SEEG monitoring is safe and effective for children with refractive epilepsy

Ref: Goldstein HE, et alJ Neurosurg Pediatr2018 Oct;22 (4): 444-452doi: 10.3171/2018.5.PEDS1856Epub 2018 Jul 20.)incurable epilepsy (medically refractory-localization-cosy, LRE) in a well-positioned case of seizure (seizure onset zone, SOZ) surgery effect is obviousStereotactic electroencephalograms (stereoelectroencephalography, SEEG) are implanted to replace the epidural mesh or bar electrodeimplants to help accurately locate the epileptic lesionsRecently, research by Hannah EGoldstein of Neurosurgery at Columbia University Medical Center and others used SEEG to locate the safety and effectiveness of surgical treatment in children with refractive epilepsy, published online in July 2018 in J.Neurosurg Pediatrthe study included 25 cases of CHILDREN with SEEG treatment between June 2014 and November 2017Patients using video electroencephalograms and other noninvasive electroencephalograms did not find significant eclampsia, so decided to use invasive SEEG location to remove the lesionsHead MRI enhancement and CT enhancement scans are carried out before electrode implantation, and electrodes are accurately located and implanted through the ROSA robotRecord and evaluate SEEG-related parameters, SOZ sites, postoperative complications and seizuresresults showed that 25 patients were aged 5-21 years, with an average age of 13 years, 15 women and 10 menA total of 30 SEEG monitoring, implanted 342 electrodes, 10 cases under SEEG monitoring before implanting electrodes, had eclampsia or ablation surgery, 7 MRI scans did not find lesions, 8 cases of MRI found many lesions30 SEEG monitored electrode implants, of which 7 were implanted outside the temporal lobe, 1 in the temporal lobe-edge system, and 22 times in the outer temporal lobe or the temporal lobe-edge system14 double-sided electrode implants, 8 implants to the left side and 8 times on the right side After implanting the electrode, monitorford for 3-19 days, an average of 8 days All patients were discharged successfully on the day the electrodes were removed after surgery complications, 1 case of electrode shift to the sub-dura cavity, asymptomatic sub-dura small hematoma occurred, 2 cases of late-onsy electrode superficial scalp infection, through wound drug change and oral antibiotics under control 23 (92%) patients were treated with SEEG to accurately locate SOZ, of which 18 were treated routinely 2 CASES OF SOZ LOCATED BY SEEG WERE LOCATED IN THE ACTIVE LANGUAGE CENTER, MONITORED THE SEIZURE WAVES WITH THE EPIDURAL MESH ELECTRODE 1 WEEK BEFORE SURGERY, AND PERFORMED SURGERY BY DEPICTING THE FUNCTIONAL AREA Patients who surgically removed the eclampsia lesions were followed up for more than 6 months and found that 8 of the 15 cases reached Engel Class I, 6 Engel class II or III, and 1 Engel class IV the final author pointed out that for pediatric refractive bureau epilepsy, stereotactic electroencephalogram monitoring can provide the state of electroencephalo-emetic activity of the two-sided polycephalus lobes, avoid opening the cranial placement electrode, is a creative, but safe and effective positioning of the eclampsia-induced lesions (
jiy compiled, Professor Wang Zhiqiu , of Huashan Hospital, Fudan University, reviewed, editor-in-chief of "Outside Information" and professor of Chen Jicheng , affiliated with Fudan University, relevant links