Stereo-EEG ictal/interictal patterns and underlying pathologies

Giacomo, Roberta Di; Uribe-San-Martín, Reinaldo; Mai, Roberto; Francione, Stefano; Nobili, Lino; Sartori, Ivana; Gozzo, Francesca; Pelliccia, Veronica; Onofrj, Marco; Russo, Giorgio Lo; Curtis, Marco de; Tassi, Laura

doi:10.1016/j.seizure.2019.10.001

Cited by 47 publications

(58 citation statements)

References 42 publications

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“…Our case emphasises the need for careful correlation of ictal clinical manifestation with spatiotemporal organisation of the ictal epileptic discharges to identify the primary epileptogenic tuber. Our patient showed an ictal EEG onset pattern of LVFA associated with DC-shift and supports the findings of other studies that have shown ictal fast activity as a biomarker of epileptogenicity (Di Giacomo et al, 2019). Other factors unique to TSC that make delineation of the epileptogenic zone challenging include focal seizures in TSC that may demonstrate inter-tuberal activation causing ictal discharges to propagate rapidly to other tubers.…”

Section: Evaluation Of Surgery For Tsc By Seeegsupporting

confidence: 88%

Successful epilepsy surgery for tuberous sclerosis complex evaluated by stereoelectroencephalography

Fong

Bleasel

Dexter

et al. 2020

Epileptic Disorders

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Evaluating the candidacy for epilepsy surgery in patients with tuberous sclerosis can be challenging, particularly when non-invasive investigations do not show a clear epileptogenic zone. Stereoencephalography may be useful in such cases. We present a case in which the primary epileptogenic tuber was successfully identified by stereoencephalography, which resulted in seizure freedom following epilepsy surgery. [Published with video sequences].

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Section: Evaluation Of Surgery For Tsc By Seeegsupporting

confidence: 88%

Successful epilepsy surgery for tuberous sclerosis complex evaluated by stereoelectroencephalography

Fong

Bleasel

Dexter

et al. 2020

Epileptic Disorders

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“…Although many localization factors have been considered in this study, we did not analyze specific features of the SEEG recordings at seizure onset. Previous studies have shown that certain pathologies may be associated with specific patterns of EEG change at seizure onset, some of which may be associated with better postsurgical outcomes 27‐29 . Instead, we used expert neurophysiologist‐reported assessment as a measure of seizure onset.…”

Section: Discussionmentioning

confidence: 99%

The UK experience of stereoelectroencephalography in children: An analysis of factors predicting the identification of a seizure‐onset zone and subsequent seizure freedom

Chari¹,

Moeller²,

Boyd³

et al. 2021

Epilepsia

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Objective Stereoelectroencephalography (SEEG) is being used more frequently in the pre‐surgical evaluation of children with focal epilepsy. It has been shown to be safe in children, but there are no multicenter studies assessing the rates and factors associated with the identification of a putative seizure‐onset zone (SOZ) and subsequent seizure freedom following SEEG‐guided epilepsy surgery. Methods Multicenter retrospective cohort study of all children undergoing SEEG at six of seven UK Children's Epilepsy Surgery Service centers from 2014 to 2019. Demographics, noninvasive evaluation, SEEG, and operative factors were analyzed to identify variables associated with the identification of a putative SOZ and subsequent seizure freedom following SEEG‐guided epilepsy surgery. Results One hundred thirty‐five patients underwent 139 SEEG explorations using a total of 1767 electrodes. A putative SOZ was identified in 117 patients (85.7%); odds of successfully finding an SOZ were 6.4 times greater for non‐motor seizures compared to motor seizures (p = 0.02) and 3.6 times more if four or more seizures were recorded during SEEG (p = 0.03). Of 100 patients undergoing surgical treatment, 47 (47.0%) had an Engel class I outcome at a median follow‐up of 1.3 years; the only factor associated with outcome was indication for SEEG (p = 0.03); an indication of “recurrence following surgery/treatment” had a 5.9 times lower odds of achieving seizure freedom (p = 0.002) compared to the “lesion negative” cohort, whereas other indications (“lesion positive, define extent,” “lesion positive, discordant noninvasive investigations” and “multiple lesions”) were not statistically significantly different. Significance This large nationally representative cohort illustrates that SEEG‐guided surgery can still achieve high rates of seizure freedom. Seizure semiology and the number of seizures recorded during SEEG are important factors in the identification of a putative SOZ, and the indication for SEEG is an important factor in postoperative outcomes.

