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The researchers describe the development of and initial experience with an updated SEEG technique for planning epilepsy surgery. To determine the epileptogenic zone, interictal and ictal information should be taken into consideration. Further studies will assess outcomes in these patients. Stereo EEG Technique Updated and Simplified. Stereo-EEG cansample deeperareas of thebrainincluding deepsulci and hard to reach areas such as the insula. Conclusions: This study demonstrates that sEEG can be used to guide the location of RNS leads by targeting structures involved early in the ictal network. Individual patient data is displayed in table 1. RNS leads were placed in the hippocampus in 11 patients, neocortex in 11 patients, and insula in 1 patient. RNS was implanted bilaterally in 48% of patients (10/21), unilateral left in 29% of patients (6/21), and unilateral right in 24% of patients (5/21). The median number of regions sampled was 14. 81% of patients (17/21) had bilateral sEEG implantation, 10% (2/21) unilateral left, and 10% (2/21) unilateral right. 29% of patients (6/21) had a vagus nerve stimulator and 25% of patients (5/21) had prior resective surgery. Journal of Clinical Neurophysiologå3 (6):483-489, December 2016. The median age at time of sEEG was 31 years (range 18-60 years), with a median duration of epilepsy of 18 years (range 2-48). The electrode implantation strategy in stereoelectroencephalography involves appreciation of these features, which are illustrated by four cases drawn from distinct electroclinical epilepsy syndromes. Results: Of patients with RNS placed between 20, 70% (21/30) were evaluated with sEEG. Through review of the electronic medical record and sEEG tracings, the following variables were recorded: pre-implantation hypothesis, number of sEEG electrodes, ictal findings, and location of RNS lead placement. I: Introduction - Chapter 1: The History and Principles of Stereo EEG - The Prestereo EEG Era - Laying the.
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Methods: This retrospective study included adult epilepsy patients evaluated at the Cleveland Clinic with sEEG prior to RNS placement (N=21). A practical approach to stereo EEG -book. Bernabei JM, Arnold TC, Shah P, Revell A, Ong IZ, Kini LG, Stein JM, Shinohara RT, Lucas TH, Davis KA, Bassett DS, Litt B. The goal of this study is to report the experience with sEEG and RNS at a comprehensive epilepsy center. Electrocorticography and stereo EEG provide distinct measures of brain connectivity: implications for network models. Stereoelectroencephalography (sEEG) may help target the placement of RNS leads. For this reason, stereoelectroencephalography is reserved to selected and particularly complicated epilepsy cases.Rationale: Neuromodulation therapy such as brain-responsive neurostimulation (RNS system, NeuroPace) is often considered in patients with medically refractory epilepsy who are not candidates for surgical resection or who continue to have seizures despite prior resective surgery. Little is known about the ideal placement of RNS leads. Potential risks of the procedure, accounting for less than 1% of cases, include brain hemorrhage and infection, which can lead to permanent neurological impairment or death. the area of brain generating the seizures which should be eventually surgically resected to achieve freedom from epileptic seizures. Intracerebral electrodes are placed within the desired brain areas to record the electrical activity during epileptic seizures, thus contributing to define with accuracy the boundaries of the "epileptogenic zone", i.e. In 2002, we described specific intracerebral ictal Stereo-EEG pat- terns in focal cortical dysplasia (FCD) type II, characterized by re- petitive fast spikes (. Anne Hospital, Paris, France, in the second half of the 20th century. This technique was introduced in the diagnostic work up of patients with epilepsy by the group of the S. It may be used in patients with epilepsy not responding to medical treatment, and who are potential candidates to receive brain surgery in order to control seizures. Stereoelectroencephalography ( SEEG) is the practice of recording electroencephalographic signals via depth electrodes (electrodes surgically implanted into the brain tissue).