In the United States, pediatric stereoelectroencephalography (SEEG) is becoming more common, with published material mostly consisting of large single-center case series. This study uses a multicenter case series to analyze the experience of pediatric epilepsy centers that have used the method in the last several years, looking at patient demographics, outcomes, and consequences. A retrospective cohort methodology was used based on the STROBE criteria. They performed the ANOVA test to see any significant variations in the means of continuous variables between the centers. Univariate and multivariate logistic regression were used to compare dichotomous outcomes between centers.
The study included 170 SEEG implantation procedures from six level 4 pediatric epilepsy facilities. At the time of SEEG insertion, the average patient age was 12.3 ± 4.7 years. No significant difference between the mean age at the SEEG insertion between centers (p = 0.3). The mean number of SEEG trajectories per patient was 11.3 ± 3.6, with variations between centers (p < 0.001). The number of cases that were identified for Epileptogenic loci was 84.7% of cases (144/170). A follow-up surgical intervention was performed in 140 cases (140/170, or 82.4%), with 47.1% (66/140) of patients seizure-free after a mean follow-up of 30.6 months. There was a 5.3 % (9/170) total postoperative hemorrhage rate, with patients in 4 of these cases (4/170, 2.4%) experiencing symptomatic hemorrhage and patients in 3 of these cases (3/170, 1.8%) requiring operational hemorrhage evacuation. There were no deaths or long-term consequences. As the first multicenter case series in pediatric SEEG, this study has aided in establishing normative practice patterns in the application of a novel surgical technique, provided a generalizable and useful framework for anticipated outcomes, and allowed for discussion of what is an acceptable complication rate based on the experiences of multiple institutions.
REF:thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/28/6/article-p669.xml