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“…LVFA is the most common pattern of seizure onset detected by intracranial recordings [15]. Previous findings showed that seizure symptoms are heterogeneous in insulo-opercular epilepsy.…”

Section: Electrographic Findingsmentioning

confidence: 99%

“…In most cases, clinical-anatomic analysis of seizure is mainly based on intracranial electrophysiological data, which may cause underestimation of the lesion boundary. Meanwhile, the locations and patterns of ictal discharges have been proven to have certain pathological relations, especially with FCD type II [15]. In this sense, the early spread network would be a specific hint to make the margin of pathological lesions visible, independent of the inherent anatomical functional network.…”

Section: Anatomical Electroclinical Correlationsmentioning

confidence: 99%

Bilateral asymmetric tonic seizure in insulo-opercular epilepsy: an anatomo-electro-clinical study

Wang

et al. 2020

Acta Epileptologica

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Background Insulo-opercular seizures are highly heterogeneous in seizure semiology and electrical features. Bilateral asymmetric limb posturing, as a classical pattern of supplementary sensorimotor area (SMA) seizure, also occurs in insulo-opercular epilepsy. This study was aimed to study the anatomo-electro-clinical correlations in bilateral asymmetric tonic seizures (BATS), in order to advance the understanding of insulo-opercular epilepsy. Methods Eight patients with insulo-opercular epilepsy as confirmed by stereoelectroencephalography (SEEG) and manifesting BATS as the major ictal motor sign, in Guangdong Sanjiu Brain Hospital Epilepsy Center from 2014 to 2018, were employed in this study. The BATS of the patients were evaluated, and the semiologic features and concomitant intracerebral EEG changes were quantified. Then the variables were examined with Cluster Analysis, and the semiologic features were correlated with anatomic localization using the Kendall correlation test. Results Of the 8 patients, the most frequent initial motor sign was bilateral asymmetric tonic posturing (62.5%). Facial tonic-clonic sign also had a high prevalence in the evolution of seizures (87.5%). The results of Cluster Analysis showed that the semiologic features were subdivided into two main groups, one group comprising exclusively BATS and the other including signs of focal tonic seizure, aura, focal limb tonic-clonic seizure (TCS), facial TCS, hypermotor behavior, eye movement, autonomic changes and generalized TCS. The BATS was strongly associated with the posterior long gyrus (PLG) of insula (t = 0.732) and parietal operculum (t = 1.000); the hypermotor behaviors were associated with the anterior long gyrus (ALG) (t = 0.770); and the autonomic changes were associated with the anterior limiting sulcus (ALS) (t = 0.734) and middle short gyrus (MSG) (t = 0.700). Conclusions The seizure semiology of insulo-opercular epilepsy is characterized, in temporal order, by BATS, with or without simultaneous hypermotor behaviors, and frequently ends up with facial tonic-clonic signs, which is different from that of the SMA seizure. The early spread network involving the posterior insular lobe and parietal operculum may contribute to this pattern of manifestation.

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Stereo-EEG ictal/interictal patterns and underlying pathologies

Cited by 47 publications

References 42 publications

Successful epilepsy surgery for tuberous sclerosis complex evaluated by stereoelectroencephalography

Successful epilepsy surgery for tuberous sclerosis complex evaluated by stereoelectroencephalography

The UK experience of stereoelectroencephalography in children: An analysis of factors predicting the identification of a seizure‐onset zone and subsequent seizure freedom

Bilateral asymmetric tonic seizure in insulo-opercular epilepsy: an anatomo-electro-clinical study

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