Stereoelectroencephalography-guided radiofrequency thermocoagulation in periventricular nodular heterotopia related epilepsy

Abstract

Objective To investigate the seizure outcome in a case series of patients with periventricular nodular heterotopia related epilepsy treated by stereo-EEG (SEEG)-guided radio-frequency thermocoagulation (RF-TC). Methods Five patients with periventricular nodular heterotopia related epilepsy admitted to Department of Neurosurgery, Beijing Fengtai Hospital from March 2015 to May 2017 were retrospectively studied. Following video-EEG monitoring, patients underwent SEEG recording for further identification of epileptogenic zone. All patients underwent RF-TC of periventricular nodular heteropia using contiguous contacts of the electrodes employed for recording. The contacts for RF-TC lesions were chosen according to anatomical and electrical criteria. Postoperative follow-up was conducted by outpatient visits or telephone, and the prognosis was assessed by Engel classification. Results This cohort included 5 cases and 23 electrodes. No serious complications were observed after operation. During the follow-up of 9-27 months, 4 patients were seizure-free (Engel Ⅰ), and 1 patient did not benefit from RF-TC (Engel Ⅳ). No obvious complications were reported during or after RF-TC in this series. Conclusions SEEG-guided RF-TC seems to have important clinical value in epileptogenicity validation and treatment of relatively limited periventricular nodular heterotopia. Key words: Epilepsy; Neurosurgical procedures; Stereoelectroencephalography; Radiofrequency thermocoagulation; Periventricular nodular heterotopia