TY - JOUR
T1 - Multimodal approach leads to seizure-freedom in a case of highly refractory drug-resistant focal epilepsy
AU - Smith, Kelsey M.
AU - Alden, Eva C.
AU - Simpson, Hugh D.
AU - Brinkmann, Benjamin H.
AU - Gregg, Nicholas M.
AU - Miller, Kai J.
AU - Lundstrom, Brian N.
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2022/1
Y1 - 2022/1
N2 - Drug-resistant, nonlesional, extratemporal lobe focal epilepsy can be difficult to treat and may require a high degree of multidisciplinary teamwork to localize the seizure onset zone for resective surgery. Here, we describe a patient with longstanding drug-resistant, nonlesional, extratemporal focal epilepsy with a high seizure burden who became seizure-free after prolonged evaluation and eventual left frontal cortical resection. Prior evaluations included magnetoencephalography, invasive video-EEG monitoring, and implantation of a responsive neurostimulation (RNS) device for ongoing intracranial stimulation. Highly sophisticated techniques were utilized including stereotactic localization of prior evaluations to guide repeat stereo-EEG (SEEG), electrical stimulation mapping, SEEG-guided radiofrequency ablation, and awake resection with language and motor mapping using a cognitive testing platform . Incorporating a wide array of data from multiple centers and evaluation time periods was necessary to optimize seizure control and minimize the risk of neurological deficits from surgery.
AB - Drug-resistant, nonlesional, extratemporal lobe focal epilepsy can be difficult to treat and may require a high degree of multidisciplinary teamwork to localize the seizure onset zone for resective surgery. Here, we describe a patient with longstanding drug-resistant, nonlesional, extratemporal focal epilepsy with a high seizure burden who became seizure-free after prolonged evaluation and eventual left frontal cortical resection. Prior evaluations included magnetoencephalography, invasive video-EEG monitoring, and implantation of a responsive neurostimulation (RNS) device for ongoing intracranial stimulation. Highly sophisticated techniques were utilized including stereotactic localization of prior evaluations to guide repeat stereo-EEG (SEEG), electrical stimulation mapping, SEEG-guided radiofrequency ablation, and awake resection with language and motor mapping using a cognitive testing platform . Incorporating a wide array of data from multiple centers and evaluation time periods was necessary to optimize seizure control and minimize the risk of neurological deficits from surgery.
KW - Awake cortical resection
KW - Electrical stimulation mapping
KW - Epilepsy surgery
KW - SEEG
KW - SEEG-guided radiofrequency ablation
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U2 - 10.1016/j.ebr.2022.100570
DO - 10.1016/j.ebr.2022.100570
M3 - Article
AN - SCOPUS:85141957824
SN - 2213-3232
VL - 20
JO - Epilepsy and Behavior Reports
JF - Epilepsy and Behavior Reports
M1 - 100570
ER -