Journal article
Determinants of diagnostic accuracy and therapeutic outcomes of SEEG in epilepsy: a systematic review
Neurosurgical review, Vol.48(1), p.740
10/27/2025
DOI: 10.1007/s10143-025-03894-3
PMID: 41144046
Abstract
Stereoelectroencephalography (SEEG) is a cornerstone in the presurgical evaluation of drug-resistant focal epilepsy. Despite its growing adoption, variability in outcomes and complication rates suggests the influence of multiple technical, institutional, and contextual factors. A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251065875). Six databases were searched up to July 2024. Eligible studies included original research in English or Spanish reporting on SEEG procedures in patients with drug-resistant epilepsy, with outcomes related to diagnostic accuracy, complications, and therapeutic interventions. Data were extracted and synthesized narratively across five thematic domains. Fifty studies involving 6,054 patients were included. Most were retrospective and conducted in high-income countries. Epileptogenic zone (EZ) identification rates ranged from 11.6% to 100%, with over 30 studies reporting rates ≥ 90%. A total of 465 SEEG-related complications were reported, predominantly intracranial hemorrhages. Lower complication rates were observed in high-volume centers using robotic or frame-based systems. Post-SEEG interventions, primarily surgical resections, led to favorable outcomes, with Engel Class I achieved in 551 patients. Institutional experience and access to advanced technologies emerged as key determinants of safety and efficacy. SEEG is a highly effective diagnostic and therapeutic modality in epilepsy surgery. However, its performance is strongly influenced by surgical expertise, procedural planning, and institutional context. Standardizing protocols, expanding training, and improving access in underserved regions are essential to optimize outcomes and ensure equitable care.
Details
- Title: Subtitle
- Determinants of diagnostic accuracy and therapeutic outcomes of SEEG in epilepsy: a systematic review
- Creators
- David F Estupiñan-Pepinosa - Universidad de Los AndesMaria F Cordoba-Gallego - Universidad de Los AndesJuan P Quintero-Ruiz - Universidad de Los AndesNikolas Correa-Molina - Universidad de Los AndesPaola A Niño-Muñoz - Universidad de Los AndesJuan S Aguirre-Patiño - Fundación Santa Fe de BogotáCesar A Buitrago - Fundación Santa Fe de BogotáLuis C Mayor-Romero - Fundación Santa Fe de BogotáPaula Martinez-Micolta - Fundación Santa Fe de BogotáJheremy S Reyes - Cancer and Molecular Medicine Research Group (CAMMO), Bogotá, D.C., Colombia
- Resource Type
- Journal article
- Publication Details
- Neurosurgical review, Vol.48(1), p.740
- DOI
- 10.1007/s10143-025-03894-3
- PMID
- 41144046
- NLM abbreviation
- Neurosurg Rev
- ISSN
- 1437-2320
- eISSN
- 1437-2320
- Publisher
- SPRINGER; NEW YORK
- Language
- English
- Date published
- 10/27/2025
- Academic Unit
- Neurology
- Record Identifier
- 9985016524402771
Metrics
14 Record Views