TY - JOUR
T1 - Multimodal approach leads to seizure-freedom in a case of highly refractory drug-resistant focal epilepsy
AU - Smith, Kelsey M.
AU - Alden, Eva C.
AU - Simpson, Hugh D.
AU - Brinkmann, Benjamin H.
AU - Gregg, Nicholas M.
AU - Miller, Kai J.
AU - Lundstrom, Brian N.
N1 - Funding Information:
KMS has research supported by CURE Epilepsy (funds to Mayo Clinic). BNL was supported by NIH NINDS K23NS112339. BHB was supported by the Epilepsy Foundation of America (My Seizure Gauge), NIH NS123066, and the Mayo Clinic Neurology AI program.
Publisher Copyright:
© 2022 The Authors
PY - 2022/1
Y1 - 2022/1
N2 - Drug-resistant, nonlesional, extratemporal lobe focal epilepsy can be difficult to treat and may require a high degree of multidisciplinary teamwork to localize the seizure onset zone for resective surgery. Here, we describe a patient with longstanding drug-resistant, nonlesional, extratemporal focal epilepsy with a high seizure burden who became seizure-free after prolonged evaluation and eventual left frontal cortical resection. Prior evaluations included magnetoencephalography, invasive video-EEG monitoring, and implantation of a responsive neurostimulation (RNS) device for ongoing intracranial stimulation. Highly sophisticated techniques were utilized including stereotactic localization of prior evaluations to guide repeat stereo-EEG (SEEG), electrical stimulation mapping, SEEG-guided radiofrequency ablation, and awake resection with language and motor mapping using a cognitive testing platform . Incorporating a wide array of data from multiple centers and evaluation time periods was necessary to optimize seizure control and minimize the risk of neurological deficits from surgery.
AB - Drug-resistant, nonlesional, extratemporal lobe focal epilepsy can be difficult to treat and may require a high degree of multidisciplinary teamwork to localize the seizure onset zone for resective surgery. Here, we describe a patient with longstanding drug-resistant, nonlesional, extratemporal focal epilepsy with a high seizure burden who became seizure-free after prolonged evaluation and eventual left frontal cortical resection. Prior evaluations included magnetoencephalography, invasive video-EEG monitoring, and implantation of a responsive neurostimulation (RNS) device for ongoing intracranial stimulation. Highly sophisticated techniques were utilized including stereotactic localization of prior evaluations to guide repeat stereo-EEG (SEEG), electrical stimulation mapping, SEEG-guided radiofrequency ablation, and awake resection with language and motor mapping using a cognitive testing platform . Incorporating a wide array of data from multiple centers and evaluation time periods was necessary to optimize seizure control and minimize the risk of neurological deficits from surgery.
KW - Awake cortical resection
KW - Electrical stimulation mapping
KW - Epilepsy surgery
KW - SEEG
KW - SEEG-guided radiofrequency ablation
UR - http://www.scopus.com/inward/record.url?scp=85141957824&partnerID=8YFLogxK
U2 - 10.1016/j.ebr.2022.100570
DO - 10.1016/j.ebr.2022.100570
M3 - Article
C2 - 36411878
AN - SCOPUS:85141957824
SN - 2589-9864
VL - 20
JO - Epilepsy and Behavior Reports
JF - Epilepsy and Behavior Reports
M1 - 100570
ER -