The Stereo-Electroencephalography Methodology

The stereo-electroencephalography (SEEG) methodology and technique was developed almost 60 years ago in Europe. The efficacy and safety of SEEG has been proven. The main advantage is the possibility to study the epileptogenic neuronal network in its dynamic and 3-dimensional aspect, with optimal time and space correlation, with the clinical semiology of the patient’s seizures. The main clinical challenge for the near future remains in the further refinement of specific selection criteria for the different methods of invasive monitoring, with the ultimate goal of comparing and validating the results (long-term seizure-free outcome) obtained from different methods of invasive monitoring.

Key points

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Stereo-electroencephalography (SEEG) defines the anatomic boundaries of the cortical and subcortical brain areas responsible for primary generations and early propagation of the epileptiform activity.
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Both frame-based and frameless techniques can be used for implantation of SEEG electrodes.
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Vascular imaging is fundamental for the safe implantation of SEEG electrodes. Attention to the vascular anatomy is essential to reduce the risk of hemorrhagic complications.