The usefulness of electrocorticography (ECoG) in pediatric temporal lobe epilepsy

• Grant number: 24/07976-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2024
• End date: July 31, 2025
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Marcelo Volpon Santos
• Grantee: Rafael Andrade Cruz
• Host Institution: Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP (HCMRP). Secretaria da Saúde (São Paulo - Estado). Ribeirão Preto , SP, Brazil

Abstract

Introduction: Resection surgery is the primary treatment for drug-resistant temporal lobe epilepsy (TLE) in the pediatric population. Defining a clear anatomo-electro-clinical hypothesis to delineate the epileptogenic zone (EZ) is a crucial step for optimal planning of the surgical strategy. In some cases, the use of invasive monitoring methods, such as electrocorticography (ECoG), becomes necessary when non-invasive methods are insufficient. However, its effectiveness in cases of refractory childhood epilepsy remains unclear in the literature due to the peculiarities of its use. Objectives: This study aims to evaluate the effectiveness of ECoG as a monitoring method to achieve seizure freedom after surgery. Additionally, it seeks to specifically correlate its contribution to different etiologies of TLE. Materials and Methods: A cohort study based on data from medical records of patients undergoing surgical resection, using the Engel scale as a comparative prognostic method, at three distinct follow-up periods: 2 years, 5 years, and 10 years. This method will be applied to two distinct groups: those who used ECoG and those who did not, correlating them with their specific etiology. Finally, the results will be rigorously reviewed. Statistical Analysis: Fisher's exact test will be used to compare sample variability, checking for dependency between the analyzed variables. Relevance: It is expected that the results obtained from this project will provide valuable insights for surgical practice, allowing the development of more personalized and effective treatment strategies for pediatric patients with drug-resistant temporal lobe epilepsy.