Neurocirugia · 2025
Epileptogenicity post stereoelectroencephalography and subdural grids invasive monitoring: A retrospective analysis of adult and pediatric patients with refractory epilepsy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Pulido Sonia, Ivankovic Sven, Winslow Nolan, Maldonado Andres
Аннотация
OBJECTIVE: To assess if removal of stereoelectroencephalography (SEEG) or subdural grids (SDG) is associated with an increased seizure frequency in patients with refractory epilepsy during the immediate postoperative period.
METHODS: 37 patients with refractory epilepsy that underwent monitoring with SEEG or SDG during November 2012-March 2022 were identified using electronic medical records from a single institution. Seizure history, duration of intracranial monitoring, and monitored brain regions were recorded.
RESULTS: 5.0% and 5.9% of SEEG and SDG patients had a seizure within 48h post-termination of monitoring. 25% and 11.8% of SEEG and SDG patients had a seizure between 48h and 1-week after surgery. Between 1 week and 1 month after SEEG or SDG removal, 35% and 41.2% of patients had a seizure. 30% and 50% SEEG or SDG patients had a seizure between 1- and 2-months following removal. Overall change in postoperative seizure frequency was not significant. Seizure frequency increased for 11.8% of SDG patients while frequency remained unchanged for 5.9% and decreased for 82.4%. No patients post-SEEG removal in our cohort experienced an increased seizure frequency. 95% experienced a decrease in seizure frequency and no change was observed in 5%.
CONCLUSION: SEEG is not associated with increased epileptogenicity after termination of monitoring. Two patients post-SDG removal experienced an increase in seizure frequency. While patients with refractory epilepsy may continue to have seizures during the immediate postoperative period, it is likely that patients will experience a decrease in seizure frequency after removal of SEEG or SDG.
METHODS: 37 patients with refractory epilepsy that underwent monitoring with SEEG or SDG during November 2012-March 2022 were identified using electronic medical records from a single institution. Seizure history, duration of intracranial monitoring, and monitored brain regions were recorded.
RESULTS: 5.0% and 5.9% of SEEG and SDG patients had a seizure within 48h post-termination of monitoring. 25% and 11.8% of SEEG and SDG patients had a seizure between 48h and 1-week after surgery. Between 1 week and 1 month after SEEG or SDG removal, 35% and 41.2% of patients had a seizure. 30% and 50% SEEG or SDG patients had a seizure between 1- and 2-months following removal. Overall change in postoperative seizure frequency was not significant. Seizure frequency increased for 11.8% of SDG patients while frequency remained unchanged for 5.9% and decreased for 82.4%. No patients post-SEEG removal in our cohort experienced an increased seizure frequency. 95% experienced a decrease in seizure frequency and no change was observed in 5%.
CONCLUSION: SEEG is not associated with increased epileptogenicity after termination of monitoring. Two patients post-SDG removal experienced an increase in seizure frequency. While patients with refractory epilepsy may continue to have seizures during the immediate postoperative period, it is likely that patients will experience a decrease in seizure frequency after removal of SEEG or SDG.