Stereo EEG (Electroencephalography)
What is stereo EEG?
Stereo EEG, also called SEEG, stands for stereo electroencephalography. It is a minimally invasive procedure that helps the doctor find the source of your child’s seizures. During the stereo EEG, small wires with contacts record activity on the surface of and deep inside the brain. Our team uses this information to determine if epilepsy surgery is right for your child.
Neurosurgeons will put the wires directly in your child’s brain using a robotic operating surgery assistant (ROSA) in the operating room. ROSA allows the neurosurgeon to place the wires precisely and reduces your child’s pain and time in recovery. The wires fit through tiny holes in your child’s skull. The surgeon will make between 6 and 15 holes for the wires. Most children have about 8. Your child will be given general anesthesia for this procedure, so they will be fully asleep. Once the wires are in place, your child will stay in the Epilepsy Monitoring Unit (EMU) at our hospital in Seattle for about 1 week.
During your child’s stay in the EMU, we will place a wrap on their head to protect their scalp and the stereo EEG wires. Our nurses and the surgery team will watch the wrap and rewrap your child’s head as needed. A certified nursing assistant (CNA) will be in your child’s room at all times to keep them safe and make sure your child does not touch their head, the wires or their head wrap. The CNA will also be able to help your child with their basic care needs.
Our team will closely monitor your child’s brain activity. We will be looking to find patterns and pinpoint where your child’s seizures start. A video camera will also be on at all times in your child’s room to see how their body acts during a seizure.
Once we have enough information, neurosurgeons use sedation and then remove the wires during a quick procedure in the operating room. Sedation may make your child feel relaxed and awake, relaxed and drowsy, or lightly sleepy. Breathing slows down, so they may be given oxygen.
What are the advantages of stereo EEG?
Many tests are available to make sure epilepsy surgery is the right choice for your child. Stereo EEG requires smaller cuts (incisions) and is safer and more precise than complex tests such as grid or strip placement, which involves removing part of the skull (craniotomy). Compared to other tests, advantages of stereo EEG include:
- Lower risk of infection and complications, such as bleeding and swelling
- Less time under anesthesia
- Reduced pain and need for pain medicine during recovery
- More targeted treatment because neurosurgeons can safely reach areas below the surface of the brain
Who can benefit from stereo EEG?
Stereo EEG is used for children who:
- Are being evaluated for epilepsy surgery
- Have focal epilepsy, or seizures that start from a specific region in the brain
- Have not responded to 2 or more types of medicines or other treatments
Stereo EEG is not an option for children with generalized epilepsy.
What’s special about stereo EEG at Seattle Children’s?
We have the only epilepsy program in the Northwest specifically for children that is accredited level 4 by the National Association of Epilepsy Centers (NAEC). Only level 4 centers perform a broad range of complex surgeries and have specialized programs to treat epilepsy.
As a level 4 center, we use the most advanced technology to assess patients and diagnose epilepsy. We offer programs that are unique in the region, including epilepsy genetics and tuberous sclerosis (a rare genetic condition that causes tumors to grow in different parts of the body, especially the brain).
Deciding how to treat epilepsy and other brain conditions involves many factors. We do imaging studies and talk with you and your child to learn about their condition and how it affects them. Taking into account everything we learn, our team will explain:
- If stereo EEG is an option
- If it’s a better choice than other treatments
- If we recommend stereo EEG for your child and why