title: Depth electrodes in pediatric epilepsy surgery.
abstract: BACKGROUND
  The surgical removal of the epileptogenic zone in medically intractable seizures depends on accurate localization to minimize the neurological sequelae and prevent future seizures. To date, few studies have demonstrated the use of depth electrodes in a pediatric epilepsy population. Here, we report our study of pediatric epilepsy patients at our epilepsy center who were successfully operated for medically intractable seizures following the use of intracranial depth electrodes. In addition, we detail three individuals with distinct clinical scenarios in which depth electrodes were helpful and describe our technical approach to implantation and surgery.
  
  
  METHODS
  We retrospectively reviewed 18 pediatric epilepsy patients requiring depth electrode studies who presented at the University of Alberta Comprehensive Epilepsy Program between 1999 and 2010 with medically intractable epilepsy. Patients underwent cortical resection following depth electrode placement according to the Comprehensive Epilepsy Program surgical protocols after failure of surface electroencephalogram and magnetic resonance imaging to localize ictal onset zone.
  
  
  RESULTS
  The ictal onset zone was successfully identified in all 18 patients. Treatment of all surgical patients resulted in successful seizure freedom (Engel class I) without neurological complications.
  
  
  CONCLUSIONS
  Intracranial depth electrode use is safe and able to provide sufficient information for the identification of the epileptogenic zone in pediatric epilepsy patients previously not considered for epilepsy surgery.
authors.affiliation: Comprehensive Epilepsy Program, University of Alberta Hospital, Edmonton, Alberta, Canada.
authors.forename: Janani
authors.initials: J
authors.lastname: Kassiri
authors.forename: Jeff
authors.initials: J
authors.lastname: Pugh
authors.forename: Sharon
authors.initials: S
authors.lastname: Carline
authors.forename: Laura
authors.initials: L
authors.lastname: Jurasek
authors.forename: Thomas
authors.initials: T
authors.lastname: Snyder
authors.forename: Matt
authors.initials: M
authors.lastname: Wheatley
authors.forename: D Barry
authors.initials: DB
authors.lastname: Sinclair
mesh_terms: D000293:Adolescent; D002540:Cerebral Cortex / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D004569:Electroencephalography; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D016896:Treatment Outcome; D014743:Videotape Recording