Stereoelectroencephalography-guided radiofrequency thermocoagulation

Neurosurg Focus Video. 2024 Jul 1;11(1):V14. doi: 10.3171/2024.4.FOCVID2442. eCollection 2024 Jul.

Abstract

Within the neurosurgeon's armamentarium, stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) is an elegant tool to manage epilepsy in selected cases. This technique can 1) be curative when targeting small-volume ictal onset zones, 2) be used as a diagnostic tool by observing the consequences of coagulation on seizures or by recording the epileptic network in SEEG, and 3) offer palliative treatment through multiple lesions within a wide epileptic network. It is performed on awake patients, under continuous neurological evaluation, while monitoring impedance, time, and energy delivered. It could offer highly favorable outcomes in some cases, as in periventricular nodular heterotopia where 81% of patients are responders.

Keywords: SEEG; epilepsy surgery; stereoelectroencephalography; thermocoagulation.