Clinical Efficacy of SEEG Guided Radiofrequency Thermocoagulation in Drug refractory Epilepsy -- An Updated Systematic Review and Meta analysis
Abstract
widely used in the clinical treatment of epilepsy, but there is no unified understanding of the clinical effectiveness of this technique. The purpose of this paper is to summarize the efficacy of the method and the differences of its efficacy in different etiologies by analyzing the published literature, so as to provide reference for clinical practice.
Methods: We searched within Web of Science, PubMed, EmbaseandCochraneusing a predetermined search string to identify and evaluate
relevant studies. The primary outcome was seizure-free rate after SEEG guided RFTC treatment of epilepsy. The secondary outcome was the
rate of complications. All the publications until 5 February 2021 were searched.
Results: Thirty-three studies, with a total number of 808 patients, were identified. The seizure-free rate of patients with drug-refractory epilepsy after radiofrequency thermocoagulation was 44.40% (95%CI 34.50%-54.80%), and statistical heterogeneity was high. Subgroup analysis
showed that heterogeneity originated from etiology. The pooled complication rate was 17.60% (95 % CI 11.70%25.50%) with high heterogeneity (I2
= 72.93 %). Subgroup analysis showed that heterogeneity of complication rate originated from etiology. The complication rate of HS
group, HH group, others, PNH group were 43.50%, 33.70%, 24.00% and 4.80%, respectively.
Significance: SEEG guided radiofrequency thermocoagulation is effective in the treatment of drug-resistant epilepsy. Etiology has a significant effect on the seizure-free rate and the complication rate after radiofrequency thermocoagulation. PNH, FCD and HH have a relatively
significant effect, PNH has the best effect.
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[1] Moshe SL, Perucca E, Ryvlin P, Tomson T. Epilepsy: new advances.Lancet. 2015; 385: 884-898.
[2] Kwan P, Schachter SC, Brodie MJ. Drug-resistant epilepsy. N. Engl. J. Med. 2011; 365: 919-926.
[3] Mempel E, Witkiewicz B, Stadnicki R, Luczywek E, Nowak JJANS. The Effect of Medial Amygdalotomy and Anterior Hippocampotomy on Behavior and Seizures in Epileptic Patients. Acta Neurochir Suppl (Wien). 1980; 30: 161-167.
[4] Parrent AG, Blume WT. Stereotactic amygdalohippocampotomy for the treatment of medial temporal lobe epilepsy. Epilepsia. 1999; 40:
1408-1416.
[5] Fukuda M, Kameyama S, Wachi M, Tanaka R. Stereotaxy for hypothalamic hamartoma with intractable gelastic seizures: Technical case
report. Neurosurgery. 1999; 44: 1347-1350.
[6] Guenot M, Isnard T, Ryvlin T, Fischer T, Mauguiere T, Sindou M. SEEG-guided RF thermocoagulation of epileptic foci: Feasibility,
safety, and preliminary results. Epilepsia. 2004; 45: 1368-1374.
[7] Moles A, Guenot M, Rheims S, Berthiller J, Catenoix H, Montavont A, et al. SEEG-guided radiofrequency coagulation (SEEG-guided
RF-TC) versus anterior temporal lobectomy (ATL) in temporal lobe epilepsy. Journal of Neurology. 2018; 265: 1998-2004.
[8] Mirandola L, Mai RF, Francione S, Pelliccia V, Gozzo F, Sartori I, et al. Stereo-EEG: Diagnostic and therapeutic tool for periventricular
nodular heterotopia epilepsies. Epilepsia. 2017; 58: 1962-1971.
[9] Fan X, Shan Y, Lu C, An Y, Wang Y, Du J, et al. Optimized SEEG-guided radio frequency thermocoagulation for mesial temporal lobe
epilepsy with hippocampal sclerosis. Seizure. 2019; 71: 304-311.
[10] Cossu M, Fuschillo D, Casaceli G, PellicciaV, Castana L, Mai R, et al. Stereoelectroencephalography-guided radiofrequency thermocoagulation in the epileptogenic zone: a retrospective study on 89 cases. Journal of Neurosurgery. 2015; 123: 1358-1367.
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