Background Stereotactic electroencephalography(SEEG)has emerged as a widely utilized diagnostic approach in epilepsy surgery,demonstrating broad clinical applications and a favorable safety profile.SEEG,when combined ...Background Stereotactic electroencephalography(SEEG)has emerged as a widely utilized diagnostic approach in epilepsy surgery,demonstrating broad clinical applications and a favorable safety profile.SEEG,when combined with radiofrequency thermocoagulation(RF-TC),facilitates the identification of epileptogenic zones and serves as a therapeutic option that eliminates the need for general anesthesia,thus incuring no additional costs for patients.This study aimed to investigate whether SEEG-guided RF-TC provides early therapeutic benefits.Methods A retrospective analysis was performed on 44 patients with drug-resistant epilepsy who underwent RF-TC treatment between April 2019 and December 2022,with complete follow-up data available.RF-TC was administered after the recording three or more habitual epileptic seizures in all patients.Demographic characteristics were retrospectively assessed,and treatment outcomes were evaluated using the Engel classification system.Results SEEG-guided RF-TC treatment was successfully performed in all patients without significant neurological complications.An average of 7.7±0.4 electrodes were implanted per patient,with a SEEG monitoring duration of 7.5 days(range:6.8–11).Follow-up after thermocoagulation ranged from 9 to 63 months.At the three-month follow-up,56.8%of patients achieved Engel I(11 cases)and II(14 cases)were included.At the six-month follow-up,40.9%of patients achieved Engel grades I(9 cases)and II(9 cases),with five patients proceeding to surgical treatment.By the 12-month follow-up,40.9%of patients reached Engel grades I(5 cases)and II(13 cases),with a cumulative total of 12 patients undergoing surgical intervention.At the 24-month follow-up,20.5%of patients achieved Engel grades I(3 cases)and II(6 cases),resulting in a cumulative total of 16 patients undergoing surgical treatment.A statistically significant reduction in seizure frequency was observed before and after thermocoagulation in all 44 patients(P=0.007),although the therapeutic effect of thermocoagulation decreased over time.Conclusions SEEG-guided RF-TC is a safe and effective treatment modality for drug-resistant epilepsy.However,as follow-up duration increases,both seizure-free rates and response rates following RF-TC progressively decline.展开更多
基金supported by National Key R&D Program of China(2021YFF1200700).
文摘Background Stereotactic electroencephalography(SEEG)has emerged as a widely utilized diagnostic approach in epilepsy surgery,demonstrating broad clinical applications and a favorable safety profile.SEEG,when combined with radiofrequency thermocoagulation(RF-TC),facilitates the identification of epileptogenic zones and serves as a therapeutic option that eliminates the need for general anesthesia,thus incuring no additional costs for patients.This study aimed to investigate whether SEEG-guided RF-TC provides early therapeutic benefits.Methods A retrospective analysis was performed on 44 patients with drug-resistant epilepsy who underwent RF-TC treatment between April 2019 and December 2022,with complete follow-up data available.RF-TC was administered after the recording three or more habitual epileptic seizures in all patients.Demographic characteristics were retrospectively assessed,and treatment outcomes were evaluated using the Engel classification system.Results SEEG-guided RF-TC treatment was successfully performed in all patients without significant neurological complications.An average of 7.7±0.4 electrodes were implanted per patient,with a SEEG monitoring duration of 7.5 days(range:6.8–11).Follow-up after thermocoagulation ranged from 9 to 63 months.At the three-month follow-up,56.8%of patients achieved Engel I(11 cases)and II(14 cases)were included.At the six-month follow-up,40.9%of patients achieved Engel grades I(9 cases)and II(9 cases),with five patients proceeding to surgical treatment.By the 12-month follow-up,40.9%of patients reached Engel grades I(5 cases)and II(13 cases),with a cumulative total of 12 patients undergoing surgical intervention.At the 24-month follow-up,20.5%of patients achieved Engel grades I(3 cases)and II(6 cases),resulting in a cumulative total of 16 patients undergoing surgical treatment.A statistically significant reduction in seizure frequency was observed before and after thermocoagulation in all 44 patients(P=0.007),although the therapeutic effect of thermocoagulation decreased over time.Conclusions SEEG-guided RF-TC is a safe and effective treatment modality for drug-resistant epilepsy.However,as follow-up duration increases,both seizure-free rates and response rates following RF-TC progressively decline.
