Stereoelectroencephalography: Indication and Efficacy.

Publisher: Japan Neurosurgical Society Country of Publication: Japan NLM ID: 0400775 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1349-8029 (Electronic) Linking ISSN: 04708105 NLM ISO Abbreviation: Neurol Med Chir (Tokyo) Subsets: MEDLINE

Original Publication: Tokyo : Japan Neurosurgical Society.

Stereotaxic Techniques*/adverse effects ; Stereotaxic Techniques*/instrumentation; Brain Mapping/*methods ; Drug Resistant Epilepsy/*diagnosis ; Electroencephalography/*methods; Cerebral Cortex/pathology ; Cerebral Cortex/physiopathology ; Drug Resistant Epilepsy/physiopathology ; Drug Resistant Epilepsy/surgery ; Electrodes, Implanted/adverse effects ; Electroencephalography/adverse effects ; Electroencephalography/instrumentation ; Encephalitis/etiology ; Encephalitis/prevention & control ; Epilepsies, Partial/diagnosis ; Epilepsies, Partial/physiopathology ; Epilepsies, Partial/surgery ; Humans ; Intracranial Hemorrhages/etiology ; Intracranial Hemorrhages/prevention & control ; Magnetic Resonance Imaging ; Neuroimaging ; Neuronavigation/adverse effects ; Neuronavigation/instrumentation ; Neuronavigation/methods ; Preoperative Care ; Robotics

Stereoelectroencephalography (SEEG) is a method for invasive study of patients with refractory epilepsy. Localization of the epileptogenic zone in SEEG relied on the hypothesis of anatomo-electro-clinical analysis limited by X-ray, analog electroencephalography (EEG), and seizure semiology in the 1950s. Modern neuroimaging studies and digital video-EEG have developed the hypothesis aiming at more precise localization of the epileptic network. Certain clinical scenarios favor SEEG over subdural EEG (SDEEG). SEEG can cover extensive areas of bilateral hemispheres with highly accurate sampling from sulcal areas and deep brain structures. A hybrid technique of SEEG and subdural strip electrode placement has been reported to overcome the SEEG limitations of poor functional mapping. Technological advances including acquisition of three-dimensional angiography and magnetic resonance image (MRI) in frameless conditions, advanced multimodal planning, and robot-assisted implantation have contributed to the accuracy and safety of electrode implantation in a simplified fashion. A recent meta-analysis of the safety of SEEG concluded the low value of the pooled prevalence for all complications. The complications of SEEG were significantly less than those of SDEEG. The removal of electrodes for SEEG was much simpler than for SDEEG and allowed sufficient time for data analysis, discussion, and consensus for both patients and physicians before the proceeding treatment. Furthermore, SEEG is applicable as a therapeutic alternative for deep-seated lesions, e.g., nodular heterotopia, in nonoperative epilepsies using SEEG-guided radiofrequency thermocoagulation. We review the SEEG method with technological advances for planning and implantation of electrodes. We highlight the indication and efficacy, advantages and disadvantages of SEEG compared with SDEEG.

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Keywords: efficacy; epilepsy surgery; indication; intracranial EEG; stereoelectroencephalography

Date Created: 20170623 Date Completed: 20180608 Latest Revision: 20181113

20250114

PMC5566696

10.2176/nmc.ra.2017-0008

28637943