Matthew F Sacino1, Sean S Huang2, John Schreiber3, William D Gaillard3, Chima O Oluigbo1. 1. Department of Neurosurgery, Children's National Medical Center, George Washington University, Washington, District of Columbia. 2. Department of Health Systems Administration, Georgetown University, Washington, District of Columbia. 3. Department of Neurology, Children's National Medical Center, George Washington University, Washington, District of Columbia.
Abstract
BACKGROUND: Stereoelectroencephalography (SEEG) is an alternative addition to subdural grids (SDG) in invasive extra-operative monitoring for medically refractory epilepsy. Few studies exist on the clinical efficacy and safety of these techniques in pediatric populations. OBJECTIVE: To provide a comparative quantitative summary of surgical complications and postoperative seizure freedom associated with invasive extra-operative presurgical techniques in pediatric patients. METHODS: The systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was conducted utilizing Ovid Medline, Embase, Pubmed, and the Cochrane database. RESULTS: Fourteen papers with a total of 697 pediatric patients undergoing invasive SDG monitoring and 9 papers with a total of 277 pediatric patients undergoing SEEG monitoring were utilized in the systemic review. Cerebral spinal fluid (CSF) leaks were the most common adverse event in the SDG studies (pooled prevalence 11.9% 95% confidence interval [CI] 5.7-23.3). There was one case of CSF leak in the SEEG studies. Intracranial hemorrhages (SDG: 10.7%, 95% CI 5.3-20.3; SEEG: 2.9%, 95% CI -0.7 to 10.8) and infection (SDG: 10.8%, 95% CI 6.7-17) were more common in the SDG studies reviewed. At the time of the last postoperative visit, a greater percentage of pediatric patients achieved seizure freedom in the SEEG studies (SEEG: 66.5%, 95% CI 58.8-73.4; SDG: 52.1%, 95% CI 43.0-61.1). CONCLUSION: SEEG is a safe alternative to SDG and should be considered on an individual basis for selected pediatric patients. Published by Oxford University Press on behalf of Congress of Neurological Surgeons 2018.
BACKGROUND: Stereoelectroencephalography (SEEG) is an alternative addition to subdural grids (SDG) in invasive extra-operative monitoring for medically refractory epilepsy. Few studies exist on the clinical efficacy and safety of these techniques in pediatric populations. OBJECTIVE: To provide a comparative quantitative summary of surgical complications and postoperative seizure freedom associated with invasive extra-operative presurgical techniques in pediatric patients. METHODS: The systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was conducted utilizing Ovid Medline, Embase, Pubmed, and the Cochrane database. RESULTS: Fourteen papers with a total of 697 pediatric patients undergoing invasive SDG monitoring and 9 papers with a total of 277 pediatric patients undergoing SEEG monitoring were utilized in the systemic review. Cerebral spinal fluid (CSF) leaks were the most common adverse event in the SDG studies (pooled prevalence 11.9% 95% confidence interval [CI] 5.7-23.3). There was one case of CSF leak in the SEEG studies. Intracranial hemorrhages (SDG: 10.7%, 95% CI 5.3-20.3; SEEG: 2.9%, 95% CI -0.7 to 10.8) and infection (SDG: 10.8%, 95% CI 6.7-17) were more common in the SDG studies reviewed. At the time of the last postoperative visit, a greater percentage of pediatric patients achieved seizure freedom in the SEEG studies (SEEG: 66.5%, 95% CI 58.8-73.4; SDG: 52.1%, 95% CI 43.0-61.1). CONCLUSION: SEEG is a safe alternative to SDG and should be considered on an individual basis for selected pediatric patients. Published by Oxford University Press on behalf of Congress of Neurological Surgeons 2018.
Authors: Aura Kullmann; Debra Kridner; Steve Mertens; Mark Christianson; Dave Rosa; Camilo A Diaz-Botia Journal: Front Neurosci Date: 2022-04-29 Impact factor: 5.152
Authors: Jonathan P Scoville; Evan Joyce; Joshua Hunsaker; Jared Reese; Herschel Wilde; Amir Arain; Robert L Bollo; John D Rolston Journal: Oper Neurosurg (Hagerstown) Date: 2021-06-15 Impact factor: 2.703