Stereo-electro-encephalography (SEEG) methodology: technical nuances and insights into image-guided robot-assisted electrode implantation

Author:

d’Orio Piergiorgio12,Monteiro Pedro13,Otayza José I.14,Rocca Alessandra15,Revay Martina12,Castana Laura1,Cardinale Francesco12

Affiliation:

1. “Claudio Munari” Epilepsy Surgery Centre, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy;

2. Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy;

3. Neurosurgery Department, University Hospital Center, Coimbra, Portugal;

4. Hospital Barros Luco, Santiago, Chile; and

5. Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy

Abstract

An accurate definition of the epileptogenic zone is critical to the success of epilepsy surgery. When noninvasive presurgical studies are insufficient, stereoelectroencephalography (SEEG) becomes indispensable. This study illustrates a systematic approach using an illustrative case of centroparietal epilepsy, detailing the stepwise workup, planning, and image-guided robot-assisted frameless stereotactic implantation of intracerebral electrodes. The video provides insights into technical aspects and a single-center experience. Demonstrating efficacy, safety, and feasibility, SEEG emerges as a valuable procedure for studying drug-resistant focal epilepsy. The video can be found here: https://stream.cadmore.media/r10.3171/2024.4.FOCVID2427

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Reference9 articles.

1. Stereotaxic approach to epilepsy;Talairach J,1973

2. Stereoelectroencephalography in the presurgical evaluation of focal epilepsy: a retrospective analysis of 215 procedures;Cossu M,2005

3. Indications and limits of stereoelectroencephalography (SEEG);Minotti L,2018

4. Stereoelectroencephalography: surgical methodology, safety, and stereotactic application accuracy in 500 procedures;Cardinale F,2013

5. Cerebral angiography for multimodal surgical planning in epilepsy surgery: description of a new three-dimensional technique and literature review;Cardinale F,2015

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