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This article was published in April 2013. The information may be out of date. Please check our epilepsy information or our site A-Z.

New process improves surgery planning

10 Apr 2013

SEEG imageA new report published in the March issue of Neurosurgery has shed light onto Stereo-electroencephalography (SEEG).

SEEG is a process that aims to improve surgical panning and surgery for patients with intractable epilepsy. It uses 3D imaging of the brain alongside placing electrodes in the area of the brain in which seizures originate. This results in highly detailed data of the brain to increase accuracy when planning brain surgery.

Although SEEG is not new, Dr Francesco Cardinale and his team have been working on the process to ‘update’ it. The updated technique uses just one surgical step instead of the traditional two surgical steps; 3D imaging of brain blood vessels followed by electrode implantation.

Dr Cardinale’s workflow uses 3D magnetic resonance imaging and 3D digital subtraction angiography. This does not involve a surgical procedure. The data is then used to reconstruct a detailed model of the brain, creating a ‘homemade’ computer script to plan the surgical approach.

When using both SEEG approaches, the aim is always to provide the surgeon with precise information.

The researchers from Niguarda Ca’ Granda Hospital in Milan, reported on the outcomes of 500 SEEG procedures. All of the operations were on patients with drug resistant (intractable) epilepsy. Both techniques were highly successful, with complications in only 2.4 per cent (12 cases).

The updated technique provided strong data, with no loss of information and a “dramatic reduction in procedural error risks”. The researchers believe that their technique allows them to estimate a “safe entry region” for electrode placement with 99 per cent accuracy.

The latest report adds to existing evidence that SEEG is a safe and effective procedure for patients with intractable epilepsy.

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