Simultaneous Scalp and Stereotactic Depth Electrode Recordings for Improved Invasive Monitoring and Seizure Localization in Children with Epilepsy
Abstract number :
2.005
Submission category :
3. Neurophysiology / 3A. Video EEG Epilepsy-Monitoring
Year :
2022
Submission ID :
2204399
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:24 AM
Authors :
Simeon Wong, MHSc-BME – Hospital for Sick Children; Nebras Warsi, MD – Hospital for Sick Children; Rohit Sharma, RET, REPT – Clinical Manager, Neurology, Hospital for Sick Children; Hiroshi Otsubo, MD – Hospital for Sick Children; George Ibrahim, MD, FRCSC – Staff Surgeon, Neurosurgery, Hospital for Sick Children
Rationale: Invasive monitoring using stereotactically inserted depth EEG (SEEG) electrodes is becoming increasingly popular in North America. SEEG has a more favorable risk profile than traditional craniotomies, but comparative studies have suggested SEEG monitoring result in fewer resections. Lowered coverage and difficulties in correlating with prior scalp EEGs have been identified as factors. Although a few reports have attempted to address correlation between scalp and SEEG, the routine collection of simultaneous stereo and scalp EEG is uncommon.
Methods: We retrospectively reviewed pediatric patients over the previous 2 years at the Hospital for Sick Children who underwent SEEG insertion for invasive monitoring of epileptic activity. We present our methodology for conducting simultaneous scalp and stereotactic EEG recordings. We also conducted lead field modelling to simulate the potential impact on EEG interpretation due current leakage through the insertion burrholes and compare the topology and waveforms of simulated intracranial signals between models with and without burrholes.
Results: We identified 20 patients who underwent simultaneous stereo and scalp EEG for invasive monitoring. No patients experienced adverse events related to the application of scalp EEG. We present three case examples where the presence of scalp EEG informed the clinical reading of the intracranial recordings._x000D_
The presence of burrholes in the skull layer of the leadfield models did not discernably modify simulated waveforms or scalp EEG topology. Altered placements of 10-20 leads to avoid burrholes may alter EEG waveforms.
Conclusions: The placement and simultaneous acquisition of scalp EEG during invasive monitoring through stereotactically inserted EEG electrodes is routinely performed at the Hospital for Sick Children. In a retrospective analysis of cases, no adverse events were identified. Scalp EEG recordings may assist with clinical interpretation. Burrholes in the skull layer did not discernably alter EEG waveforms or topology in a simulation.
Funding: Canadian Institutes of Health Research - Banting and Best Doctoral Research Award
Neurophysiology