Journal article
Stereo-electroencephalography in the setting of a preexisting deep brain stimulation device: illustrative case
Journal of neurosurgery. Case lessons, v 9(17), 24854
28 Apr 2025
PMID: 40294526
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND Deep brain stimulation (DBS) and responsive neurostimulation are increasingly being used to treat drug-resistant epilepsy (DRE). However, patients who experience partial or limited improvement in seizure control could require additional surgical interventions or refinement of their epilepsy network characterization, including further stereo-electroencephalography (SEEG) investigations. SEEG in the setting of previously implanted hardware demonstrates a myriad of technical challenges. The authors present the first reported demonstration of SEEG electrode implantation with a preexisting DBS device. OBSERVATIONS The patient was a 36-year-old male with a history of severe DRE with focal impaired awareness seizures beginning at 7 years of age. Despite having a bilateral DBS device for the anterior nucleus of the thalamus, he continued to have 1-2 seizures per day and was offered SEEG. The patient tolerated the surgery well without any morbidity, with a successfully improved definition of his epilepsy network. SEEG allowed the medical team to titrate stimulation settings while following intracranial electrographic response. LESSONS SEEG in the setting of preexisting DBS can be performed safely without damage to functioning hardware, and the authors obtained characterization and localization of the epilepsy network. Further follow-up will be needed to assess the efficacy outcomes of additional intervention in this patient.
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Details
- Title
- Stereo-electroencephalography in the setting of a preexisting deep brain stimulation device: illustrative case
- Creators
- Stephen Jaffee - Allegheny Hlth Network, Neurosci Inst, Dept Neurosurg, Pittsburgh, PA USANavnika Gupta - Allegheny Health NetworkDallas Kramer - Allegheny Health NetworkDorian M. Kusyk - Allegheny Health NetworkJames Valeriano - Allegheny Health NetworkAmanda Merkley - Carnegie Mellon UniversityTrent Kite - Allegheny Health NetworkShaifali Arora - Allegheny Health NetworkPulkit Grover - Carnegie Mellon UniversityAlexander C. Whiting - Allegheny Health Network
- Publication Details
- Journal of neurosurgery. Case lessons, v 9(17), 24854
- Publisher
- Amer Assoc Neurological Surgeons
- Number of pages
- 5
- Grant note
- Highmark Health (Pittsburgh, Pennsylvania)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001517497500010
- Scopus ID
- 2-s2.0-105005527776
- Other Identifier
- 991022172662204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery