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Depth EEG in Sensorimotor Cortex Epilepsy 

Depth EEG in Sensorimotor Cortex Epilepsy
Chapter:
Depth EEG in Sensorimotor Cortex Epilepsy
Author(s):

Bertrand Devaux

, Francine Chassoux

, Elisabeth Landré

, and Baris Turak

DOI:
10.1093/med/9780198714668.003.0028
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date: 23 October 2019

Surgery for intractable seizures originating from the sensorimotor cortex is associated with a risk of permanent deficit and a risk of incomplete epileptogenic tissue removal. Depth electrode implantation in the sensorimotor region has been performed over several decades with acceptable morbidity. Motor, sensory, premotor, supplementary motor area, and connected areas (parietal lobe, cingulate gyrus, and insular cortex) are explored with orthogonal and oblique electrodes. Implantation strategy is guided by ictal semiology and by the type of epileptogenic lesion identified on imaging. SEEG may identify (1) an MRI-negative focal cortical dysplasia, frequently localized in the sensorimotor region, (2) the epileptogenic part of a heterotopia or a polymicrogyria, (3) the extent of cortex resection in infantile hemiplegia, as an alternative to hemispherotomy, and may guide stereotactic radiofrequency thermocoagulations of a focal lesion as an alternative to surgical resection.

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