Outcomes of stereoelectroencephalography exploration at an epilepsy surgery center.
Adolescent
Adult
Aged
Cohort Studies
Electrodes, Implanted
/ trends
Electroencephalography
/ methods
Epilepsy
/ diagnostic imaging
Female
Humans
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Patient Admission
/ trends
Prospective Studies
Retrospective Studies
Stereotaxic Techniques
/ trends
Treatment Outcome
Young Adult
drug-resistant focal epilepsy
epilepsy surgery
outcomes
stereoelectroencephalography
Journal
Acta neurologica Scandinavica
ISSN: 1600-0404
Titre abrégé: Acta Neurol Scand
Pays: Denmark
ID NLM: 0370336
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
01
11
2019
revised:
13
12
2019
accepted:
11
02
2020
pubmed:
15
2
2020
medline:
1
9
2020
entrez:
15
2
2020
Statut:
ppublish
Résumé
Epilepsy surgery is offered in resistant focal epilepsy. Non-invasive investigations like scalp video EEG monitoring (SVEM) help delineate epileptogenic zone. Complex cases may require intracranial video EEG monitoring (IVEM). Stereoelectroencephalography (SEEG)-based intracerebral electrode implantation has better spatial resolution, lower morbidity, better tolerance, and superiority in sampling deep structures. Our objectives were to assess IVEM using SEEG with regard to reasoning behind implantation, course, surgical interventions, and outcomes. Seventy-two admissions for SEEG from January 2014 to December 2018 were included in the study. Demographic and clinical data were retrospectively collected. The cohort comprised of 69 adults of which 34 (47%) had lesional MRI. Reasons for SEEG considering all cases included non-localizing ictal onset (76%), ictal-interictal discordance (21%), discordant semiology (17%), proximity to eloquent cortex (33%), nuclear imaging discordance (34%), and discordance with neuropsychology (19%). Among lesional cases, additional reasons included SVEM discordance (68%) and dual or multiple pathology (47%). Forty-eight patients (67%) were offered resective surgery, and 41 underwent it. Twenty-three (56%) had at least one year post-surgical follow-up of which 14 (61%) had Engels class I outcome. Of the remaining 23 who were continued on medical management, 4 (17%) became seizure-free and 12 (51%) had reduction in seizure frequency. SEEG monitoring is an important and safe tool for presurgical evaluation with good surgical and non-surgical outcomes. Whether seizure freedom following non-surgical management could be related to SEEG implantation, medication change, or natural course needs to be determined.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
463-472Investigateurs
Yahya Agha-Khani
(Y)
Nathalie Jette
(N)
Rey Avendano
(R)
Salma Hanna
(S)
Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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