid clinicians in adopting CSCS.
• CSCS represents a significant advancement in managing drug-resistant epilepsy, especially when the eloquent cortex is involved.