Anatomo-Electro-Functional Investigations in Rolandic and Peri-Rolandic Epilepsies: A conceptual framework for
Naoki Ikegaya1, Thandar Aung2, Arka N Mallela3
1Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States; Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
Summary
This study introduces a new framework using stereoelectroencephalography (SEEG) to map epilepsy in the Rolandic and Peri-Rolandic (RPR) regions. The approach successfully identified seizure zones, leading to improved surgical outcomes for patients with RPR epilepsies.
Area of Science:
- Neurosurgery
- Epileptology
- Neurophysiology
Background:
- Epilepsies originating in the Rolandic and Peri-Rolandic (RPR) regions pose diagnostic challenges.
- Accurate localization of epileptogenic zones (EZ) is crucial for effective surgical treatment.
Purpose of the Study:
- To develop a hypothesis-driven stereoelectroencephalography (SEEG) framework for RPR regions.
- To enhance understanding of RPR epileptogenic networks and their functional implications.
- To improve surgical outcomes for RPR epilepsies.
Main Methods:
- Review of 102 SEEG cases, with 8 patients selected for RPR EZ analysis.
- Orthogonal implantation of an average of 14 SEEG electrodes along seven key trajectories.
- Analysis of electrode locations, electrical stimulation, and surgical outcomes.
Main Results:
- Seven key SEEG trajectories provided comprehensive RPR coverage.
- 87% of tested electrode contacts elicited sensorimotor responses upon stimulation.
- All SEEG explorations successfully localized the EZ, and 100% of surgeries resulted in seizure freedom with minimal deficits.
Conclusions:
- The developed SEEG framework enables reliable functional and EZ mapping in RPR regions.
- This anatomo-electro-functional framework optimizes SEEG exploration for RPR epilepsies.
- The approach supports effective resections and enhances surgical outcomes.
