title: Stereo-electroencephalography (SEEG) in children surgically cured of their epilepsy.
abstract: OBJECTIVE
  SEEG in children has a low morbidity and leads to a good surgical outcome, in particular in younger patients. We analysed, in detail, the SEEG data of patients that were subsequently cured by surgery.
  
  
  METHODS
  We selected the 48 children explored between 2009 and 2013 in our centre and surgically cured after SEEG-based resections with at least one-year follow-up. We retrospectively studied demographic and surgical data and paid particular attention to the data acquired during the invasive recording. Moreover, we compared the children younger than 5 years of age (group 1: 17 children) to those older than 5 years of age at the time of exploration (group 2: 31 patients).
  
  
  RESULTS
  SEEG was well tolerated. Only one patient had slight intracerebral bleeding seen on the post-operative CT-scan without any clinical consequence and which did not prevent the recording. SEEG explored at least four lobes in 59% of patients, either because of a suspected very widespread epileptogenic zone or because of the lack of a precise hypothesis. Auras were recorded only in group 2 (32% of patients, P=0.0009). Despite these difficulties, SEEG led to tailored resections including multilobar resections in 14% and infralobar resections in 69% of patients. The electrical pattern of seizures had no particularities as compared with adults. Interictal spikes and slow waves outside the resection zone were significantly less frequent in group 1 (P=0.02). In symptomatic epilepsies, the lesion matched the irritative zone in only 11% of patients and the ictal onset zone in 32% respectively.
  
  
  CONCLUSIONS
  Our study confirms the low morbidity of SEEG in children. SEEG can disclose a limited epileptogenic zone. Our data suggest that the epileptic network is less complex in younger patients, which has to be confirmed by a quantitative analysis of SEEG signals.
authors.affiliation: Service de neurochirurgie pédiatrique, fondation Rothschild, 25-29, rue Manin, 75940 Paris cedex 19, France. Electronic address: delphinetaussig@yahoo.fr.
authors.forename: Delphine
authors.initials: D
authors.lastname: Taussig
authors.affiliation: Department of Neurophysiology, Rouen University Hospital, 1, rue de Germont, 76031 Rouen, France.
authors.forename: Axel
authors.initials: A
authors.lastname: Lebas
authors.affiliation: Service de neurochirurgie pédiatrique, fondation Rothschild, 25-29, rue Manin, 75940 Paris cedex 19, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Chipaux
authors.affiliation: Centre d'investigation clinique, unité Inserm CIC-CRB 1404, Rouen University Hospital, 1, rue de Germont, 76031 Rouen, France.
authors.forename: Maryvonne
authors.initials: M
authors.lastname: Jan
authors.affiliation: Service de neurochirurgie pédiatrique, fondation Rothschild, 25-29, rue Manin, 75940 Paris cedex 19, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Fohlen
authors.affiliation: Service de neurochirurgie pédiatrique, fondation Rothschild, 25-29, rue Manin, 75940 Paris cedex 19, France; Inserm U1129, "infantile épilepsies and Brain Plasticity", Paris, France; University Paris Descartes, Sorbonne Paris Cité, Paris, France; CEA, Gif-sur-Yvette, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Bulteau
authors.affiliation: Service de neurochirurgie pédiatrique, fondation Rothschild, 25-29, rue Manin, 75940 Paris cedex 19, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Dorison
authors.affiliation: Service de neurochirurgie pédiatrique, fondation Rothschild, 25-29, rue Manin, 75940 Paris cedex 19, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ferrand-Sorbets
authors.affiliation: Service de neurochirurgie pédiatrique, fondation Rothschild, 25-29, rue Manin, 75940 Paris cedex 19, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Delalande
authors.affiliation: Service de neurochirurgie pédiatrique, fondation Rothschild, 25-29, rue Manin, 75940 Paris cedex 19, France; Inserm U1129, "infantile épilepsies and Brain Plasticity", Paris, France; University Paris Descartes, Sorbonne Paris Cité, Paris, France; CEA, Gif-sur-Yvette, France.
authors.forename: Georg
authors.initials: G
authors.lastname: Dorfmüller
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D004827:Epilepsy / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D038361:Neuronavigation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Children; Chirurgie de l’épilepsie; Electrical stimulations; Enfants; Epilepsy surgery; Explorations invasives; Focal cortical resections; Invasive explorations; Résections corticales focales; Stereo-electroencephalography; Stimulations électriques; Stéréoélectroencéphalographie