Objective:

This study aims to report our initial experience with the effectiveness, safety, and outcomes following the adoption of stereotactic electroencephalography (sEEG) technique for surgical evaluation of patients with drug-resistant focal epilepsy. 

Background:

Design/Methods:

This was a retrospective, single-center, observational study which reviewed every patient undergoing Phase II monitoring at our center from 2019 to 2022. At our center, 21 patients underwent sEEG monitoring, and 225 sEEG electrodes were implanted. Variables collected included demographic data, Phase I data, type of coverage (unilateral vs. bilateral), length of in-hospital stay, rate of complications, and seizure-free outcome using the ENGEL surgical outcome scale.

Results:

Among the 21 patients who were implanted, 7 (33.3%) were completely asymptomatic following the procedure. The most common complication was a headache in 9 patients (42.8%), followed by asymptomatic hemorrhage in 3 patients (14.2%). Only one patient (4.76%) experienced symptomatic hemorrhage but required no surgical intervention. Other less common complications included vasogenic edema at the surgical site, perceived cognitive slowing, visual hallucinations, and dislodged electrodes requiring revision. One patient had a complete resolution of seizures following sEEG implantation. The average duration of hospitalization was eight days, with a trend towards more extended hospitalization in patients experiencing procedural complications. SEEG method confirmed the epileptogenic zone in 15 patients (68%). Of these, 11 patients (50%) underwent surgical resection or ablation, and four (18%) received neuromodulation. 72% (n=8/11) achieved seizure freedom (i.e., ENGEL-I outcome).

Conclusions:

New surgical epilepsy centers can safely adopt sEEG while anticipating a relatively low rate of debilitating complications from the procedure. The rate of complications documented in our cohort is comparable to other established surgical epilepsy programs.