Authors :
Presenting Author: Rebekah Landre, MS – St. Louis Children's Hospital
Michael Morrissey, PhD – Washington University in St Louis
Lauren Mills, BS – Washington University School of Medicine
Jon Willie, MD PhD – Department of Neurosurgery, Washington University in St. Louis
Sean McEvoy, MD – Washington University School of Medicine
Jarod Roland, MD – Washington University School of Medicine
Réjean Guerriero, DO – Washington University in St Louis
Stuart Tomko, MD – Washington University in St Louis
Rationale: SEEG-guided radiofrequency ablation (RFA) is a minimally invasive procedure used to treat medically refractory epilepsy. Previous studies targeting adult populations support RFA can lead to transient improvements in seizure burden (Kerezoudis et al., 2022). Limited data exists on RFA in the pediatric population, and thus we present our observations.
Methods:
We analyzed a retrospective cohort of eight pediatrics patients who underwent RFA through SEEG electrode after identification of seizure network(s) at St. Louis Children’s Hospital between July 2023 and June 2024. Results:
Eight patients aged 9 to 16 years (median age 13, 5 females and 3 males) underwent SEEG-guided RFA. One patient had RFA performed in the operating room while awake prior to explanation of SEEG electrodes. Sevenunderwent awake RFA at the bedside followed by additional SEEG recording for approximately 12 to 24 hours post-procedure. Of the eight patients, five have experienced Engel 1 seizure control on follow up between 2 to 9 months post-procedure. Three experienced seizure freedom for a limited period (1 week, 10 weeks, 8 months) followed by gradual recurrence with decreased frequency compared to pre-procedure. Two of these patients went on to Engel class 1 after additional treatment.
Conclusions:
SEEG-guided RFA may provide an additional tool for treatment of epilepsy. The procedure carries a low risk of serious complication. The ablation may further inform future treatments and in a small portion of cases may serve as a definitive treatment of epilepsy.
Funding: N/A