Authors :
Presenting Author: Lena Habermehl, MD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Akshaya Rathin Sivaji, MD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Mohamed Ahmed Abdelsabour Hasan, MD – University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Lauren Eyring, BSN, RN – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Guadalupe Fernandez-Baca Vaca, MD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Karlee Hanchin, NP – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Luisa Londono, MD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Jun Park, MD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Michael Rose, Lead EEG Technologist – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Michael D Staudt, MD – Department of Neurological Surgery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
Rupin Singh, MD – 1 Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Saeideh Salahizadeh, MD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Suraj Thyagaraj, PhD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Jon Zande, MD – Department of Neurology, University of Michigan, Ann Arbor, MI, USA
Neel Fotedar, MD – Epilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
Rationale:
Many studies have compared stereotactic electroencephalography (SEEG) with subdural electrodes (SDE) as forms of invasive EEG (iEEG). Based on the results, SEEG is the favored method. We wanted to investigate whether SDE are used more frequently in patients with suspected proximity to eloquent areas and therefore achieves inferior results.
Methods:
We retrospectively reviewed the epilepsy surgery conference protocols from 2006 to 2023 at UH Cleveland Medical Center and included all patients undergoing epilepsy surgery. Demographic data, outcome, proximity to eloquent areas and type of iEEG was assessed. Descriptive statistics, as well as normality tests were performed. Kruskal Wallis Test, (pairwise) Chi-square test with Bonferroni correction were used to assess group differences.
Results:
205 patients underwent surgery. Engel 1 outcome was significantly less frequent in the SDE group (45.7%), compared to SEEG (70.6%) and direct surgery (75%). Seizure onset zone (SOZ) and eloquent cortical areas overlapped 35.6% of the SDE patients, but only 9.0% of the SEEG patients (p< 0.001). This overlap was associated with Engel 2-4 outcome (p=0.032).