Application of Stereo-EEG in pediatric patients with drug-resistant epilepsy

Objective To explore the values of stereoelectroencephalography (SEEG) in pediatric patients with drug-resistant epilepsy. Methods The clinical data of 24 pediatric patients with drug-resistant epilepsy in whom SEEG were performed from October 2014 to July 2017 at Department of Neurosurgery, Xuanwu Hospital, Capital Medical University were retrospectively analyzed. Eight patients underwent surgical resection and 15 underwent SEEG-guided radiofrequency- thermocoagulation (RF-TC) with the aim of ablating the epileptogenic zone (EZ). Besides, 1 patient who showed multiple and distant onset zones underwent both resection and SEEG-guided RF-TC. The postoperative outcome was evaluated by Engel classification. Results A total of 160 (average: 6.7±2.4, range: 2-13) electrodes were implanted in 24 patients. Postoperative follow-up time was 13±8 months (range: 3-36 months). The outcome of Engel class Ⅰ was reported in 14 patients (resection: 3 cases, RF-TC: 11 cases), class Ⅱ in 7, class Ⅲ in 2 patients and class Ⅳ in 1. No permanent neurological deficit was found. Conclusion SEEG in pediatric drug-resistant patients could facilitate the exploration of EZ and its scope to guide the surgical treatment, which might have good outcomes. Key words: Epilepsy; Child; Neurosurgical procedures; Stereoelectroencephalography; Radiofrequency thermocoagulation