Stereotactic interventions form an increasingly significant portion of the minimally invasive approaches for surgical management of epilepsy.1,2 This manuscript will review the application of three recent stereotactic techniques in the modern epilepsy surgery armamentarium, namely stereotactic electroencephalography (SEEG), responsive neural stimulation (RNS) and laser interstitial thermal therapy (LITT). While these interventions are a contemporary advancement, they are intellectually indebted to some of the most major developments and pioneers in the history of neurosurgery. Sir Victor Horsley, the father of modern neurosurgery, and Robert Clarke developed the first stereotactic frame in 1908, but use of the stereotactic coordinate space did not find wide use until it could be paired with intracranial imaging. Acquisition of pneumoencephalograms and/ or arterial angiography (developed by Dandy and Moniz, respectively) with a stereotactic reference frame enabled Spiegel and Wycis to precisely localize brain structures.3 The ability to attain sub-millimeter accuracy followed the advent of computed tomography (CT) and magnetic resonance imaging (MRI). These advancements were applied to epilepsy first by Bancaud and Talairach with their development of SEEG.4 While LITT and RNS represent more recent advancements, they are indebted to the work of Lars Leksell and Alim Benabid for their pioneering work in stereotactic ablative therapy and deep brain stimulation (DBS), respectively.
Lang, MD, Michael J.; Chitale, MD, Ameet; Sharan MD, Ashwini; and Wu, MD, Chengyuan
"Advancements in Stereotactic Epilepsy Surgery: Stereo-EEG, Laser Interstitial Thermotherapy, and Responsive Neurostimulation,"
JHN Journal: Vol. 11
, Article 5.
Available at: https://jdc.jefferson.edu/jhnj/vol11/iss2/5