P2-3-6. Simultaneous recording of SDE and SEEG for pharmacoresistant focal epilepsy

Abstract

Based on the concept of epilepsy surgery, subdural electrode (SDE) implantation is performed to identify the epileptic focus and to decide the range of resection. One of the major limitations of SDE is their inability to evaluate electric signals from the depth of the brain. On the other hands, stereotactic electroencephalography (SEEG) can appropriately cover target areas even though they reside in deep structures, and enable us to observe epileptic network. Hereby we report a patient with the pharmacoresistant left parietal lobe epilepsy, presenting with hyperkinetic seizures, which needs differentiation from the frontal lobe epilepsy. Sensory language area had to be identified by functional mapping. In this patient, we have performed simultaneous implantation of both SDE and SEEG covering the left frontal and the left parietal lobes. As a result, both sensory language area and epileptogenic zone were identified in the parietal lobe, not in the frontal lobe. The current case demonstrated that simultaneous implantation of SDE and SEEG is a feasible technique for identifying the epileptogenic zone and the functional areas in preoperative evaluation of epilepsy surgery.