Surgical techniques: Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC)
| Autor: | Jean Isnard, Alexandra Montavont, Hélène Catenoix, Sylvain Rheims, Pierre Bourdillon, Karine Ostrowsky-Coste, Marc Guénot |
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| Přispěvatelé: | Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hospices Civils de Lyon (HCL), Centre de recherche en neurosciences de Lyon (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2020 |
| Předmět: |
Drug Resistant Epilepsy
medicine.medical_specialty SEEG [SDV]Life Sciences [q-bio] medicine.medical_treatment Surgical contraindication Stereoelectroencephalography Resection Responder rate Stereotaxic Techniques 03 medical and health sciences 0302 clinical medicine Radiofrequency thermocoagulation Periventricular Nodular Heterotopia Epilepsy surgery Electrocoagulation medicine Humans Thermo-SEEG Deep electodes Drug-resistant business.industry Focal epilepsy General Medicine Management algorithm Functional neurosurgery Neurology Radiofrequency Stereotactic Electrocorticography Epilepsies Partial Neurology (clinical) Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Seizure-European Journal of Epilepsy Seizure-European Journal of Epilepsy, Elsevier, 2020, 77, pp.64-68. ⟨10.1016/j.seizure.2019.01.021⟩ |
| ISSN: | 1059-1311 |
| Popis: | International audience; Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC) consists of coupling SEEG investigation with RF-TC stereotactic lesioning directly through the recording electrodes. In this systematic review the surgical technique, indications, and outcomes are described. Maximum accuracy is reached when a frame-based procedure with a robotic assistance and a per-operative vascular X-ray imaging are performed. Monitoring of the lesioning procedure based on the impedance, a sharp modification of which indicates that the thermocoagulation has reached its maximum volume, allows the optimization of the lesion size. The first indication concerns patients in whom a SEEG is required to determine whether surgery is feasible and in whom resection is indeed possible. Even if surgery is performed owing to insufficient efficacy of SEEG-guided RF-TC, the procedure remains interesting owing to its high positive predictive value for good outcome after surgery. The second indication concerns patients in whom phase I non-invasive investigations have concluded to surgical contraindication and who may still undergo SEEG in a purely therapeutic perspective (small deep zones inaccessible to surgery and network nodes of large epileptic networks). Lastly, SEEG-guided RF-TC can be considered as a first-line treatment for periventricular nodular heterotopia (PNH). Independently of indication, the overall seizure-free rate is 23% and the responder rate is 58%. The best results are obtained for PNH (38% seizure-free and 81% responders), while the worst results have been reported for temporal lobe-epilepsy in a dedicated study. The overall complication rate is 2.5%. More evidence is needed to help determine the exact place of SEEG-guided RF-TC in the surgical management algorithm. |
| Databáze: | OpenAIRE |
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