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Thermocoagulation of the Ictal Onset Zone Using SEEG (Thermo-SEEG) 

Thermocoagulation of the Ictal Onset Zone Using SEEG (Thermo-SEEG)
Chapter:
Thermocoagulation of the Ictal Onset Zone Using SEEG (Thermo-SEEG)
Author(s):

Marc Guénot

, and Pierre Bourdillon

DOI:
10.1093/med/9780198714668.003.0034
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date: 16 September 2019

Stereo-EEG (SEEG)-guided radiofrequency thermocoagulation (thermo-SEEG), is a stereotactic lesioning procedure in which the SEEG electrodes are used to deliver a radiofrequency current. This technique offers drug-resistant epileptic patients undergoing phase 2 investigations the possibility to benefit from lesions of the ictal onset zone without any additional invasive stereotactic procedure. A SEEG recording site can be considered eligible for thermo-SEEG if bipolar recordings through two adjacent contacts of the same electrode, located in cortical grey matter, show evidence of either spike-wave discharges or low-amplitude fast pattern at the onset of seizures. Electrical stimulations are systematically performed during video-SEEG recording sessions to avoid possible side-effects of a lesion. After 1-year follow-up, 45.6% of patients show greater than 50% improvement in terms of seizure frequency and 11.9% are seizure-free. Moreover, thermo-SEEG is safer than conventional surgery, with only a 3.2% rate of side-effects, which are almost always transient, including the expected ones.

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