Journal of Pediatric Epilepsy 2022; 11(03): 075-079
DOI: 10.1055/s-0042-1743192
Original Article

Safety and Efficacy of Stereoelectroencephalography in Pediatric Epilepsy Surgery

1   Division of Pediatric Neurology, University of Alberta, Edmonton, Alberta, Canada
2   Comprehensive Epilepsy Program, University of Alberta, Edmonton, Alberta, Canada
,
Cameron Elliott
2   Comprehensive Epilepsy Program, University of Alberta, Edmonton, Alberta, Canada
3   Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada
,
Natarie Liu
1   Division of Pediatric Neurology, University of Alberta, Edmonton, Alberta, Canada
2   Comprehensive Epilepsy Program, University of Alberta, Edmonton, Alberta, Canada
,
Karl Narvacan
4   Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
,
Matt Wheatly
2   Comprehensive Epilepsy Program, University of Alberta, Edmonton, Alberta, Canada
3   Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada
,
D.Barry Sinclair
1   Division of Pediatric Neurology, University of Alberta, Edmonton, Alberta, Canada
2   Comprehensive Epilepsy Program, University of Alberta, Edmonton, Alberta, Canada
› Author Affiliations

Abstract

Stereoelectroencephalography (SEEG) is the preoperative assessment of choice when the epileptogenic zone (EZ) is unclear in patients requiring surgery for severe, drug-refractory epilepsy. There are relatively little data on the safety and efficacy of SEEG in the pediatric epilepsy population. We, therefore, investigated the insertional complications, rate of successful identification of the EZ, and long-term seizure outcomes following surgery after SEEG in children. This was a retrospective study of drug-resistant pediatric epilepsy patients treated with surgery between 2005 and 2020 and who underwent presurgical SEEG. Rationale for and coverage of SEEG, identification of the EZ, and ultimate seizure outcome following SEEG-tailored resections were collected and analyzed. Thirty patients (15 male, mean age: 12.4 ± 5 years) who underwent SEEG were studied. SEEG-related complications occurred in one case (3%). A total of 190 multicontact electrodes (mean: 7.0 ± 2.5 per patient) were implanted across 30 insertions capturing 440 electrographic seizures (mean: 17.5 ± 27.6 per patient). The most common rationale for SEEG was normal magnetic resonance imaging with surface EEG that failed to identify the EZ (17/30; 57%). SEEG identified a putative EZ in all cases, resulting in SEEG-tailored resections in 25/30 (83%). Freedom from disabling seizures was achieved following resections in 20/25 cases (80%) with 5.9 ± 4.0 years of postoperative follow-up. SEEG is a safe and effective way to identify the EZ in the presurgical evaluation of children with refractory epilepsy and permits effective and long-lasting SEEG-tailored resections.



Publication History

Received: 29 October 2021

Accepted: 30 December 2021

Article published online:
28 February 2022

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