Stimulation Mapping Using Stereoelectroencephalography: Current and Future Directions

Derek D George; Steven G Ojemann; Cornelia Drees; John A Thompson

doi:10.3389/fneur.2020.00320

Stimulation Mapping Using Stereoelectroencephalography: Current and Future Directions

Front Neurol. 2020 May 12:11:320. doi: 10.3389/fneur.2020.00320. eCollection 2020.

Authors

Derek D George¹, Steven G Ojemann², Cornelia Drees³, John A Thompson^{2

3}

Affiliations

¹ School of Medicine, University of Colorado School of Medicine, Aurora, CO, United States.
² Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, United States.
³ Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States.

Abstract

Electrical stimulation mapping (ESM) using stereoelectroencephalography (SEEG) is an essential component in the workup of surgical epilepsy. Since the initial application of ESM in the mid-1960s, it remains unparalleled in defining eloquent brain areas and delimiting seizure foci for the purposes of surgical planning. Here, we briefly review the current state of SEEG stimulation, with a focus on the techniques used for identifying the epileptogenic zone and eloquent cortex. We also summarize clinical data on the efficacy of SEEG stimulation in surgical outcomes and functional mapping. Finally, we briefly highlight future applications of SEEG ESM, including novel functional mapping approaches, identifying rare seizure semiologies, neurophysiologic investigations for understanding cognitive function, and its role in SEEG-guided radiofrequency thermal coagulation.

Keywords: electrical stimulation mapping; epilepsy; epileptogenic zone; functional neurosurgery; review; stereoelectroencephalography; subdural grid.

Publication types

Review