Applications and Predictors of Outcomes Following Stereo-Electroencephalography in Pediatric Patients With Drug-Resistant Epilepsy

IF 5 1区医学 Q1 NEUROSCIENCES CNS Neuroscience & Therapeutics Pub Date : 2025-03-12 DOI:10.1111/cns.70332

Qingzhu Liu, Chang Liu, Shuang Wang, Taoyun Ji, Yu Sun, Guojing Yu, Yao Wang, Hao Yu, Yuwu Jiang, Xiaoyan Liu, Lixin Cai

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Abstract

Aims

This study aims to evaluate the role of stereo-electroencephalography (SEEG) in managing pediatric patients with drug-resistant epilepsy. We further explore prognostic factors influencing surgical outcomes following SEEG-guided resective or disconnective surgery.

Methods

A retrospective review was conducted on pediatric patients who underwent SEEG at the Pediatric Epilepsy Center, Peking University First Hospital, between July 2017 and July 2022. Univariate and multivariate analyses identified key predictors for SEEG-guided surgery. Kaplan–Meier survival analysis was employed to estimate the seizure-free rate, and further statistical tests were applied to evaluate factors associated with seizure outcomes.

Results

Among the 148 children included in this study, 102 underwent SEEG-guided resective/disconnective surgery. Multivariate regression identified age at surgery (p < 0.05, 95% CI 0.190–0.997) as an independent predictor for selecting resective/disconnective surgery. The seizure-free rate in patients who underwent SEEG-guided surgery was 69.6%. Multivariate regression confirmed that total resection with lesional MRI (p < 0.05, 95% CI 0.012–0.186) and FCD type II (p < 0.05, 95% CI 0.051–0.851) were strong predictors of seizure freedom.

Conclusions

SEEG plays a crucial role in pediatric epilepsy surgery, particularly in children under 6 years old. Total resection with lesional MRI and FCD type II was the most favorable prognostic predictor for achieving seizure freedom in children undergoing SEEG-guided surgery.

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立体脑电图在小儿耐药癫痫患者中的应用及预后预测因素

目的本研究旨在评价立体脑电图（SEEG）在治疗小儿耐药癫痫患者中的作用。我们进一步探讨影响seeg引导下切除或分离手术手术结果的预后因素。方法回顾性分析2017年7月至2022年7月在北京大学第一医院儿童癫痫中心接受SEEG治疗的儿童患者。单因素和多因素分析确定了seeg引导手术的关键预测因素。Kaplan-Meier生存分析用于估计无癫痫发作率，并应用进一步的统计检验来评估与癫痫发作结果相关的因素。结果在本研究纳入的148名儿童中，102名接受了seeg引导下的切除/分离手术。多因素回归发现手术年龄（p < 0.05, 95% CI 0.190-0.997）是选择切除/分离手术的独立预测因子。接受seeg引导手术的患者无癫痫发作率为69.6%。多因素回归证实，病变MRI全切除（p < 0.05, 95% CI 0.012-0.186）和FCD II型（p < 0.05, 95% CI 0.051-0.851）是癫痫发作自由的强预测因子。结论SEEG在儿童癫痫手术中起着至关重要的作用，特别是在6岁以下儿童中。全切除病变MRI和FCD II型是最有利的预后预测指标实现癫痫发作自由的儿童接受seeg引导手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.