Bridging surface and depth: A systematic review of seizure patterns in simultaneous scalp and stereo-EEG

IF 2 4区 医学 Q3 CLINICAL NEUROLOGY
Cristiana Santos , Daniel Filipe Borges , Joana Isabel Soares
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引用次数: 0

Abstract

Background

Drug-resistant epilepsy often requires invasive monitoring. Although simultaneous scalp EEG and stereo EEG are increasingly used together, their added value for preoperative evaluation and surgical planning remains uncertain and warrants systematic investigation.

Methods

We systematically searched PubMed, Scopus and Web of Science for English- or Portuguese-language studies in which patients with drug-resistant epilepsy were simultaneously monitored with scEEG and SEEG. Reports lacking primary data, systematic reviews, conference abstracts, case reports and studies limited to scEEG with electrocorticography were excluded. Two reviewers independently screened all records, extracted data and assessed methodological quality. The protocol was registered in PROSPERO (CRD42024590432) and conducted in accordance with PRISMA-P guidelines.

Results

From 9750 records, 16 articles underwent full-text analysis, and eight retrospective observational studies met the inclusion criteria. These eight studies - evenly split between the United States and Europe - included 250 patients. Data on diagnostic yield and postoperative outcomes were inconsistent. Key findings included (i) detailed mapping of seizure onset and propagation across cortical and subcortical regions, (ii) typical latency intervals between scEEG and SEEG detection, and (iii) concordance rates in localizing the epileptogenic zone.

Conclusions

Simultaneous scEEG-SEEG provides complementary cortical and mesial findings that sharpen the delineation of the epileptogenic zone and allow for targeted surgery. SEEG captures the deep generators, while scEEG provides the broader context for electrode placement. Current evidence is limited to small, methodologically heterogeneous series. Standardized protocols, larger multicenter cohorts and multimodal co-registration are needed to confirm the diagnostic gain and anchor this two-layered approach in routine clinical care.
桥接表面和深度:头皮和立体脑电图同时发作模式的系统回顾
背景:耐药癫痫通常需要侵入性监测。虽然同时头皮脑电图和立体脑电图越来越多地一起使用,但它们在术前评估和手术计划中的附加价值仍然不确定,需要系统的研究。方法系统检索PubMed、Scopus和Web of Science中同时监测耐药癫痫患者scEEG和SEEG的英文或葡萄牙文研究。缺乏原始数据的报告、系统综述、会议摘要、病例报告和仅限于脑电图与皮质电图的研究被排除在外。两名审稿人独立筛选所有记录,提取数据并评估方法学质量。该方案已在PROSPERO注册(CRD42024590432),并按照PRISMA-P指南进行。结果9750份记录中,16篇文章进行了全文分析,8项回顾性观察性研究符合纳入标准。这8项研究——平均分布在美国和欧洲——包括250名患者。诊断率和术后结果的数据不一致。主要发现包括:(1)癫痫发作和在皮层和皮层下区域传播的详细图谱,(2)scEEG和SEEG检测之间的典型潜伏期间隔,以及(3)癫痫区定位的一致性率。结论:同时进行的scieg - seeg提供了补充的皮层和中膜的发现,可以清晰地描绘癫痫发生区,并允许有针对性的手术。SEEG捕获深层发电机,而scEEG为电极放置提供了更广泛的背景。目前的证据仅限于小的、方法学上不一致的系列。需要标准化的方案,更大的多中心队列和多模式联合登记来确认诊断收益并将这种双层方法固定在常规临床护理中。
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来源期刊
Epilepsy Research
Epilepsy Research 医学-临床神经学
CiteScore
0.10
自引率
4.50%
发文量
143
审稿时长
62 days
期刊介绍: Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.
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