Stereotactic Eeg Versus Subdural Electrode Eeg In The Preoperative Evaluation Of Patients With Drug-Refractory Epilepsy

Objective:To investigate the effectiveness and safety of stereoelectroencephalography(SEEG)and subdural electrode electroencephalography(SDEG)in the preoperative evaluation of patients with drug-refractory epilepsy.Methods:1.Nineteen patients with drug-refractory epilepsy who underwent electrode implantation from January 1,2015 to January 1,2022in the Department of Neurosurgery II of the People’s Hospital of Hebei Province were selected for retrospective analysis,including 8 patients in the SEEG group and 11 patients in the SDEG group.The medical history,imaging findings,EEG results and surgical records of all patients were reviewed in detail to compare the effectiveness and safety of SEEG and SDEG in localizing the seizure initiation area in patients with drug-refractory epilepsy.2.Statistical analysis:SPSS 25.0 software was used for statistical analysis.For normally distributed data,independent sample t-test was used for comparison between two groups,and`x±s form was used for measurement data;X~2test or Fisher exact test was used for counting data;X~2test or rank sum test was performed for rank data.p<0.05was considered as statistically significant difference,and p<0.01 was considered as statistically significant difference.Results:1.The seizure initiation area was monitored in all 8 patients in the SEEG group and in 6 of 11 patients in the SDEG group,multifocal discharges were found in 5 cases,and the seizure initiation area was not monitored.Statistical analysis of the data related to the techniques of the two groups in locating the seizure initiation zone showed that the differences between the two groups were statistically significant(SEEG 8cases vs SDEG 6 cases,P value=0.045<0.05).2.statistical analysis of the results related to complications after electrode implantation in patients in the SEEG and SDEG groups,and the differences between the two groups were statistically significant(SEEG 0cases vs SDEG 5 cases,P value=0.045<0.05).3,Patients in the SEEG and SDEG groups were evaluated and treated surgically,with postoperative follow-up for at least one year,and there was a statistically significant difference between groups in the study data for patients with postoperative outcomes up to Engle grade I(SEEG 6 cases vs SDEG 2 cases,P value=0.024<0.05).Conclusion:Compared to SDEG,SEEG is a safer and more effective invasive test in the preoperative evaluation of patients with drug-refractory epilepsy and has unique advantages in localizing the seizure initiation zone.