The discussion to improve the curative effect of stereo electroencephalogram-guided radiofrequency thermocoagulation for refractory epilepsy_Journal of Epilepsy

Authors：

HAN Yanming ^1,3 , SHEN Yunjuan ^1,3 , HE Wenbin ^1,3 , SHI Zhe ^1,3 , LAN Zhengbo ^1,3 , LIU Yali ^1,3 , WANG Xiaoqiang ^1,3 , YANG Wenzhen ^1,3 , SHI Xuefeng ^1,3 , YANG Baohui ^1,3 , WANG Tiancheng ^2,3 , MEN Xiaoxu ^1,3 ,  ZHANG Xinding ^1,3

1. Department of Neurosurgery,the Second Hospital of Lanzhou University, Lanzhou 730030, China;
2. Department of Neurology,the Second Hospital of Lanzhou University, Lanzhou 730030, China;
3. Comprehensive Epilepsy Center,the Second Hospital of Lanzhou University, Lanzhou 730030, China;

Corresponding author：

ZHANG Xinding, Email: hwb1003@foxmail.com

Keywords：

SEEG; Radiofrequency thermocoagulation; Curative effect; Seizure frequency

DOI：

10.7507/2096-0247.20210083

Video：

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Objective To preliminarily explore the damage effect of stereo electroencephalogram-guided radiofrequency thermocoagulation after increasing the number of electrodes in the epileptic foci.Methods Eight cases were included from 42 patients requiring SEEG from the Department of Neurosurgery of the Second Hospital of Lanzhou University during June 2017 to Jan. 2019, of which 6 cases were hypothetical epileptogenic foci located in the functional area or deep in the epileptogenic foci that could not be surgically removed, 2 patients who were unwilling to undergo craniotomy; added hypothetical epileptic foci Electrodes, the number of implanted electrodes exceeds the number of electrodes needed to locate the epileptic foci. After radiofrequency thermocoagulation damages the epileptogenic foci, the therapeutic effect is analyzed.Results In 8 patients, the number of implanted electrodes increased from 1 ~ 6, with an average of (4±2.2), and the number of thermosetting points increased by 2 ~ 10, with an average of (7±3.1); follow-up (9±3.2) months, Epilepsy control status: 3 cases of Engel Ⅰ, 3 cases of Engel Ⅱ, 2 cases of Engel Ⅲ; 8 cases of epileptic seizure frequency decreased≥50%. There was a statistically significant difference in the frequency of attacks before and after thermocoagulation (P<0.05).Conclusions Increasing the lesion volume of the epileptic foci can obviously improve the efficacy of epilepsy. SEEG-guided radiofrequency thermocoagulation is an effective supplementary method for classical resection.

Citation： HAN Yanming, SHEN Yunjuan, HE Wenbin, SHI Zhe, LAN Zhengbo, LIU Yali, WANG Xiaoqiang, YANG Wenzhen, SHI Xuefeng, YANG Baohui, WANG Tiancheng, MEN Xiaoxu, ZHANG Xinding. The discussion to improve the curative effect of stereo electroencephalogram-guided radiofrequency thermocoagulation for refractory epilepsy. Journal of Epilepsy, 2021, 7(6): 505-509. doi: 10.7507/2096-0247.20210083 Copy

