Beyond seizure control: The impact of SEEG-guided radiofrequency thermocoagulation on quality of life

Stereoencephalography (SEEG)-guided radiofrequency thermocoagulation (RF-TC) is an effective method in improving seizure control. However, as far as we know, no studies have addressed the effectiveness of this treatment in terms of quality of life, despite the global burden of epilepsy. Therefore, the aim of this study is to evaluate the effect of SEEG-guided RF-TC on seizure frequency in a cohort of patients with refractory focal epilepsy (RFE), and to explore the relationship between seizure outcomes and changes in quality of life after 1-year follow-up.

In this retrospective study, seizure outcomes and quality of life in patients with RFE treated with SEEG-guided RF-TC were examined before and after 1 year of intervention, following the presurgical assessment protocol of the Refractory Epilepsy Unit.

Thirty-six patients (44.4% women; mean age 38.78 ± 12.86 years) were included. The mean number of thermocoagulated contacts per patient was 27.63 ± 17.97. Seizures per month decreased significantly after SEEG-guided RF-TC (95% CI [-12.50, -5.50], p < 0.001), with 47.2% of patients achieving seizure freedom and 88.6% responding to the treatment after a 1-year follow-up. Quality of life improved after intervention in six out of seven of the subscales, as well as in the quality of life composite score. Finally, the seizure reduction rate and seizure frequency after SEEG-guided RF-TC predicted changes in the quality of life composite score (p = 0.047 and p = 0.039, respectively).

Our results show that more favorable seizure outcomes after SEEG-guided RF-TC are associated with better quality of life. These findings emphasize the importance of considering a holistic approach when evaluating the effectiveness of epilepsy treatments.