A Practical Approach to Stereo EEG

✍ Scribed by Stephan Schuele MD MPH (editor)

• Publisher: Demos Medical
• Tongue: English
• Leaves: 486
• Category: Library

✦ Synopsis

Stereo EEG has revolutionized the way invasive EEG explorations are performed, facilitating the assessment of more complex cases with increased precision, a lower surgical risk, and better patient outcomes. A Practical Approach to Stereo EEG is the first dedicated reference on stereoelectroencephalography written for trainees, physicians, and technologists involved in invasive EEG evaluation and monitoring. This go-to resource provides a practical overview of the concepts, methodology, technical requirements, and implantation strategies for common and uncommon surgical epilepsies amenable to stereo EEG. Including over three hundred detailed figures, anatomical drawings, and MRI correlations, this guidebook is an indispensable tool for anyone training, practicing, and teaching in the field.

With chapters written by leading experts from around the world, the book is divided into 10 sections covering noninvasive evaluation, technical aspects, electrode planning, practical approach for specific epilepsies, surgical placement in adults and children, interpretation, brain mapping, surgical procedures, and outcomes. Chapters integrate highlighted key concepts with illustrative case examples throughout to enhance clinical applicability. Four detailed case discussions of specific epilepsy syndromes covered in the book are also available online to demonstrate the process of patient evaluation, surgical planning, and decision-making in a multidisciplinary patient management conference.

A Practical Approach to Stereo EEG is the essential comprehensive clinical handbook for practitioners at any level of training or experience involved in invasive EEG evaluations or working at surgical epilepsy centers.

Key Features:

• Covers all practical aspects of stereo EEG, including the methodology, technical requirements, and strategies to successfully perform and interpret invasive monitoring
• Highly illustrated cases are interwoven within chapters to heighten clinical use
• World-class contributors with global expertise provide hands-on experience in successful use of stereo EEG in complex situations
• Additional online chapter-based narrated cases discuss specific epilepsy syndromes
• Purchase includes access to ebook available on most devices and computers

