Clinical features of 21 cases of drug-resistant epilepsy and the therapeutic effect of stereotactic electroencephalography guided epileptic foci resection.

OBJECTIVE

To investigate the clinical characteristics of 21 patients with drug-resistant epilepsy (DRE) and evaluate the therapeutic outcome of guided resection of epileptic foci by stereotactic electroencephalography (SEEG).

METHODS

The clinical data of 21 patients with DRE treated in the Brain Hospital of Guangxi Zhuang Autonomous Region from April 2022 to April 2024 were retrospectively analyzed. All patients underwent multimodal imaging assessment before surgery, and the SEEG electrode implantation scheme was designed based on clinical data. The etiology was determined via SEEG. Intraoperative resection of epileptogenic foci was guided by SEEG, followed by a postoperative follow-up to evaluate the therapeutic effect. Patients' prognosis was assessed according to the Engle Seizure Control Scale, with Engel grade I indicating a good prognosis and grades II to IV indicating a poor prognosis. Logistic regression analysis was used to further explore the influencing factors of surgical prognosis.

RESULTS

A total of 240 SEEG electrodes were implanted in 21 patients, ranging from 8 to 17 per patient, with an average of (11.43±2.77) electrodes. There were a total of 1472 contact points, ranging from 31 to 118 per patient, with an average of (70.10±21.32). The postoperative follow-up time varied from 2 to 15 months. One patient experienced memory decline. Of the 21 patients, 11 (52.38%) had a good prognosis and 10 (47.62%) had a poor prognosis. Multivariate logistic regression analysis showed that long course of disease was an independent risk factor for poor postoperative prognosis.

CONCLUSION

In the treatment of drug-resistant epilepsy, multimodal imaging based SEEG can effectively detect epileptogenic foci, guiding the surgical excision safely and efficiently. This method holds promise for enhancing surgical outcomes in the treatment of DRE.