Trends in Thalamic Stereoelectroencephalography Utilization During Phase II Monitoring in North America: A Survey

Authors

Ahmad Alhourani, Department of Neurosurgery, University of California at San Francisco, San Francisco , California , USA.
Philip B. Ostrov, Department of Neurosurgery, University of Louisville, Louisville , Kentucky , USA.
Jason M. Schwalb, Department of Neurosurgery, Indiana University, Indianapolis , Indiana , USA.
Andrew I. Yang, Department of Neurosurgery, Barrow Neurological Institute, Phoenix , Arizona , USA.
Adriana E. Palade, Department of Neurology, University of Louisville, Louisville , Kentucky , USA.
Edward F. Chang, Department of Neurosurgery, University of California at San Francisco, San Francisco , California , USA.
Joseph S. Neimat, Department of Neurosurgery, University of Louisville, Louisville , Kentucky , USA.

Document Type

Article

Abstract

BACKGROUND AND OBJECTIVES: Thalamic neuromodulation is widely used in epilepsy surgery. However, thalamic sampling in invasive monitoring is not consistently used. We aimed to quantify current trends in thalamic stereoelectroencephalography (SEEG) utilization. METHODS: We performed a survey of epilepsy neurosurgeons and neurologists to gauge their attitudes and experience with thalamic SEEG. We contacted all members of the American Society for Stereotactic and Functional Neurosurgery and American Epilepsy Society organizations using a mailing list. RESULTS: We received 40 responses from centers using SEEG, including 31 neurosurgeons and 9 epileptologists. Among these respondents, 65% (26/40) included thalamic targets in their SEEG plans. The most common clinical rationales were to define the seizure network (22/26, 84.6%) or the high probability of targeted structure being a neuromodulation target (22/26, 84.6%). Over half of the respondents who used thalamic SEEG (15/26, 57.6%) endorsed that the findings informed target selection and feasibility of thalamic neuromodulation. The most commonly implanted thalamic targets included centromedian (23/26) and anterior nucleus of the thalamus (ANT) (22/26), followed by pulvinar (19/26). CONCLUSION: Thalamic SEEG is a diagnostic tool that is being increasingly used across epilepsy centers. This may be an important tool to support the paradigm shifts occurring in the surgical management of epilepsy.

Publication Date

5-9-2025

Publication Title

Operative neurosurgery (Hagerstown, Md.)

E-ISSN

2332-4260

PubMed ID

40341506

Digital Object Identifier (DOI)

10.1227/ons.0000000000001614

Recommended Citation

Alhourani, Ahmad; Ostrov, Philip B.; Schwalb, Jason M.; Yang, Andrew I.; Palade, Adriana E.; Chang, Edward F.; and Neimat, Joseph S., "Trends in Thalamic Stereoelectroencephalography Utilization During Phase II Monitoring in North America: A Survey" (2025). Neurosurgery. 2307.
https://scholar.barrowneuro.org/neurosurgery/2307