Children's Hospital Colorado
Neuroscience Institute
A gold shield that says "Best Children's Hospitals Neurology & Neurosurgery 2017-18" with a blue and red ribbon across the middle that says "U.S. News and World Report".
Neuroscience Institute

About Stereoelectroencephalography (SEEG) and Seizures

What is stereoelectroencephalography (SEEG)?

Neurosurgeons at Children’s Hospital Colorado use stereoelectroencephalography (SEEG) to identify the source of a child’s seizures in his or her brain. A child may be recommended for SEEG when his or her seizures don’t respond to medicine or other treatments, and other tests suggest that the seizures are coming from a single area of the brain.

SEEG is a minimally invasive procedure that uses sophisticated technology to implant up to 20 electrodes (0.8mm in diameter) through small holes in the skull (about the width of a piece of spaghetti) into the tissue of the brain. The electrodes monitor a child’s seizures and help pinpoint where they begin. Once the source is located, the electrodes are taken out and surgery to remove the identified tissue may be recommended.

Traditionally, a more invasive method was used to place electrodes. It included either removing a section of the skull or using a type of scaffold and a complex mechanical tool. Using one of these methods could take the surgeons up to 10 hours to place 20 electrodes. By using the SEEG method, the procedure time is significantly reduced and the complications are minimized.

Meet ROSA, our robotic operating surgical assistant

Neurosurgeons in our Neuroscience Institute use a state-of-the-art innovative surgical tool called a robotic operating surgical assistant (ROSA). ROSA is used to perform brain surgery and procedures. Her sophisticated software allows the surgeons to provide precise treatment quicker due to the advanced image-guided surgical planning.

Benefits of the SEEG operation

  • As a minimally invasive procedure, the risk of infection is lower and patients experience less pain and use less pain medicine during recovery.
  • SEEG is completed in a shorter amount of time than other methods, which allows your child to come off of anesthesia sooner.
  • Using ROSA increases the accuracy of electrode placements.

What can patients and families expect from SEEG

Preparing for the SEEG procedure

Your child’s care team helps both you and your child get ready for the procedure. Our neurosurgeons explain what SEEG is in an age-appropriate manner, which helps the whole family understand what to expect.

The day of surgery

Once your child is admitted to Children’s Colorado, he or she may have a CT study and additional lab work. Families also meet with a pediatric anesthesiologist to learn about the sleep-like state that keeps your child pain-free during the procedure.

During the SEEG

  1. Once in the operating room, your child is put under anesthesia and enters a sleep-like state.
  2. In the weeks leading up to surgery, the neurosurgeon, epilepsy doctors and other members of the epilepsy team use information gathered throughout the epilepsy surgery work-up to make an individualized plan for your child. They use ROSA’s sophisticated computer software to plot where to place the electrodes.
  3. Then the neurosurgeon places a grid of small markers (called fiducials) on the patient’s head. These create a map that ROSA uses to find the coordinates of where to place the electrodes.
  4. The ROSA’s robotic arm moves precisely to the location and direction of the planned electrode, giving the surgeon a steady, accurate guide through which to place the electrode.
  5. After the electrodes are placed, your child goes to the ICU for close monitoring during the initial hours after surgery. Your child’s care team notifies you, so you can be there as your child wakes up.

After the procedure

Patients keep the electrodes in until a seizure(s) is recorded (usually 1 week). The team may also send electricity into the electrodes to map out the functions of the nearby brain. As soon as the epilepsy team has the information, the electrodes are removed. Taking out the electrodes is a quick procedure.

Our epilepsy specialists review the information collected by the electrodes to see if surgery is the right option for your child. Before you leave, your child’s care team shares the results with you and provides a recommend action plan.

If epilepsy surgery is suggested, your child will return to the hospital at a later date.

Who's eligible for SEEG?

Your child may be eligible for SEEG if:

  • Seizures haven’t responded to medicine or other medical treatment.
  • He or she is a candidate for epilepsy surgery.
  • The source of the seizures is not fully known.

Why choose Children’s Colorado Epilepsy Program for SEEG?

Our Neuroscience Institute is the only children’s hospital in the region that is using ROSA and SEEG.

This minimally invasive surgical tool allows neurosurgeons at Children’s Colorado to produce more accurate seizure recordings in a shorter amount of time than traditional methods. Our surgical team is always striving to improve the care we give to children.

We are a Level IV Epilepsy Center

According to the National Association of Epilepsy Centers (NAEC), Children’s Colorado is a Level IV Epilepsy Center. That means our Epilepsy Program provides the highest quality of care for patients with complex health needs. Our program provides complete care for children with epilepsy from evaluation to surgical treatments.