Abstract Details

Title Level Four Epilepsy Center Experience With Stereo-electroencephalography

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-020

Objective To demonstrate that stereo-electroencephalography (SEEG) may successfully replace evaluation with subdural electrodes (SDE) in the majority of patients who need invasive evaluations for epilepsy surgery.

Background SEEG is an informative and safe method of invasive evaluation in patients with medically intractable focal epilepsy. The goal of SEEG is to localize the epileptogenic zone for subsequent therapeutic surgical intervention, but the appropriate balance between traditional subdural grid methods and SEEG is not yet established.

Design/Methods We are reporting results of 105 stereo-electrodes implantations performed by a single neurosurgeon. Demographics, recommended surgical treatment and complications data were collected and analyzed.

Results Average patient age at stereo-electrodes placement was 36.9 years. Average epilepsy duration was 18.7 years. Thirty three patients had previous neurosurgery, including previous resective epilepsy surgery in 13 patients, preceded by subdural electrodes evaluation in seven. Average SEEG monitoring time was 10 days (from 5 to 30). Based on SEEG evaluation results, resection of the epileptogenic zone was recommended for 54 patients, laser ablation for 6, Responsive Neurostimulator (RNS) for 23, resection plus RNS for 11, laser ablation plus RNS for 3. An SDE evaluation after SEEG was recommended for 3 patients, and the second SEEG evaluation was recommended for 3 patients. VNS was recommended for one patient with multifocal SEEG seizure onset.
Among a total of 105 implantations, one patient had a subdural hematoma after stereotactic electrodes placement (0.9%). One patient had aseptic meningitis after electrodes removal. Two subjects had superficial wound infection after discharge. Six patients had small (1 cm) subdural hematomas after electrodes removal.

Conclusions Our center experience demonstrates that extra-operative EEG monitoring with stereo-electrodes is a reliable and safe method of intracranial evaluation of patients with medically intractable focal epilepsy. SEEG electrodes placement should be widely implemented for localization of the epileptogenic zone as minimally invasive and highly informative technique.

Authors/Disclosures
Irina Podkorytova PRESENTER	Irina Podkorytova has nothing to disclose.
Ghazala Perven, MD (UT Southwestern Medical Center)	Dr. Perven has nothing to disclose.
Kan Ding, MD (UT Southwestern Medical Center)	The institution of Dr. Ding has received research support from National Institute of Aging. The institution of Dr. Ding has received research support from NINDS.
Mark Agostini, MD (U.T. Southwestern Medical Center)	Dr. Agostini has nothing to disclose.
Ryan Hays, MD, MBA, FAES, FAAN (UT Southwestern Medical Center)	Dr. Hays has nothing to disclose.
Sasha Alick-Lindstrom, MD, MPH FACNS, FAES, FAAN (UT Southwestern Medical Center)	Dr. Alick-Lindstrom has nothing to disclose.
Marisara Dieppa, MD (University of Texas SW Medical School)	Dr. Dieppa has nothing to disclose.
Rohit Das, MD, FAAN (VA Portland Healthcare System)	Dr. Das has received personal compensation for serving as an employee of Oregon Health Science University. Dr. Das has received personal compensation in the range of $10,000-$49,999 for serving as a Physician Advisor with Concentra .
Hina N. Dave, MD (Debakey VA hospital)	Dr. Dave has nothing to disclose.
J. H. Harvey, DO (UT Southwestern Medical Center)	Dr. Harvey has received personal compensation for serving as an employee of Neuralogix. Dr. Harvey has received personal compensation for serving as an employee of Integris . Dr. Harvey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Harvey has stock in Epiminder.
Rodrigo Zepeda, MD (University of Texas Southwestern)	The institution of Dr. Zepeda has received research support from NIH.
Bradley Lega, MD (UT Southwestern)	The institution of Bradley Lega has received research support from NIH.

��ɫ��

��ɫ��