Child's Nervous System

, Volume 22, Issue 8, pp 766–778 | Cite as

Stereo-EEG in children

  • M. Cossu
  • F. Cardinale
  • L. Castana
  • L. Nobili
  • I. Sartori
  • G. Lo Russo
Special Annual Issue

Abstract

Background

Stereotactic placement of intracerebral multilead electrodes for chronic EEG recording of seizures or stereoelectroencephalography (SEEG) was introduced 50 years ago at Saint Anne Hospital in Paris, France for the presurgical evaluation of patients with drug-resistant focal epilepsy. SEEG explorations are indicated whenever the noninvasive tests fail to adequately localize the epileptogenic zone (EZ).

Indications

Currently, approximately 35% of our operated-on children require a SEEG evaluation. Arrangement of electrodes is individualized according to the peculiar needs of each child, to verify a predetermined hypothesis of localization of the EZ based on pre-SEEG anatomo-electro-clinical findings. Multilead intracerebral electrodes are designed to sample cortical structures on the lateral, intermediate, and mesial aspect of the hemisphere, as well as deep-seated lesions. Stereotactic stereoscopic teleangiograms and coregistered 3-D MRI are employed to plan avascular trajectories and to accurately target the desired structures. Pre-SEEG stereotactic neuroradiology and electrode implantation are usually performed in separate procedures. Electrodes are removed once video-SEEG monitoring is completed.

Intracerebral electrical stimulations

Intracerebral electrical stimulations are used to better define the EZ and to obtain a detailed functional mapping of critical cortical and subcortical regions.

Morbidity

Surgical morbidity of SEEG is definitely low in children.

SEEG-guided resective surgery

In 90% of evaluated children, SEEG provides a guide for extratemporal or multilobar resections. SEEG-guided resective surgery may yield excellent results on seizures with 60% of patients in Engel’s Class I.

Keywords

Child Epilepsy Stereotaxic techniques Electroencephalography Invasive procedures Neurosurgery 

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • M. Cossu
    • 1
  • F. Cardinale
    • 1
  • L. Castana
    • 1
  • L. Nobili
    • 1
  • I. Sartori
    • 1
  • G. Lo Russo
    • 1
  1. 1.Centro “Claudio Munari” per la Chirurgia dell’Epilessia e del Parkinson, Ospedale NiguardaMilanItaly

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