Stereo‐electroencephalography‐guided three‐dimensional radiofrequency thermocoagulation for mesial temporal lobe epilepsy with hippocampal sclerosis: A retrospective study with long‐term follow‐up

Li, Kaiwei; Shi, Jianwei; Wei, Penghu; He, Xiaosong; Shan, Yongzhi; Zhao, Guoguang

doi:10.1002/epi4.12866

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…Several reports have illustrated the benefits of the technique, namely larger lesion sizes [51,52]. Using a combination of orthogonal and oblique sEEG implant approaches, structures such as the mesial temporal structures [53] and insular cortices [52,54] may be particularly amenable to this approach. While 3D lesioning may increase RF lesion sizes to something more akin to MRgLITT (albeit without the need for a second procedure), the use of small precise lesioning afforded by SgRFTC may also be of great value in certain clinical conditions.…”

Section: Future Of Sgrftcmentioning

confidence: 99%

Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation: Diagnostic and Therapeutic Implications

Castellano,

Singla,

Barot

et al. 2024

Brain Sciences

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Despite recent medical therapeutic advances, approximately one third of patients do not attain seizure freedom with medications. This drug-resistant epilepsy population suffers from heightened morbidity and mortality. In appropriate patients, resective epilepsy surgery is far superior to continued medical therapy. Despite this efficacy, there remain drawbacks to traditional epilepsy surgery, such as the morbidity of open neurosurgical procedures as well as neuropsychological adverse effects. SEEG-guided Radiofrequency Thermocoagulation (SgRFTC) is a minimally invasive, electrophysiology-guided intervention with both diagnostic and therapeutic implications for drug-resistant epilepsy that offers a convenient adjunct or alternative to ablative and resective approaches. We review the international experience with this procedure, including methodologies, diagnostic benefit, therapeutic benefit, and safety considerations. We propose a framework in which SgRFTC may be incorporated into intracranial EEG evaluations alongside passive recording. Lastly, we discuss the potential role of SgRFTC in both delineating and reorganizing epilepsy networks.

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Section: Future Of Sgrftcmentioning

confidence: 99%

Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation: Diagnostic and Therapeutic Implications

Castellano,

Singla,

Barot

et al. 2024

Brain Sciences

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SEEG‐RFTC in patients with refractory focal epilepsy: real‐world outcomes from 121 cases

Liu,

Cai,

Mao

et al. 2024

Ann Clin Transl Neurol

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ObjectiveRadiofrequency thermocoagulation (RFTC) has emerged as an effective and safe treatment method for patients with refractory focal epilepsy, when stereo‐electroencephalography (SEEG) is implanted. Although real‐world research results are still limited, a considerable number of patients have shown favorable outcomes with this less invasive method. This study aims to describe the outcomes and predictive factors of SEEG‐RFTC in real‐world research.MethodsA retrospective observational study was conducted on patients in the authors' epilepsy center. In total, 121 patients who underwent RFTC were included in the study. Post‐RFTC outcomes were evaluated using the seizure‐free rate and response rate (seizure frequency reduction more than 50%). Predictive factors influencing post‐RFTC outcome were considered by comparing different variables.ResultsThe mean follow‐up period was 18.3 months. Eighty‐two patients (67.8%) were responders and 54 (44.6%) were seizure free. In 36 patients with malformation of cortical development, the seizure‐free rate and the response rate were 69.44% and 83.33%, respectively. In 20 patients with hippocampal sclerosis, 19 patients were responders and 14 (70%) patients were seizure free at the last follow‐up. The MRI feature and etiology of epilepsy are correlated with the outcome. MR‐positive is a predictive factor for seizure freedom (p < 0.01) and responders (p < 0.01). Other factors have no predictive value for post‐RFTC outcome.InterpretationSEEG‐RFTC is a safe procedure and yields favorable outcomes in numerous cases of focal DRE. The MRI feature and etiology of epilepsy are correlated with the seizure‐free rate and response rate. And MRI positivity is the predictor for good RFTC outcome.

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Early assessment of responsive neurostimulation for drug-resistant epilepsy in China: A multicenter, self-controlled study

Yang,

Wei,

Shi

et al. 2024

Chinese Medical Journal

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Background: To evaluate the efficacy and safety of the first cohort of people in China treated with a responsive neurostimulation system (EpilcureTM, GenLight MedTech, Hangzhou, China) for focal drug-resistant epilepsy in this study. Methods: This multicenter, before-and-after self-controlled study was conducted across 8 centers from March 2022 to June 2023, involving patients with drug-resistant epilepsy who were undergoing responsive neurostimulation (RNS). The study was based on an ongoing multi-center, single-blind, randomized controlled study. Efficacy was assessed through metrics including median seizure count, seizure frequency reduction (SFR), and response rate. Multivariate linear regression was conducted to explore the relationships of basic clinical factors and intracranial electrophysiological characteristics with SFR. The postoperative quality of life, cognitive function, depression, and anxiety were evaluated as well. Results: The follow-up period for the 19 participants was 10.7 ± 3.4 months. Seizure counts decreased significantly 6 months after device activation, with median SFR of 48% at the 6th month (M6) and 58% at M12 (P <0.05). The average response rate after 13 months of treatment was 42%, with 21% (n = 4) of the participants achieving seizure freedom. Patients who have previously undergone resective surgery appear to achieve better therapeutic outcomes at M11, M12 and M13 (β <0, P <0.05). No statistically significant differences were observed in patients’ scores of quality of life, cognition, depression and anxiety following stimulation when compared to baseline measurements. No serious adverse events related to the devices were observed. Conclusions: The preliminary findings suggest that EpilcureTM exhibits promising therapeutic potential in reducing the frequency of epileptic seizures. However, to further validate its efficacy, larger-scale randomized controlled trials are required. Registration: Chinese Clinical Trial Registry (No. ChiCTR2200055247)

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Stereo‐electroencephalography‐guided three‐dimensional radiofrequency thermocoagulation for mesial temporal lobe epilepsy with hippocampal sclerosis: A retrospective study with long‐term follow‐up

Cited by 3 publications

References 14 publications

Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation: Diagnostic and Therapeutic Implications

Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation: Diagnostic and Therapeutic Implications

SEEG‐RFTC in patients with refractory focal epilepsy: real‐world outcomes from 121 cases

Early assessment of responsive neurostimulation for drug-resistant epilepsy in China: A multicenter, self-controlled study

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