Study Suggests Risky Diagnostic Surgery Can Be Used Safely on Young Children with Epilepsy
Stereoelectroencephalography Had Been Thought Too Risky for Toddlers Due to the Thinness of Their Skulls
A diagnostic surgery that implants electrodes to identify areas of epileptic onset in patients with drug-resistant epilepsy, known as Stereoelectroencephalography (SEEG), can be safely used in young children according to a new study published in Child’s Nervous System by New York Medical College (NYMC) faculty and students.
“SEEG had been contraindicated in patients who are very young because their skulls are so thin, creating concerns that the insertion of electrodes would be more likely to cause damage to the skull and the surrounding structures,” said Jessica Dorilio, SOM Class of 2025 and co-first author of the study with Carrie Muh, M.D., associate professor of neurosurgery and of pediatrics.
The study demonstrated that the insertion of SEEG electrodes can be safe in toddlers, allowing for the proper identification of the location of seizure onset to determine the proper management for patients, such as laser ablation therapy or resection.
“We found that the complication risk of SEEG placement in young children with thin skulls was not significantly higher than in older children and that risks can be mitigated through proper techniques, including careful pre-operative planning and accurate intra-operative registration,” said Dr. Muh. “Based on their SEEG findings, all patients in the study went on to therapeutic surgery. The results of this study open a new area of surgical diagnostic treatment for young children with drug-resistant epilepsy that was previously considered unsafe.”
Additional authors on the study include Cameron P. Beaudreault, SOM Class of 2024; Patricia McGoldrick, N.P., instructor of pediatrics; Jared M. Pisapia, M.D., assistant professor of neurosurgery; and Steven Wolf, M.D., clinical professor of pediatrics.