✦ Table of Contents

Cover
Title
Copyright
Contents
Contributors
Foreword
Preface
Abbreviations
Section I: Introduction
Chapter 1: The History and Principles of Stereo EEG
The Prestereo EEG Era
Laying the Foundation
Conceptualization of Stereo EEG
Technical Requirements
From Comprehensive Brain Sampling to Rational Surgery
The Stereo EEG Scriptures
Summary
Key References
Section II: Noninvasive Evaluation
Chapter 2: Phase I Evaluation
Key Concepts
Introduction
Symptomatogenic Zone
Irritative Zone
Ictal Onset Zone
Epileptogenic Lesion
Functional Deficit Zone
Eloquent Cortex
Epileptogenic Zone and Surgical Planning
Summary
Key References
Chapter 3: Advanced MRI Imaging
Key Concepts
Introduction
An Optimized MRI Epilepsy Protocol
What MRI “Can See”
MRI for Identifying Lesions in Mesial Temporal Lobe Epilepsy
MRI for Identifying Lesions in Neocortical Epilepsies
The Future of MRI: a Role for Artificial Intelligence and Classifiers?
Key References
Chapter 4: Electromagnetic Source Imaging for Stereo EEG Planning
Key Concepts
Introduction and History
Electrophysiological and Modelling Basis of Magnetoencephalography
Advantages of Magnetoencephalography for Guidance Of stereo EEG Implantation
Practical Use of Magnetoencephalography in Preimplantation Planning for Stereo EEG
Ictal Magnetoencephalography
Cautions and Limitations
Summary
Key References
Chapter 5: Nuclear Imaging
Key Concepts
Introduction
Single-Photon Emission Computed Tomography
PET
Case Examples
Summary
Key References
Chapter 6: Patient Selection for Stereo EEG
Key Concepts
Introduction
Developing a Hypothesis
Invasive Monitoring
Stereo EEG Versus Subdural Grid Implantation
Indications for Stereo EEG
Summary
Key References
Section III: Technical Aspects
Chapter 7: Electrodes
Key Concepts
Introduction
Electrode Materials
Electrode Parameters
Imaging Compatibility
Electrode Manufacturers
Summary
Key References
Chapter 8: Coregistration of Multimodal Imaging
Key Concepts
Introduction
Importance of Multimodal Image Coregistration in Stereo EEG
Identification of Structural Cerebral Abnormalities
Localization of Epileptic Activity
Presurgical Mapping of Eloquent Cortex
Illustrative Case
Summary
Key References
Chapter 9: Invasive Monitoring
Key Concepts
Introduction
Technical Aspects
Video-SEEG Monitoring: Early Management
Patient’s Care and Safety Procedures
Interictal and Ictal Recordings
Activation Procedures
Intracerebral Stimulations
Summary
Key References
Section IV: Electrode Placement
Chapter 10: The Epileptogenic Zone: A Critical Reconstruction
Key Concepts
Introduction
Different Methods, Different Meaning
What Is Seizure Onset? From Focus to Network
The Network Idea
Validation of the Network Hypothesis: Looking Inside the Coactivation
Phasic Synchrony and Tonic Desynchrony
The Fast Activity Conundrum
Deciphering Seizure Onset
The Quest for a Fingerprint of the Epileptogenic Zone
Epileptogenic Zone: A Pathophysiological Synthesis
Summary
Key References
Chapter 11: Toward a Revised Conceptual Framework of Stereo EEG Anatomo-Clinico-Electrical
Key Concepts
Introduction
Towards a New Conceptual Framework
Summary
Key References
Chapter 12: MRI-Negative Versus MRI-Positive Epilepsy in the Context of Stereo EEG
Key Concepts
Introduction
MRI-Positive Intractable Epilepsy and Stereo EEG
MRI-Negative Refractory Focal Epilepsy and Stereo EEG
Illustrative Cases
Summary
Key References
Section V: Practical Approach
Chapter 13: Temporal Lobe Epilepsy
Key Concepts
Introduction
Epilepsy and the Temporal Lobe
Temporal Lobe Epilepsy Syndromes
Stereo EEG in Temporal Lobe Epilepsy
Summary
Acknowledgments
Key References
Chapter 14: Frontal Lobe Epilepsy
Key Concepts
Introduction
Anatomy, Connectivity, and Functional Organization Of the Frontal Lobe
Semiological Classification of Frontal Lobe Seizures Along a Rostro-Caudal Axis
Summary
Acknowledgment
Key References
Chapter 15: Posterior Cortex Epilepsy
Key Concepts
Introduction
Anatomy and Function of the Posterior Region
Posterior Cortex Epilepsy Syndromes
Clinical Approach to Posterior Cortex Epilepsy Cases
Summary
Key References
Chapter 16: Temporal Plus Epilepsy
Key Concepts
Introduction
A Practical Approach to Temporo-Frontal Epilepsy
A Practical Approach to Temporo-Perisylvian Epilepsy
A Practical Approach to Temporo-Parieto-Occipital Epilepsy
Summary
Key References
Chapter 17: Operculo-Insular Epilepsy
Key Concepts
Introduction
Anatomy and Function of the Operculo-Insular Region
Operculo-Insular Epilepsy as a Distinct Syndrome
Clinical Approach to Operculo-Insular Epilepsy Cases
Summary
Key References
Chapter 18: Tuberous Sclerosis Complex
Key Concepts
Introduction
Epilepsy Surgery in Tuberous Sclerosis Complex
Presurgical Evaluation with Case Example
Stereo EEG
Minimally Invasive Surgery and Open Resection
Summary
Key References
Chapter 19: Stereo EEG in Epilepsy Associated with Nodular Heterotopia
Key Concepts
Introduction
Where Is the Epileptogenic Zone in Patients with Nodular Heterotopia?
What Noninvasive Methodology Can Teach Us About Epileptogenicity of Nodular Heterotopia
