Value of stereo-electroencephalogram in reoperation of patients with pharmacoresistant epilepsy: a single center, retrospective study.

ABSTRACT

PURPOSE: To systematically elucidate the value of stereo-electroencephalogram (SEEG) in the reoperation of patients with pharmacoresistant epilepsy. METHODS: Epilepsy patients who had previously undergone a failed operation and agreed to a reoperation were included in this study. The single center retrospective study evaluated the value of SEEG in epileptogenic zones (EZ) lateralization and localization as well as the complications related to the implantation. RESULTS: In total, fourteen patients met the inclusion criteria and received reoperation after implantation of SEEG. The average number of electrodes in each patient is 7.9. At the last available follow-up, nine (64.3%) patients were completely seizure-free according to the International League Against Epilepsy (ILAE) criteria. No significant complications were found in the cohort, two patients' electrodes were loosened and removed because of the seizure. No significant predictors of seizure-free status were identified in the present study, including the result of presurgical MRI, pathology and surgical strategy. CONCLUSIONS: Based on the comprehensive presurgical assessment data and careful discussion of multidisciplinary team, failed epileptic surgery deserves a second chance. Moreover, SEEG is an effective and safe methodology to determine the location of the EZ with the goal of performing reoperation.