Less-Invasive Epilepsy Surgery

SEEG gives patients another option

Epilepsy is one of the most common neurological disorders, affecting up to 1 percent of the population in the United States. For those whose epilepsy cannot be controlled with anticonvulsant medication, epilepsy surgery is an option.

Stereoelectroencephalography (SEEG) is a surgical procedure that identifies where seizures are originating. “With SEEG, doctors place electrodes in targeted brain areas, which are then monitored to precisely locate seizure source,” says Cleveland Clinic epilepsy surgeon Jorge Alvaro Gonzalez-Martinez, MD, PhD.

Once the source is identified, a second surgical procedure will be scheduled, usually four to six weeks after the SEEG, “and a good seizure outcome may be possible,” he says.

In March 2009, Cleveland Clinic launched the first SEEG program in North America. “SEEG is considered to be a less-invasive approach compared to other methods of invasive monitoring,” Dr. Gonzalez-Martinez says.

“The electrodes are placed through small burr holes (2mm in diameter) that allow us to explore larger areas in the brain with minimal tissue damage.”

However, he cautions, “It is still brain surgery and there are some risks involved. The three main complications are infection, bleeding and stroke. So far in our series, we’ve had only mild complications with no clinical significance.”

A patient doesn’t have to have a particular number of seizures per day to qualify for the surgery. “There is no limit,” Dr. Gonzalez-Martinez says. “The main question is how debilitating are the seizures? And how many anti-epileptic drugs have failed for the patient? For example, depending on the person’s career or lifestyle, one seizure per month may be considered debilitating.”

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