A greatly improved pre-surgical procedure has been unveiled – that may now increase the success of epilepsy surgery. Stereoelectroencephalography (SEEG) is much less invasive than existing techniques and could lead to better outcomes
The 30 per cent of people with epilepsy who do not respond to drug therapy may have surgery to control their seizures. Previously, this meant undergoing a very invasive type of electroencephalography. This involved removing large parts of a person’s skull to place electrodes on the surface of the brain, which would measure seizure activity.
The Cleveland Clinic reported on the SEEG technique. It has existed in some form for 50 years, but Dr Gonzales-Martinez has been able to reduce the lengthy procedure to just two hours. The SEEG technique allows surgeons to find the focus of seizure activity with greater precision and accuracy.
Now with SEEG, doctors create tiny two-millimetre holes in the skull. They then pass between 10 and 15 small probes through the holes and deep into the brain. After the probes have been inserted, the person then stays in hospital for about a week for monitoring. The information gathered can then be used to accurately assess which sections of brain tissue can be removed.
Existing surgery offers a fairly small chance of stopping epileptic seizures – between 20 and 30 per cent. The Cleveland Clinic report that with the introduction of SEEG, success rates have increased to between 55 and 60 per cent.
The procedure may also help to prevent any cognitive side-effects of surgery. With the previous treatment, the removal of large sections of tissue could cause serious post-surgery problems. These sometimes include problems with speech or memory. Now doctors can more precisely identify the areas of the brain causing seizures – removing less brain tissue and potentially avoiding these unwanted effects.
Dr Gonzales-Martinez says: “Once we know where the seizures are originating and where these functional areas are located, we know what we can remove and what we must preserve for a person to be seizure-free without any neurological deficit.
“We can now offer hope for patients that once had no hope. My dream is that one day we can do non-invasive tests, localise the seizures and then stop them without resection [major surgery].”
Written by Morgan Mitchell
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