SEEG stands for stereoelectroencephelography. Let’s break this down:
Electroencephalography, the EEG part of SEEG, is a way of studying electrical brain activity by placing electrodes (small metal probes that sense electrical activity in the brain) along the scalp.
It is most often used to diagnose epilepsy.
When the “s” for stereo is added, it means that electrodes are not only placed along the scalp but also inside the brain tissue using computer guidance (stereotactic) techniques. These are called depth electrodes, and they give a more detailed and complete picture of brain activity than an EEG alone can give.
In the webinar the doctors highlighted the advantages of SEEG over the traditional method of using subdural monitoring.
Traditional subdural monitoring involves removing a piece of the skull (in an operation called a craniotomy) to place electrodes on the surface of the brain. With SEEG, electrode placement can be done in a much less invasive way, with no craniotomy, shorter operating times, much smaller incisions, and less discomfort for the patient. SEEG allows surgeons to precisely place electrodes into deeper, harder to reach and more exacting locations then any other modality of available recording techniques.
ROSA robotic SEEG involves using a special robotic arm (called ROSA–short for Robotic Operating Surgical Assistant) to place the electrodes. Read our post about ROSA here. Usually SEEG requires a device called a stereotactic frame to be attached to the patient’s head, and the frame has to be reset for each electrode placement. The surgeon uses this frame as a reference point to find the precise areas of the brain to place the electrodes.
Dr. Feldstein and Dr. McKhann explained that the surgeons determine the best trajectory for each electrode based on the patient’s brain anatomy on MRI and CT scans. The ROSA robot then directly targets each electrode, allowing the electrodes to be placed more quickly, easily, and safely than with the frame method.
SEEG is only used for patients whose epilepsy is severe and does not respond to medical treatment. For those patients SEEG helps surgeons determine whether brain surgery to remove the area where the seizures arise is a good option, and if so which part or parts of the brain need to be targeted.
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