Authors :
Presenting Author: Ammar Shaikhouni, MD, PhD – Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, OH
Benjamin Edmonds, MD – Seattle Children's Hospital ,University of Washington
Nunthasiri Wittayanakorn, MD – Children's National Hospital, George Washington University
Chima Oluigbo, MD – Children's National Hospital, George Washington University
Neggy Rismanchi, MD, Ph.D. – UC Davis Health, UC Davis
Cemal Karakas, MD – University of Louisville
Angela Price, MD – Children's Medical Center Dallas, UTSW
Andrew Knox, MD – University of Wisconsin-Madison
Debopam Samanta, MD – University of Arkansas
Maija Steenari, MD – Childrens Hospital of Orange County, CA
Taylor Abel, MD – Children's Hospital of Pittsburgh, UPMC
Steven Wolf, MD – Boston Children's Health Physicians; Westchester Medical Center Health Network
Sean Lew, MD – Children's Wisconsin, Medical College of Wisconsin
Joffre Oyala, MD – Childrens Hospital of Orange County
gregory albert, MD – Arkansas Children Hospital
Charuta Joshi, MBBS, MSCS, FAES, CSCN – Childrens Medical Center Dallas, UTSW
Rationale:
Thalamic stereo-EEG (sEEG) is increasingly used in pediatric drug-resistant epilepsy (DRE) to assess subcortical network involvement, yet its influence on neuromodulation targeting and outcomes is poorly defined. We investigated how thalamic electrophysiology during sEEG influences the selection of thalamic nuclei for RNS or DBS, and evaluated early seizure outcomes.
Methods:
We analyzed 106 pediatric patients (M:F = 53:53) who underwent thalamic sEEG across 12 NAEC level-4 centers. Median age was 16 years (IQR: 11–18); epilepsy duration was 7 years. Etiology was structural in 49 (46%), unknown in 43 (41%), and genetic/other in 14 (13%). We assessed whether early ictal thalamic involvement (≤3 sec from cortical onset) or interictal thalamic activity predicted subsequent thalamic neuromodulation. Associations were tested using Chi-square (p< 0.05).