1.	Marc Guenot, Jean Isnard, Philippe Ryvlin. SEEG-guided RF thermocoagulation of epileptic foci: feasibility, safety, and preliminary results. Epilepsia, 2004, 45(11): 1368-1374.
2.	Pierre Bourdillon, Michel Cucherat, Jean Isnard, et al. Stereoelectroencephalography‐guided radiofrequency thermocoagulation in patients with focal epilepsy:A systematic review and meta‐analysis. Epilepsia, 2018, 59(10): 2296-2304.
3.	Alexis Moles1, Marc Guénot, Sylvain Rheims, et al. SEEG-guided radiofrequency coagulation (SEEG-guided RF-TC) versus anterior temporal lobectomy (ATL) in temporal lobe epilepsy. Journal of Neurology, 2018, 265: 1998-2004.
4.	张华强, 李沐阳, 赵国光. 立体脑电图引导多电极立体交叉射频热凝治疗药物难治性癫痫. 中华神经外科杂志, 2018, 32(12): 1197-1201.
5.	Massimocossu Md, dalila Fuschillo, Giuseppe casaceli, et al. Stereoelectro -encephalography-guided radiofrequency thermocoagulation in the epileptogenic zone: a retrospective study on 89 cases. J Neurosurg, 2015, 123: 1358-1367.
6.	Helene Catenoix, Francois Mauguiere, Alexandra Montavont,et al. Seizures outcome after Stereoelectroencephalography-guided thermocoagulations in malform -ations of cortical development poorly accessible to surgical resection. Neurosurgery, 2015, 77(1): 9-14.
7.	Catenoix MDF. Mauguiere, Guenot, et al SEEG-guided thermocoagulations: A palliative treatment of nonoperable partial: epilepsies. Neurology, 2008, 71(18): 1719-1726.
8.	Malikova H, Vojtech Z, Liscak R, et al. Microsurgical and stereotactic radiofrequency amygdalohippocampectomy for the treatment of mesial temporal lobe epilepsy: different volume reduction, similar clinical seizure control. Stereotact Funct Neuro surg, 2010, 88(1): 42-50.
9.	Petia Dimova, Luca de Palma, Anne-Sophie Job-Chapron, et al. Radiofrequency thermocoagulation of the seizure-onset zone during stereoelectroencephalograph. Epilepsia, 2017, 58(3): 381-392.
10.	Dimova P, de Palma L, Job Chapron AS, et al. Radio frequency thermocoagulation of the seizure—onset zone during stereoelectroence-phalography. Epilepsia, 2017, 58(3): 381-391.
11.	Bourdillon P, Rheims S, Catenoix H, et al. Malformations of cortical development: new surgical advances. Rev Neurol, 2019, 175: 183-188.

1. Marc Guenot, Jean Isnard, Philippe Ryvlin. SEEG-guided RF thermocoagulation of epileptic foci: feasibility, safety, and preliminary results. Epilepsia, 2004, 45(11): 1368-1374.
2. Pierre Bourdillon, Michel Cucherat, Jean Isnard, et al. Stereoelectroencephalography‐guided radiofrequency thermocoagulation in patients with focal epilepsy:A systematic review and meta‐analysis. Epilepsia, 2018, 59(10): 2296-2304.
3. Alexis Moles1, Marc Guénot, Sylvain Rheims, et al. SEEG-guided radiofrequency coagulation (SEEG-guided RF-TC) versus anterior temporal lobectomy (ATL) in temporal lobe epilepsy. Journal of Neurology, 2018, 265: 1998-2004.
4. 张华强, 李沐阳, 赵国光. 立体脑电图引导多电极立体交叉射频热凝治疗药物难治性癫痫. 中华神经外科杂志, 2018, 32(12): 1197-1201.
5. Massimocossu Md, dalila Fuschillo, Giuseppe casaceli, et al. Stereoelectro -encephalography-guided radiofrequency thermocoagulation in the epileptogenic zone: a retrospective study on 89 cases. J Neurosurg, 2015, 123: 1358-1367.
6. Helene Catenoix, Francois Mauguiere, Alexandra Montavont,et al. Seizures outcome after Stereoelectroencephalography-guided thermocoagulations in malform -ations of cortical development poorly accessible to surgical resection. Neurosurgery, 2015, 77(1): 9-14.
7. Catenoix MDF. Mauguiere, Guenot, et al SEEG-guided thermocoagulations: A palliative treatment of nonoperable partial: epilepsies. Neurology, 2008, 71(18): 1719-1726.
8. Malikova H, Vojtech Z, Liscak R, et al. Microsurgical and stereotactic radiofrequency amygdalohippocampectomy for the treatment of mesial temporal lobe epilepsy: different volume reduction, similar clinical seizure control. Stereotact Funct Neuro surg, 2010, 88(1): 42-50.
9. Petia Dimova, Luca de Palma, Anne-Sophie Job-Chapron, et al. Radiofrequency thermocoagulation of the seizure-onset zone during stereoelectroencephalograph. Epilepsia, 2017, 58(3): 381-392.
10. Dimova P, de Palma L, Job Chapron AS, et al. Radio frequency thermocoagulation of the seizure—onset zone during stereoelectroence-phalography. Epilepsia, 2017, 58(3): 381-391.
11. Bourdillon P, Rheims S, Catenoix H, et al. Malformations of cortical development: new surgical advances. Rev Neurol, 2019, 175: 183-188.

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The discussion to improve the curative effect of stereo electroencephalogram-guided radiofrequency thermocoagulation for refractory epilepsy

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