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01-10-2020 | Magnetic Resonance Imaging | Original Article

Decision-making in temporal lobe epilepsy surgery based on invasive stereo-electroencephalography (sEEG)

Authors: Lasse Dührsen, Thomas Sauvigny, Franz L. Ricklefs, Wolfgang Hamel, Johannes A. Koeppen, Jonas M. Hebel, Michael Lanz, Tobias Martens

Published in: Neurosurgical Review | Issue 5/2020

Abstract

In medical refractory temporal lobe epilepsy (TLE), the epileptogenic zone can be difficult to identify and therefore difficult to treat, especially in the absence of clear MRI pathologies and specific results from presurgical evaluation. Invasive monitoring with stereo-electroencephalography (sEEG) is a tool for a better determination of the epileptogenic zone. Here, we investigate the impact of sEEG on decision-making in temporal lobe epilepsy surgery. We reviewed patients with TLE who underwent further investigation with sEEG in our epilepsy unit. We examined specifically how sEEG findings influenced our decision regarding indication for a surgical procedure and resection volume. From 2013 to 2017, we performed 152 temporal resections in epilepsy patients. Twenty-one of these patients were designated for further preoperative investigation with sEEG due to incongruent findings in presurgical evaluation. Six patients were implanted bitemporally. In five cases, the hypothesis for the epileptogenic zone and localization had to be changed due to sEEG findings and resulted in a different tailored resection than intended. In three cases, sEEG findings led to the cancelation of the originally intended temporal resection as the epileptogenic zone was not definable or bilateral. In another three cases, the prognosis for reduction of seizures postoperatively had to be reduced due to the sEEG findings. However, the resection was performed after interdisciplinary discussion and informed consent of the patient. The examination by sEEG led to a change of plan for further treatment in 13 patients (61.9%) suffering TLE in total. Invasive monitoring with sEEG electrodes had a strong impact on decision-making for further treatment in patients suffering from temporal lobe epilepsy with incongruent findings in presurgical examination designated for epilepsy surgery. This applies to resection volumes as well as to prediction of seizure outcome.

de Tisi J, Bell GS, Peacock JL, McEvoy AW, Harkness WF, Sander JW, Duncan JS (2011) The long-term outcome of adult epilepsy surgery, patterns of seizure remission, and relapse: a cohort study. Lancet 378:1388–1395. https://doi.org/10.1016/S0140-6736(11)60890-8CrossRefPubMed

Bartolomei F, Wendling F, Vignal JP, Kochen S, Bellanger JJ, Badier JM, Le Bouquin-Jeannes R, Chauvel P (1999) Seizures of temporal lobe epilepsy: identification of subtypes by coherence analysis using stereo-electro-encephalography. Clin Neurophysiol 110:1741–1754PubMed

Kahane P, Bartolomei F (2010) Temporal lobe epilepsy and hippocampal sclerosis: lessons from depth EEG recordings. Epilepsia 51(Suppl 1):59–62. https://doi.org/10.1111/j.1528-1167.2009.02448.xCrossRefPubMed

Luders HO, Najm I, Nair D, Widdess-Walsh P, Bingman W (2006) The epileptogenic zone: general principles. Epileptic Disord 8(Suppl 2):S1–S9PubMed

Jayakar P, Gotman J, Harvey AS, Palmini A, Tassi L, Schomer D, Dubeau F, Bartolomei F, Yu A, Krsek P, Velis D, Kahane P (2016) Diagnostic utility of invasive EEG for epilepsy surgery: indications, modalities, and techniques. Epilepsia 57:1735–1747. https://doi.org/10.1111/epi.13515CrossRefPubMed

Cossu M, Cardinale F, Castana L, Citterio A, Francione S, Tassi L, Benabid AL, Lo Russo G (2005) Stereoelectroencephalography in the presurgical evaluation of focal epilepsy: a retrospective analysis of 215 procedures. Neurosurgery 57:706–718PubMed

Gonzalez-Martinez J, Bulacio J, Alexopoulos A, Jehi L, Bingaman W, Najm I (2013) Stereoelectroencephalography in the “difficult to localize” refractory focal epilepsy: early experience from a north American epilepsy center. Epilepsia 54:323–330. https://doi.org/10.1111/j.1528-1167.2012.03672.xCrossRefPubMed

House PM, Bruckner KE, Lohmann HH (2011) Presurgical functional transcranial Doppler sonography (fTCD) with intravenous echo enhancing agent SonoVue enables determination of language lateralization in epilepsy patients with poor temporal bone windows. Epilepsia 52:636–639. https://doi.org/10.1111/j.1528-1167.2010.02951.xCrossRefPubMed

Wieser HG, Blume WT, Fish D, Goldensohn E, Hufnagel A, King D, Sperling MR, Luders H, Pedley TA (2001) Commission on Neurosurgery of the International League Against E ILAE commission report. Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery Epilepsia 42:282–286PubMed

10.

