Abstract Details

Title Stereo-EEG Seizure Localization in Patients with Medically Intractable Focal Epilepsy Associated with Schizencephaly

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 12-011

Objective To demonstrate that stereo-electroencephalography (SEEG) may successfully localize the epileptogenic zone in patients who have focal epilepsy related to schizencephaly.

Background The optimal treatment for the medically refractory focal epilepsy in patients with schizencephaly is epilepsy surgery, however there is limited data in the role of SEEG evaluation in localization of the epileptogenic zone in this population.

Design/Methods Among 160 patients with medically intractable focal epilepsy who underwent invasive pre-surgical evaluation with stereo-electrodes in our institution during five years, 3 had schizencephaly. We describe the stereo-EEG evaluation results in these patients.

Results All patients had stereoelectrodes placement covering the cortex around the schizencephaly cleft, and bilateral sampling of mesial temporal structures. Patient 1 had the ictal onset of her clinical seizures localized near the schizencephalic cleft. Currently, she is 14 months seizure free after the resection of the epileptogenic focus. Patient 2 had the ictal onset of his clinical seizures localized to the hippocampus ipsilateral to the schizencephalic lesion. He also had two types of sub-clinical seizures: type 1 started from the hippocampus ipsilateral to the schizencephaly, and type 2 started from the schizencephaly. Currently, he is five months seizure-free after an anterior temporal lobectomy including mesial temporal structures ipsilateral to the schizencephaly. Patient 3 did not have spontaneous clinical seizures during 30 days of SEEG monitoring. She had sub-clinical seizures originating from the stereoelectrodes contacts within her schizencephalic lesion. Extraoperative electrical cortical stimulation triggered her typical seizures from these same stereoelectrodes contacts within schizencephaly. She has not had post-SEEG surgery yet.

Conclusions Our center experience demonstrates that extraoperative EEG monitoring with stereo-electrodes is a reliable and safe method of intracranial EEG evaluation of patients with medically intractable focal epilepsy related to schizencephaly.

Authors/Disclosures
Irina Podkorytova PRESENTER	Irina Podkorytova has nothing to disclose.
Bradley Lega, MD (UT Southwestern)	The institution of Bradley Lega has received research support from NIH.
Ryan Hays, MD, MBA, FAES, FAAN (UT Southwestern Medical Center)	Dr. Hays has nothing to disclose.
Mark Agostini, MD (U.T. Southwestern Medical Center)	Dr. Agostini has nothing to disclose.
Sasha Alick-Lindstrom, MD, MPH FACNS, FAES, FAAN (UT Southwestern Medical Center)	Dr. Alick-Lindstrom has nothing to disclose.
Rohit Das, MD, FAAN (VA Portland Healthcare System)	Dr. Das has received personal compensation for serving as an employee of Oregon Health Science University. Dr. Das has received personal compensation in the range of $10,000-$49,999 for serving as a Physician Advisor with Concentra .
Hina N. Dave, MD (Debakey VA hospital)	Dr. Dave has nothing to disclose.
Marisara Dieppa, MD (University of Texas SW Medical School)	Dr. Dieppa has nothing to disclose.
Kan Ding, MD (UT Southwestern Medical Center)	The institution of Dr. Ding has received research support from National Institute of Aging. The institution of Dr. Ding has received research support from NINDS.
Alexander Doyle, MD (University of Texas SW Medical School)	Dr. Doyle has nothing to disclose.
J. H. Harvey, DO (UT Southwestern Medical Center)	Dr. Harvey has received personal compensation for serving as an employee of Neuralogix. Dr. Harvey has received personal compensation for serving as an employee of Integris . Dr. Harvey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Harvey has stock in Epiminder.
Rodrigo Zepeda, MD (University of Texas Southwestern)	The institution of Dr. Zepeda has received research support from NIH.
Ghazala Perven, MD (UT Southwestern Medical Center)	Dr. Perven has nothing to disclose.