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Feasibility and safety of stereoelectroencephalography in young children

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Abstract

Purpose

Stereoelectroencephalography (SEEG) is a diagnostic surgery that implants electrodes to identify areas of epileptic onset in patients with drug-resistant epilepsy (DRE). SEEG is effective in identifying the epileptic zone; however, placement of electrodes in very young children has been considered contraindicated due to skull thinness. The goal of this study was to evaluate if SEEG is safe and accurate in young children with thin skulls.

Methods

Four children under the age of two years old with DRE underwent SEEG to locate the region of seizure onset. Presurgical planning and placement of electrodes were performed using ROSA One Brain. Preoperative electrode plans were merged with postoperative CT scans to determine accuracy. Euclidean distance between the planned and actual trajectories was calculated using a 3D coordinate system at both the entry and target points for each electrode.

Results

Sixty-three electrodes were placed among four patients. Mean skull thickness at electrode entry sites was 2.34 mm. The mean difference between the planned and actual entry points was 1.12 mm, and the mean difference between the planned and actual target points was 1.73 mm. No significant correlation was observed between planned and actual target points and skull thickness (Pearson R =  − 0.170). No perioperative or postoperative complications were observed.

Conclusions

This study demonstrates that SEEG can be safe and accurate in children under two years of age despite thin skulls. SEEG should be considered for young children with DRE, and age and skull thickness are not definite contraindications to the surgery.

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Data availability

Raw data for these patients were generated using the ROSA One Brain system. Raw and derived data supporting the findings of this study are available from the corresponding author (CRM) upon reasonable request.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery and Department of Pediatrics, Westchester Medical Center, 100 Woods Road, Taylor Pavilion E135, Valhalla, NY, 10595, USA

    Carrie R. Muh & Jared M. Pisapia

  2. Department of Neurosurgery, New York Medical College, Valhalla, NY, 10595, USA

    Carrie R. Muh & Jared M. Pisapia

  3. New York Medical College, Valhalla, NY, USA

    Jessica R. Dorilio & Cameron P. Beaudreault

  4. Department of Pediatric Neurology, Boston Children’s Health Physicians, Hawthorne, NY, USA

    Patricia E. McGoldrick & Steven M. Wolf

  5. Department of Neurology, New York Medical College, Valhalla, NY, USA

    Steven M. Wolf

Authors
  1. Carrie R. Muh
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  2. Jessica R. Dorilio
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  3. Cameron P. Beaudreault
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  4. Patricia E. McGoldrick
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  5. Jared M. Pisapia
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Contributions

CM, PM, and SW conceived and designed the study. CM and JD generated the data used in the study. JD and CB performed data extraction and analysis. CM, JD, and CB prepared figures and tables. JD, CM and CB wrote the drafts of the manuscript. All authors edited the manuscript and tables. CM, JD and CB prepared the manuscript and associated files for submission. CM and JD equally contributed to the conduct of the study. All authors contributed to manuscript revision, read, and approved the submitted version.

Corresponding author

Correspondence to Carrie R. Muh.

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Competing interests

CM reports honoraria from LivaNova and Monteris, participation as a Scientific Advisory Board member for Anuncia, and participation as an investigator in a clinical trial for NeuroPace. SW and PM report honoraria from LivaNova, Eisai, UCB, Sunovion, Greenwich Pharmaceuticals, and participation as investigators in clinical trials for Zogenix, GW Pharma, NeuroPace, Neurelis, UCB, Eisai. SW also reports speaker fees from Marinus. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Co-first authors Dr. Muh and Ms. Dorilio were equally responsible for the work described in this paper.

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Muh, C.R., Dorilio, J.R., Beaudreault, C.P. et al. Feasibility and safety of stereoelectroencephalography in young children. Childs Nerv Syst 40, 1331–1337 (2024). https://doi.org/10.1007/s00381-024-06335-6

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  • DOI: https://doi.org/10.1007/s00381-024-06335-6

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