Kitaura H, Oishi M, Takei N, Fu YJ, Hiraishi T, Fukuda M, Takahashi H, Shibuki K, Fujii Y, Kakita A (2012) Periventricular nodular heterotopia functionally couples with the overlying hippocampus. Epilepsia 53:e127–e131. https://doi.org/10.1111/j.1528-1167.2012.03509.xCrossRefPubMed

11.

Bonini F, McGonigal A, Scavarda D, Carron R, Regis J, Dufour H, Peragut JC, Laguitton V, Villeneuve N, Chauvel P, Giusiano B, Trebuchon A, Bartolomei F (2018) Predictive factors of surgical outcome in frontal lobe epilepsy explored with stereoelectroencephalography. Neurosurgery 83:217–225. https://doi.org/10.1093/neuros/nyx342CrossRefPubMed

12.

Maillard LG, Tassi L, Bartolomei F, Catenoix H, Dubeau F, Szurhaj W, Kahane P, Nica A, Marusic P, Mindruta I, Chassoux F, Ramantani G (2017) Stereoelectroencephalography and surgical outcome in polymicrogyria-related epilepsy: a multicentric study. Ann Neurol 82:781–794. https://doi.org/10.1002/ana.25081CrossRefPubMed

13.

Holtkamp M, Sharan A, Sperling MR (2012) Intracranial EEG in predicting surgical outcome in frontal lobe epilepsy. Epilepsia 53:1739–1745. https://doi.org/10.1111/j.1528-1167.2012.03600.xCrossRefPubMed

14.

Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, Hirsch E, Jain S, Mathern GW, Moshe SL, Nordli DR, Perucca E, Tomson T, Wiebe S, Zhang YH, Zuberi SM (2017) ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia 58:512–521. https://doi.org/10.1111/epi.13709CrossRefPubMedPubMedCentral

15.

Sindou M, Guenot M, Isnard J, Ryvlin P, Fischer C, Mauguiere F (2006) Temporo-mesial epilepsy surgery: outcome and complications in 100 consecutive adult patients. Acta Neurochir 148:39–45. https://doi.org/10.1007/s00701-005-0644-xCrossRefPubMed

16.

Diehl B, Luders HO (2000) Temporal lobe epilepsy: when are invasive recordings needed? Epilepsia 41(Suppl 3):S61–S74PubMed

17.

Steriade C, Martins W, Bulacio J, Morita-Sherman ME, Nair D, Gupta A, Bingaman W, Gonzalez-Martinez J, Najm I, Jehi L (2019) Localization yield and seizure outcome in patients undergoing bilateral SEEG exploration. Epilepsia 60:107–120. https://doi.org/10.1111/epi.14624CrossRefPubMed

18.

Hill TC, Rubin BA, Tyagi V, Theobald J, Silverberg A, Miceli M, Dugan P, Carlson C, Doyle WK (2017) The value of diagnostic bilateral intracranial electroencephalography in treatment-resistant focal epilepsy. World Neurosurg 103:1–10. https://doi.org/10.1016/j.wneu.2017.01.093CrossRefPubMed

19.

Barba C, Rheims S, Minotti L, Guenot M, Hoffmann D, Chabardes S, Isnard J, Kahane P, Ryvlin P (2016) Temporal plus epilepsy is a major determinant of temporal lobe surgery failures. Brain 139:444–451. https://doi.org/10.1093/brain/awv372CrossRefPubMed

20.

Jones AL, Cascino GD (2016) Evidence on use of neuroimaging for surgical treatment of temporal lobe epilepsy: a systematic review. JAMA Neurol 73:464–470. https://doi.org/10.1001/jamaneurol.2015.4996CrossRefPubMed

21.

Arya R, Mangano FT, Horn PS, Holland KD, Rose DF, Glauser TA (2013) Adverse events related to extraoperative invasive EEG monitoring with subdural grid electrodes: a systematic review and meta-analysis. Epilepsia 54:828–839. https://doi.org/10.1111/epi.12073CrossRefPubMed

22.

Mullin JP, Shriver M, Alomar S, Najm I, Bulacio J, Chauvel P, Gonzalez-Martinez J (2016) Is SEEG safe? A systematic review and meta-analysis of stereo-electroencephalography-related complications. Epilepsia 57:386–401. https://doi.org/10.1111/epi.13298CrossRefPubMed

Title: Decision-making in temporal lobe epilepsy surgery based on invasive stereo-electroencephalography (sEEG)
Authors: Lasse Dührsen
Thomas Sauvigny
Franz L. Ricklefs
Wolfgang Hamel
Johannes A. Koeppen
Jonas M. Hebel
Michael Lanz
Tobias Martens
Publication date: 01-10-2020
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Electroencephalography
Epilepsy
Published in: Neurosurgical Review / Issue 5/2020
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-019-01175-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Decision-making in temporal lobe epilepsy surgery based on invasive stereo-electroencephalography (sEEG)

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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