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Epilepsy Surgery Team Offers New Stereo EEG Mapping for Epilepsy Surgery

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According to Dr. Guy McKhann from the Epilepsy Center, a more refined and less invasive procedure is now available for some epilepsy patients to try to help cure their seizures. The procedure is called Stereoelectroencephalography (SEEG).

Working with Dr. Neil Feldstein in Pediatric Neurosurgery and Dr. Sameer Sheth in Adult Epilepsy, Dr. McKhann is now carrying out SEEG monitoring procedures at Columbia University Medical Center/New York Presbyterian Hospital in both children and adults with medically refractory epilepsy.

In appropriate patients, SEEG allows surgeons to locate the origin of a patient’s seizures in the brain without the open brain surgery procedure that is typically performed to implant a large array of electrodes for the same person. SEEG is safer and much less painful for the patient than subdural monitoring.

The preparation for epilepsy surgery involves extensive planning and brain mapping to precisely locate the seizure focus, or the part of the brain where the epileptic seizures originate. In complex cases, this is traditionally done by removing a piece of the skull (a procedure called a craniotomy) and placing electrodes on the surface of the brain (a procedure called subdural monitoring).

The patient is then tapered off their medications and monitored closely in the hospital until one or more seizures are recorded. This way, the exact seizure focus and surgical target can be determined.

Neurosurgeons can then perform a variety of surgical techniques, including the outright removal of the seizure focus to improve and, in some cases, eliminate seizures all together (see our list of related posts below for more on that).

There are advantages and disadvantages to the SEEG procedure in comparison with the subdural monitoring surgery. Only a multidisciplinary evaluation by an experienced team such as at the Columbia Comprehensive Epilepsy Center can decide which procedure is best for an individual patient.

SEEG uses sophisticated computers and stereotactic imaging technology to allow the placement of depth electrodes (usually five to fifteen) around the skull and eliminates the need for a much more invasive craniotomy.

In addition to being less invasive, this procedure has several advantages over the craniotomy method. SEEG allows the placement of electrodes across the three dimensional extent of the brain, which gives greater access to areas deeper in the brain and improves the mapping precision of the seizure focus.

Also with SEEG, electrodes can be placed in multiple areas around the skull instead of being clustered solely in the area of the brain made accessible by a craniotomy.

“This approach has been heavily used in parts of Europe for decades, but has only recently been gaining in popularity here in the US,” said Dr. McKhann. “Advances in computer and robotic technology have made this procedure more safe and efficient. A handful of other experienced epilepsy centers in the US have recently incorporated the SEEG approach, which we think is a significant advance over subdural monitoring in correctly selected patients.”

To learn more about Dr. Guy McKhann, see his bio page here.

Related Posts:
Dr. Guy McKhann Uses New MRI Guided Laser Therapy To Treat Epilepsy
Dr. Guy McKhann Brings Good News To Epilepsy Patients: Implantable Device To Control Seizures Now Available
‘I’m Living A Normal Life For The First Time’: Madison’s Epilepsy Cure
All He Wanted Was To Drive: An Epilepsy Success Story
Brain Mapping To Protect Language During Surgery

patient journey

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