Stereo-EEG around the world: State of the art in Italy

Laura Tassi; Veronica Pelliccia; Francesca Bisulli; Matteo Martinoni; Lorenzo Ferri; Flavio Giordano; Federico Melani; Luca de Palma; Nicola Specchio; Carlo Efisio Marras; Francesco Cardinale; Carmen Barba

doi:10.1016/j.neucli.2024.103041

Stereo-EEG around the world: State of the art in Italy

Neurophysiol Clin. 2025 Jan 6;55(1):103041. doi: 10.1016/j.neucli.2024.103041. Online ahead of print.

Authors

Affiliations

¹ "Claudio Munari" Epilepsy Surgery Center, Niguarda Hospital, Full Member of European Reference Network on Rare and Complex Epilepsies, EpiCARE, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. Electronic address: [email protected].
² "Claudio Munari" Epilepsy Surgery Center, Niguarda Hospital, Full Member of European Reference Network on Rare and Complex Epilepsies, EpiCARE, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
³ IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the European Reference Network EpiCARE, Via Altura 3, 40139, Bologna, Italy; Department of Neuromotor and Biomedical Sciences, University of Bologna, Via G. Massarenti 11, 40138 Bologna, Italy.
⁴ IRCCS Istituto delle Scienze Neurologiche di Bologna, Full Member of the European Reference Network EpiCARE, Via Altura 3, 40139, Bologna, Italy.
⁵ Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS, Full Member of European Reference Network on Rare and Complex Epilepsies, EpiCARE, viale Pieraccini 24, 50139, Florence, Italy; Neurofarba Department, University of Florence, viale Pieraccini 6, 50139, Florence, Italy.
⁶ Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS, Full Member of European Reference Network on Rare and Complex Epilepsies, EpiCARE, viale Pieraccini 24, 50139, Florence, Italy.
⁷ Neurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, IRCCS, Full Member of European Reference Network on Rare and Complex Epilepsies, EpiCARE, Piazza S. Onofrio 4, 00165, Rome, Italy.
⁸ Neurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.

PMID: 39764861
DOI: 10.1016/j.neucli.2024.103041

Abstract

Stereo-EEG is not just a diagnostic examination but a complex methodology, requiring an accurate synthesis of many data (anatomical, clinical, neurophysiological, cognitive, metabolic, and genetic). The implantation scheme is decided based on a hypothesis (or hypotheses) of epileptogenic zone localization. Subsequently, intracerebral electrical stimulation is used to define the extent of highly functional cortical regions and to reproduce the clinical symptoms and signs associated with seizures. Finally, stereo-EEG-guided thermocoagulation is used, with the dual purpose of stopping/reducing the seizures and determining the prognosis of possible resective (curative) surgery. The centers in Italy that use stereo-EEG derive from the French school of Bancaud and Talairach. Nevertheless, each one has interpreted, on the basis of its own specificity and talent, a new methodology and philosophy of implantation. The present work presents the state of the art of stereo-EEG use in Italy, with detail of the stereo-EEG program of the Munari center in Milano, as well as those of Florence, Bologna and Rome.

Keywords: Cortical stimulation; Epilepsy surgery; MR negative; Pre-surgical evaluation; Stereo-EEG.