Stereoelectroencephalography-guided radiofrequency thermocoagulation

Area of Science:

• Neurosurgery
• Epileptology
• Neurology

Background:

• Stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-RFTC) is a neurosurgical technique for epilepsy management.
• It offers a versatile approach with potential for curative, diagnostic, and palliative outcomes.

Purpose of the Study:

• To evaluate the efficacy and applications of SEEG-RFTC in managing epilepsy.
• To highlight its role in targeting ictal onset zones and epileptic networks.

Main Methods:

• The procedure involves awake patients undergoing continuous neurological evaluation.
• Key parameters monitored include impedance, time, and energy delivered during radiofrequency thermocoagulation.
• Lesions are strategically placed to target epileptic networks or small-volume ictal onset zones.

Main Results:

• SEEG-RFTC can be curative for small-volume ictal onset zones.
• It serves as a diagnostic tool by assessing coagulation effects on seizures and mapping epileptic networks.
• Palliative treatment is achievable through multiple lesions in extensive epileptic networks.
• High response rates, up to 81%, are observed in specific conditions such as periventricular nodular heterotopia.

Conclusions:

• SEEG-RFTC is an effective and adaptable tool in the neurosurgeon's armamentarium for epilepsy management.
• The technique demonstrates potential for favorable outcomes in selected epilepsy cases, particularly periventricular nodular heterotopia.