Intracranial EEG in the 21st Century

Epilepsy Currents
B C JobstJean Gotman

Abstract

Intracranial electroencephalography (iEEG) has been the mainstay of identifying the seizure onset zone (SOZ), a key diagnostic procedure in addition to neuroimaging when considering epilepsy surgery. In many patients, iEEG has been the basis for resective epilepsy surgery, to date still the most successful treatment for drug-resistant epilepsy. Intracranial EEG determines the location and resectability of the SOZ. Advances in recording and implantation of iEEG provide multiple options in the 21st century. This not only includes the choice between subdural electrodes (SDE) and stereoelectroencephalography (SEEG) but also includes the implantation and recordings from microelectrodes. Before iEEG implantation, especially in magnetic resonance imaging -negative epilepsy, a clear hypothesis for seizure generation and propagation should be based on noninvasive methods. Intracranial EEG implantation should be planned by a multidisciplinary team considering epileptic networks. Recordings from SDE and SEEG have both their advantages and disadvantages. Stereo-EEG seems to have a lower rate of complications that are clinically significant, but has limitations in spatial sampling of the cortical surface. Stereo-EEG can sample deeper areas ...Continue Reading

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Citations

Jan 7, 2021·Brain Sciences·Aleksandra Kawala-SterniukEdward Jacek Gorzelanczyk
Feb 21, 2021·Seizure : the Journal of the British Epilepsy Association·Ricardo Lutzky SauteJoao Pereira Leite
Mar 23, 2021·Frontiers in Human Neuroscience·Ece BoranJohannes Sarnthein
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Jul 7, 2021·Epilepsy Research·Garnett Smith, William C Stacey
Jul 31, 2021·Journal of Neural Engineering·Kristin K SellersEdward F Chang
Aug 29, 2021·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Hiroya OnoEishi Asano

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