Long-term Scalp VEEG for Refractory Epilepsy

We performed long-term scalp video electroencephalography (VEEG) to record at least three habitual seizures for each patient using a video EEG monitoring system (Micromed, Treviso, Italy). In some patients, we identified the EZ by performing stereotactic electroencephalography (SEEG). All patients underwent a high-resolution magnetic resonance imaging (MRI) protocol performed using a 3.0-T MR Scanner (Siemens, Verio, Germany) and consisting of conventional axial, sagittal, and coronal T1-weighted spin-echo sequences. In some patients, we identified the EZ by performing magnetoencephalography and positron emission tomography-computed tomography. The patients who underwent the DBS procedure after the special committee consultation excluded resective surgery based on their clinical data. For each patient, we selected the target thalamic nucleus for DBS (ANT, STN, CMN, or PN) based on the patient's epilepsy or seizure type and the location of the epileptogenic focus, as well as the possible epileptic network involved (20 (link), 21 (link)). We defined the baseline for each patient as their mean seizure frequency over the 3-month pre-implant period.