Stereo EEG (Electroencephalography)

What is stereo EEG?

Stereo EEG, also called SEEG, stands for stereo electroencephalography. It is a minimally invasive procedure that helps the doctor find the source of your child’s seizures. A neurosurgeon places small wires (electrodes) in your child’s brain to record electrical activity. Our team uses this information to determine if epilepsy surgery is right for your child.

Neurosurgeons will put the wires directly in your child’s brain using a robotic operating surgery assistant (ROSA) in the operating room. ROSA allows the neurosurgeon to place the wires precisely and reduces your child’s pain and time in recovery. The wires fit through tiny holes in your child’s skull. The surgeon will make between 6 and 15 holes for the wires. Most children have about 8. Your child will be given general anesthesia for this procedure, so they will be fully asleep. Once the wires are in place, your child will stay in the Epilepsy Monitoring Unit (EMU) at our hospital in Seattle for about 1 week.

While your child stays in the EMU, we will place a wrap on their head to protect their scalp and the stereo EEG wires. A certified nursing assistant (CNA) will stay in your child’s room to keep them safe, help with basic care needs and make sure your child does not touch their head, the wires or their head wrap.

Our team will closely monitor your child’s brain activity. We will be looking to find patterns and pinpoint where your child’s seizures start. A video camera will also be on at all times in your child’s room to see how their body acts during a seizure and to ensure your child is safe.

Once we have enough information, neurosurgeons will give your child sedation and then remove the wires during a quick procedure in the operating room. Sedation may make your child feel relaxed and awake, relaxed and drowsy or lightly sleepy. Breathing slows down, so they may be given oxygen.

What are the advantages of stereo EEG?

Stereo EEG uses smaller cuts (incisions) and is safer and more precise than other ways to monitor seizures inside your child’s skull (intracranial). We use stereo EEG in more than 80% of intracranial EEGs. Compared to other tests, the advantages of stereo EEG include:

• No need to remove part of the skull (craniotomy), as with grid or strip placement
• Lower risk of infection and complications, such as bleeding and swelling
• Less time under anesthesia
• Reduced pain and need for pain medicine as your child heals
• More targeted treatment because neurosurgeons can safely reach areas below the surface of the brain

Who can benefit from stereo EEG?

Stereo EEG is used for children who:

• Are being evaluated for epilepsy surgery
• Have focal epilepsy, or seizures that start from a specific region in the brain
• Have seizures that are not controlled despite trying 2 or more medicines or other treatments

Stereo EEG is not an option for children with generalized epilepsy.

What’s special about stereo EEG at Seattle Children’s?

We have the only epilepsy program in the Northwest specifically for children that is accredited Level 4 by the National Association of Epilepsy Centers (NAEC). As a Level 4 center, we use the most advanced technology to assess patients, diagnose epilepsy and perform a broad range of complex surgeries.

We offer programs that are unique in the region, such as epilepsy, genetics and tuberous sclerosis (a rare genetic condition that causes tumors to grow in the brain and body).

Deciding how to treat epilepsy and other brain conditions involves many factors. We do imaging studies and neuropsychological testing. Read more about our treatment planning for children with epilepsy. 

We talk with you and your child to learn about their condition and how it affects them. Taking into account all that we learn, our team will explain:

• If stereo EEG is an option
• If it’s a better choice than other treatments
• If we recommend stereo EEG for your child and why