Stereoelectroencephalography (SEEG)
Overview of Stereoencephalography (SEEG)
Stereoencephalography (SEEG) is a diagnostic test for evaluating patients with epilepsy, specifically when their seizures are not well controlled with medications and they are considering therapeutic epilepsy surgery. This test uses a surgical robot to place very thin electrodes in specific brain areas using a minimally invasive technique that does not require large skin openings or shaving large amounts of hair.
After the surgery, patients are admitted to the epilepsy monitoring unit (EMU) to record seizure activity. This allows neurologists to characterize where their seizures originate and how they spread throughout the brain. As every patient’s epilepsy is unique, SEEG enables your doctors to provide personalized, tailored recommendations for epilepsy surgery.
What is SEEG used for?
SEEG is primarily used to evaluate epilepsy, specifically in patients with drug-resistant epilepsy. It is a tool for precisely identifying areas of the brain where seizures begin and travel through, which is critical information when considering surgical treatment for epilepsy. SEEG allows neurologists and surgeons to make informed decisions about whether surgery is a viable option and which specific brain area the surgical team should target to control seizures while preserving essential brain functions.
Am I a candidate for SEEG?
Some key factors that may make someone a good candidate for SEEG include:
- When non-invasive tests, such as MRI or EEG, cannot precisely identify where seizures are starting in the brain or if they give conflicting results
- When seizures appear to involve multiple areas of the brain
- When surgery might help control seizures, but doctors need more precise information about the patient’s seizure network to avoid damaging critical functional areas of the brain.
\
Common Questions about SEEG
How long does SEEG take?
The entire SEEG process can take around one to two weeks, with the surgical procedure taking a few hours and subsequent monitoring lasting days to weeks.
What is the difference between SEEG and intracranial EEG?
Intracranial EEG broadly refers to any EEG technique in which electrodes are placed inside the skull to record electrical activity. Traditionally, neurosurgeons used strips or grids of electrodes on the surface of the brain to record this activity, which typically required temporary removal of part of the skull in a craniotomy.
At Barrow Neurological Institute, neurosurgeons typically use SEEG to perform intracranial EEG. SEEG uses thin, flexible electrodes placed in specific brain regions through small holes drilled in the skull. This minimally invasive technique does not require a large skin opening or shaving large amounts of hair.
The electrodes are strategically placed throughout the brain, providing a three-dimensional picture of seizure activity—the “stereo” in stereoEEG stands for three-dimensional.
Where in the brain are SEEG electrodes placed?
Neurosurgeons place electrodes throughout the brain, depending on where seizures are suspected to originate, based on the results of prior tests such as MRI, EEG, and MEG. The locations in which electrodes are placed are highly individualized and depend on your specific seizures and brain anatomy.
How long will I be in the hospital for SEEG?
For SEEG, you can expect to be in the hospital for one-to-two weeks.
Here’s a typical timeline:
- Surgery for electrode placement: Performed under general anesthesia, usually takes three-to-four hours.
- Recording in the EMU: After surgery, you will remain in the hospital for continuous monitoring of your brain’s electrical activity in the EMU. The length of stay varies depending on how long it takes to record sufficient seizure activity and gather the necessary data for your treatment plan.
- Surgery for removal of electrodes: Once your epilepsy team has gathered sufficient data, your neurosurgeon will remove the electrodes while you are under general anesthesia. This usually takes about 30 minutes. Afterward, patients are typically discharged home on the same day or the day after.
