Katz Joshua, Armstrong Caren, Kvint Svetlana, Kennedy Benjamin C
Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
Division of Pediatric Neurology and Pediatric Epilepsy Program, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Epilepsy Behav Rep. 2022 May 18;19:100552. doi: 10.1016/j.ebr.2022.100552. eCollection 2022.
Stereoelectroencephalography (SEEG) is an increasingly popular invasive monitoring approach to epilepsy surgery in patients with drug-resistant epilepsies. The technique allows a three-dimensional definition of the epileptogenic zones (EZ) in the brain. It has been shown to be safe and effective in adults and older children but has been used sparingly in children less than two years old due to concerns about pin fixation in thin bone, registration accuracy, and bolt security. As such, most current series of pediatric invasive EEG explorations do not include young participants, and, when they do, SEEG is often not utilized for these patients. Recent national survey data further suggests SEEG is infrequently utilized in very young patients. We present a novel case of SEEG used to localize the EZ in a 17-month-old patient with thin cranial bone, an open fontanelle, and severe drug-resistant epilepsy due to tuberous sclerosis complex (TSC), with excellent accuracy, surgical results, and seizure remission.
立体定向脑电图（SEEG）是一种在耐药性癫痫患者的癫痫手术中越来越受欢迎的侵入性监测方法。该技术能够对大脑中的致痫区（EZ）进行三维定位。已证明其在成人和大龄儿童中是安全有效的，但由于担心在薄骨中固定电极、配准精度和螺栓安全性，在两岁以下儿童中使用较少。因此，目前大多数儿科侵入性脑电图探索系列不包括幼儿参与者，即使包括，SEEG通常也不用于这些患者。最近的全国调查数据进一步表明，SEEG在非常年幼的患者中很少使用。我们报告了一个新颖的病例，使用SEEG对一名17个月大、颅骨薄、囟门未闭且因结节性硬化症（TSC）导致严重耐药性癫痫的患者进行致痫区定位，具有极高的准确性、手术效果和癫痫发作缓解情况。