Stereo EEG as a Diagnostic Tool for Epilepsy Associated with Nodular Heterotopia
Stereo EEG: A Therapeutic Tool for Patients With nodular Heterotopia and Intractable Epilepsy
Illustrative Cases
Summary
Acknowledgments
Key References
Section VI: Surgical Placement
Chapter 20: Stereo EEG Electrode Implantation Using a Stereotactic Frame
Key Concepts
Introduction
Frame-Based Stereotaxy
Surgical Technique
Complications
Summary
References
Chapter 21: Robotic Placement of Stereo EEG Electrodes
Key Concepts
Introduction
Presurgical Planning
Robotic Implantation Technique
Summary
Key References
Chapter 22: Stereo EEG Electrode Placement in Children
Key Concepts
Introduction
Summary
Disclosure
Key References
Chapter 23: Surgical Complications and Challenges in Stereo EEG
Key Concepts
Introduction
Hemorrhagic Complications
Infections
Hardware-Related Complications
Cerebrospinal Fluid Leak
Other Complications
Summary
Key References
Section VII: Interpretation
Chapter 24 Physiological Activity Recorded With Intracranial EEG: From Wakefulness to Sleep
Key Concepts
Introduction
Methodological Considerations for the Recording of Physiological Activity in Intracranial EEG
Physiological Activity During Wakefulness
Physiological Activity During NonREM Sleep
Physiological Activity During REM Sleep
Beyond the Berger Frequency Spectrum: From Direct Current (DC) Shifts to Ripples (>80 Hz)
Physiological Activity During Transitional States
Summary
Key References
Chapter 25: Interpretation of Interictal Epileptiform Discharges
Key Concepts
Introduction
Identification of Interictal Epileptiform Discharges On Stereo EEG
Morphology
Amplitude
Polarity
Evolution
Interictal Epileptiform Activity, Seizure Onset Zone, and the Epileptogenic Zone
Scalp Correlates of Interictal Epileptiform Activity
Interictal Epileptiform Activity and Histopathological Lesions
Interictal Epileptiform Activity, Sleep, and Circadian Rhythm
Quantitative Measurement of Interictal Epileptiform Activity in Stereo EEG
Summary
Key References
Chapter 26: High-Frequency Oscillations
Key Concepts
Introduction
What Are Epileptic High-Frequency Oscillations?
Evidence for Clinical Usefulness of High-Frequency Oscillations
Differentiation Between Physiological and Epileptic High-Frequency Oscillations
Methodological Considerations in the Identification of High-Frequency Oscillations
Summary
Key References
Chapter 27: Ictal Activity
Key Concepts
Introduction
Epileptogenic Networks
Patterns of Seizure Onset
Quantification of Ictal Networks
Conclusion
Key References
Section VIII: Electrical Stimulation Mapping
Chapter 28: Technical Aspects of Electrical Stimulation Mapping
Key Concepts
Introduction
Comparison of Stimulation with Subdural and Depth Electrodes
Technical Aspects
Summary
Key References
Chapter 29: Electrical Stimulation for Functional Mapping During Stereo EEG Exploration
Key Concepts
Introduction
What Is the Role of Functional Mapping in an Individual Patient?
Language
Memory
Other Functions
Summary
Acknowledgments
Key References
Chapter 30: Stimulation-Induced Seizures to Define the Epileptogenic Zone
Key Concepts
Introduction
Background and Context
Parameters and Practical Aspects of Stimulation
Effect of Antiepileptic Drug Reduction
Seizures Induced by Stimulation
How Common Is Induction of Atypical Seizures by Stimulation During stereo EEG?
What Is the Relevance of Afterdischarges Induced By stereo EEG Stimulation?
Anatomical Electroclinical Correlation of Stimulated Seizures
Prognostic Value of Stimulated Seizures
Summary
Acknowledgment
Key References
Section IX: Surgical Procedures
Chapter 31: Laser Ablation for Epilepsy
Key Concepts
Introduction
Emergence of Laser Technology in Neurosurgery
Utilization Trends
Mechanism of Therapy
Laser Systems
Operative Technique
Seizure Control Following Laser Ablation
Cognitive Outcomes Following Laser Ablation
Complications
Other Laser Ablation Targets
Summary
Key References
Chapter 32: Stereo EEG-Guided Resections: Method and Technique
Key Concepts
Introduction
The Stereo EEG Methodology and Its Principles
Planning Stereo EEG Implantations
Stereo EEG Implantation Patterns
The Stereo EEG Implantation: Technical Nuances
Stereo EEG-Guided Resections - General Considerations
Stereo EEG Implantation Planning and Resections in the “Nonlesional Scenario”
Stereo EEG Implantation Planning and resections in the “Lesional Scenario”
Summary
Key References
Section X: Outcome
Chapter 33: Seizure Outcome After Stereo EEG Implantations
Key Concepts
Introduction
Seizure Freedom After Stereo EEG-Guided Resections
Predictors of Seizure Outcome with Stereo EEG
Complications Following Stereo EEG
Seizure Outcomes After Stereo EEG-Guided Nonresective Surgery
Summary
Key References
Chapter 34: Promise and Perils of Stereo EEG-Guided Resections for Cognition and Emotion
Key Concepts
Introduction
Seizure Outcome with Minimally Invasive Therapies
Cognitive and Emotional Outcome
Adverse Cognitive Effects from Depth Electrodes
Summary
Acknowledgments and Disclosures
Key References
Index