Abstracts

Rationale: The surgical removal of the epileptogenic zone in medically intractable seizures depends on accurate localization to minimize the neurological sequelae and ensure against future seizures. To date, few studies have demonstrated the use of depth electrodes in a pediatric population. Here, we report our study of pediatric patients at our epilepsy center who were successfully operated for medically intractable seizures following the use of intracranial depth electrodes. In addition, we detail three individuals with distinct clinical scenarios in which depth electrodes are helpful and describe our technical approach to surgery. Methods: We retrospectively reviewed 18 pediatric epilepsy patients requiring depth electrode studies who presented at the University of Alberta Comprehensive Epilepsy Program between 1999 and 2010 with medically intractable epilepsy. Patients underwent cortical resection following depth electrode placement according to the Comprehensive Epilepsy Program surgical protocols after failure of surface electroencephalogram and magnetic resonance imaging to localize ictal onset zone. Results: The ictal onset zone was successfully identified in all 18 patients. Treatment of all surgical patients resulted in successful seizure freedom (Engel class I ) without neurological complications. Conclusions: Intracranial depth electrode use is safe and able to provide sufficient information for the identification of epileptogenic zone in pediatric patients previously not considered for epilepsy surgery.