Invasive Monitoring – Sub-dural Electrodes

This is an epilepsy surgery that is used for focal onset epilepsy when the area of the brain where seizures are coming from is hard to determine. The tests that have been completed (i.e. MRI, PET, Ictal SPECT, or MEG) are not able to pinpoint the exact location. The family will be a part of the discussion making process for epilepsy surgery. They will also have consultations with both their epileptologist and neurosurgeon to review the steps and answer any questions.

This is an invasive procedure which takes around 4-6 hours under a general anaesthetic in the OR at Children’s Hospital. 

  • The skull is opened up and sub-dural electrodes are placed directly over the area of the brain where the seizures are coming from.
  • After the sub-dural electrodes are in place, the skull is closed with the electrodes firmly attached. 
  • A dressing is placed securely around the head. 
  • The patient will recover in the Paediatric Critical Care Unit for several days then transfer to the paediatric floor at Children’s Hospital for further monitoring. 
  • Since this procedure does involve opening the skull, children usually experience pain and nausea for several days after the surgery. 
  • Children are then monitored by EEG for several weeks to obtain information on where the seizures are coming from.

Once more information has been gathered that identifies where the seizures are coming from, the family may be offered a focal resection (2nd epilepsy surgery) to remove the area of the brain that is causing the seizures.