Application And Efficacy Of SEEG Guided Radiofrequency Thermocoagulation In Epilepsy Surgery

Objective: To study the application of stereotactic electroencephalography(SEEG)guided radiofrequency thermocoagulation(RFTC)in epilepsy surgery,and to explore its efficacy and safety in the treatment of drug-refractory epilepsy.Methods: The clinical data of 10 patients undergoing SEEG guided RF-TC in minimally invasive neurosurgery at the First Affiliated Hospital of Kunming Medical University from January 2020 to January 2023 were retrospectively analyzed.All patients were unable to determine the epileptogenic focus after rigorous phase Ⅰ evaluation and underwent SEEG,and underwent thermocoagulation damage after locating the epileptogenic focus.The frequency of preoperative seizures,SEEG implantation,complications during and after thermocoagulation were recorded.To compare the accuracy of diagnosis of epileptic foci between SEEG and MRI,pet-CT,and Video Electroencephalogram(VEEG).Follow up visits were conducted 2,6,and12 months after thermal coagulation damage,and the number of episodes was recorded.At the same time,referring to Engel grade and Professor Tan Qifu’s evaluation of the effectiveness of epilepsy surgery,it is considered effective if the postoperative seizure reduction is>50% and Engel grade Ⅱ or above.Results: All 10 patients successfully located the epileptogenic focus through SEEG.The follow-up period after thermal coagulation damage was 6-25 months.Two months after surgery,seizures in 9 patients decreased by more than 50%(Engel Ⅰ in 8cases,Engel Ⅱ in 1 case),and 6 patients had no seizures,;In 9 patients,seizures decreased by more than 50%(Engel Ⅰ in 8 cases,Engel Ⅱ in 1 case),and 2 patients had no seizures;Five patients were followed up for 12 months,and the improvement of seizures was above 50%(Engel Ⅰ in 2 cases,Engel Ⅱ in 2 cases).All patients successfully localized the epileptogenic focus,and there were no bleeding,infection,cerebrospinal fluid leakage,permanent neurological damage,or death during SEEG implantation,cortical stimulation,and RF-TC.Conclusion: SEEG guided thermocoagulation is a safe,effective,and highly successful method for localizing epileptogenic foci,It is also an effective palliative treatment or surgical complementary treatment.