Effective use of stereoelectroencephalography (SEEG) for refractory epilepsy requires an accurate implantation strategy to ultimately enable a successful resective surgery. Providing detailed expert guidance in developing such a strategy is the overarching goal of Cleveland Clinic’s Ninth Brain Mapping Workshop, to take place in Cleveland from March 11 to 14, 2020.

The CME-certified course, titled “Imag(in)ing SEEG With Multimodal Integration,” will address the pre-SEEG workup — with multimodal guidance from MRI, EEG, MEG, SPECT and PET — as well as how multimodal findings are best used to inform surgical strategy development.

“A method for interpreting noninvasive multimodal data obtained during the planning phase of SEEG is essential to its success,” says Juan Bulacio, MD, an epileptologist with Cleveland Clinic’s Epilepsy Center who serves as one of the course’s five co-directors. “This procedure is not just for reviewing findings from different techniques. A fundamental interpretation is needed to integrate the various noninvasive findings according to their significance and their time sequence in the epileptogenic process. This brain mapping workshop will explore methods for doing so.”

Intimate workshop with expert faculty

The workshop is intimate in design, featuring opportunities for hands-on training and interaction with tutors dedicated to various case-based learning exercises. The faculty consists of epileptologists, neurosurgeons, neuroimaging specialists and neurophysiologists from Cleveland Clinic and other leading U.S. and European centers.

After kicking off Wednesday evening, March 11, with two hour-long introductory sessions on multimodality imaging and SEEG, the workshop structures most of the rest of its agenda around stages of the epileptogenic process:

• Imaging interictal activity is the focus of most of Thursday. Sessions on MEG/EEG and source localization as well as interictal connectivity and EEG-fMRI are supplemented with case-based workshops with tutors; also included are opportunities for participants to make preimplantation maps. A case-based plenary discussion concludes the segment.
• Imaging ictal activity comes to the fore late on Thursday, with sessions on analyzing clinical semiology videos and ictal SPECT as a snapshot of the seizure.
• Imaging the lesion is the focus of most of Friday, with sessions devoted to MRI and PET followed by more case-based workshops with tutors, including an exercise where participants plan a resection based on evaluation findings. Again a case-based plenary session concludes the segment, with tutors presenting SEEG findings and discussions specific to pathology and surgical approach.
• Integration of multimodal imaging and SEEG for planning resection is in the spotlight late on Friday, with discussions of how to represent multimodal imaging in relation to SEEG and how to prepare for surgery with SEEG.

After a Friday evening reception, the event concludes with a 3.5-hour Saturday morning session in which renowned epilepsy experts present in-depth cases for application of the workshop’s preceding insights.

All about integration

Participants can expect to come away with a clear understanding of how multimodal studies contribute to the pre-SEEG workup as well as how to integrate the neurophysiological assessment for that workup to define a surgical strategy.

“Attendees will be able to interpret SEEG recordings and cortical stimulation findings in the context of the pre-SEEG multimodal imaging data,” says course co-director Irene Wang, PhD, a staff scientist in Cleveland Clinic’s Epilepsy Center. “Emphasis will be put on linking 2D data to 3D representation; this is crucially import for the interpretation of SEEG, which is 3D in nature.”

For registration and more information, visit ccfcme.org/brainmapping20.

This activity has been approved for AMA PRA Category 1 Credit™.