Increased nationwide use of stereoencephalography for intracranial epilepsy electroencephalography recordings. (July 2018)

• Record Type: Journal Article
• Authors: Abou-Al-Shaar, Hussam; Brock, Andrea A.; Kundu, Bornali; Englot, Dario J.; Rolston, John D.
• Is Part Of: Journal of clinical neuroscience. Volume 53(2018)
• Page Start: 132
• Page End: 134
• Publication Date: 2018-07
• Subjects: Epilepsy -- Intracranial electroencephalography -- Stereoencephalography -- Strip electrodes -- Electrode array -- Depth electrodes; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2018.04.064
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Stereoelectroencephalography is one method for intracranial electroencephalography. SEEG has become the most common procedure for intracranial monitoring in the U.S. The use of strip electrode placement for monitoring has decreased significantly. The rate of craniotomies for subdural grid placement has not changed significantly. A desire for minimally invasive surgical options is likely driving these changes. Abstract: Intracranial electroencephalography (iEEG) can be performed using minimally invasive stereo-electroencephalography (SEEG) or by implanting subdural electrodes via a craniotomy or multiple burr holes. There is anecdotal evidence that SEEG is becoming more common in the United States, though this has yet to be quantified. To address this question, all SEEG and burr hole/craniotomy subdural iEEG procedures were extracted from the Centers for Medicare and Medicaid Services Part B data files for the years 2000–2016. National trends were compared over time. In 2016, SEEG became the most frequently performed intracranial monitoring procedure in the Medicare population, increasing from 28.8% of total cases in 2000 to 43.1% in 2016 ( p = 0.02). The proportion of strip electrode cases (through burr holes) significantly declined, while the frequency of craniotomies for subdural grid placement did not significantly change. These data are consistent with a nationwide increase in the utilization of SEEG with a concomitant decline in burr hole placement of subdural strip electrodes in the United States. The factors driving these changes are unknown, but are likely due in part to the desire for minimally invasive surgical options.