Invasive Epilepsy Monitoring: The Switch from Subdural Electrodes to Stereoelectroencephalography

Stereoelectroencephalography (SEEG) has experienced an explosion in use due to a shifting understanding of epileptic networks and wider application of minimally invasive epilepsy surgery techniques. Both subdural electrode (SDE) monitoring and SEEG serve important roles in defining the epileptogenic zone, limiting functional deficits, and formulating the most effective surgical plan. Strengths of SEEG include the ability to sample difficult to reach, deep structures of the brain without a craniotomy and without disrupting the dura. SEEG is complementary to minimally invasive epilepsy treatment options and may reduce the treatment gap in patients who are hesitant about craniotomy and surgical resection. Understanding the strengths and limitations of SDE monitoring and SEEG allows epileptologists to choose the best modality of invasive monitoring for each patient living with drug-resistant seizures.

Automated summary

Stereoelectroencephalography (SEEG) is increasingly used in epilepsy surgery due to evolving understanding of epileptic networks. It allows for sampling deep brain structures without a craniotomy or disrupting the dura, offering advantages over subdural electrode (SDE) monitoring. SEEG complements minimally invasive options, reducing the treatment gap for hesitant patients. Epileptologists can make informed decisions about invasive monitoring based on the strengths and limitations of SDE monitoring and SEEG.