Details

Autor(en) / Beteiligte

• Smith, Kelsey M.
• Alden, Eva C.
• Simpson, Hugh D.
• Brinkmann, Benjamin H.
• Gregg, Nicholas M.
• Miller, Kai J.
• Lundstrom, Brian N.

Titel

Multimodal approach leads to seizure-freedom in a case of highly refractory drug-resistant focal epilepsy

Ist Teil von

• Epilepsy & behavior reports, 2022-01, Vol.20, p.100570, Article 100570

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2022

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• •Repeat SEEG may be indicated after prior surgical failure.•SEEG-guided RF ablation can be used for diagnostic and therapeutic purposes.•Awake resections can reduce the risk of neurological deficits in epilepsy surgery. Drug-resistant, nonlesional, extratemporal lobe focal epilepsy can be difficult to treat and may require a high degree of multidisciplinary teamwork to localize the seizure onset zone for resective surgery. Here, we describe a patient with longstanding drug-resistant, nonlesional, extratemporal focal epilepsy with a high seizure burden who became seizure-free after prolonged evaluation and eventual left frontal cortical resection. Prior evaluations included magnetoencephalography, invasive video-EEG monitoring, and implantation of a responsive neurostimulation (RNS) device for ongoing intracranial stimulation. Highly sophisticated techniques were utilized including stereotactic localization of prior evaluations to guide repeat stereo-EEG (SEEG), electrical stimulation mapping, SEEG-guided radiofrequency ablation, and awake resection with language and motor mapping using a cognitive testing platform . Incorporating a wide array of data from multiple centers and evaluation time periods was necessary to optimize seizure control and minimize the risk of neurological deficits from surgery.