Stereo-EEG in children with therapy-refractory epilepsies: Robot-assistance plus stereotaxy combines speed with maximal precision for the implantation of multiple depth electrodes

Abstract

Aims: “Stereo-EEG” is an invasive diagnostic procedure for the presurgical evaluation of therapy-refractory epilepsies, during which depth electrodes are implanted stereotactically into the brain parenchyma via multiple burr holes. A comprehensive evaluation often requires up to 20 depth electrodes in multiple brain areas, which can lead to long operations (20 to 30 minute per electrode) when conventional stereotaxy is used. Special assisting robots can make these implantations much faster (< 10 minute per electrode) by automatically defining the preplanned implantation trajectories for the surgeon. Without the use of a stereotaxic frame (“frameless”); however, the same precision as with conventional stereotaxy cannot be achieved. Here, we present the first cases of our new approach which combines both techniques, aiming at combining the speed of robot-assistance with the precision of conventional stereotaxy.