Postictal self‐removal of intracerebral electrodes during stereoelectroencephalography monitoring: A case series

Auteurs

Bratu IF, Carron R, Makhalova J, Lagarde S, Bartolomei F

Les auteurs en lien sont membres de l'INS.

Équipes

NeuroStim, DynaMap

Résumé

Abstract Epilepsy surgery remains the most effective treatment for focal drug‐resistant epilepsy, and stereoelectroencephalography (SEEG) is increasingly used to define the epileptogenic‐zone network (EZN) and guide curative or palliative interventions. While SEEG is considered a safe invasive procedure, adverse events arising during monitoring itself are rarely described. We report three exceptional cases of postictal self‐removal of intracerebral electrodes during SEEG monitoring. Among 591 implanted patients between January 2000 and October 2025 at Timone Hospital, Marseille, three patients (0.5%) met the inclusion criteria. All were young right‐handed men with normal neurocognitive development, focal drug‐resistant epilepsy and no psychiatric comorbidity. Self‐removal occurred during the postictal phase of spontaneous seizures—two following focal‐to‐bilateral tonic–clonic seizures and one after a focal impaired‐awareness seizure—on the second day of monitoring under complete or partial antiseizure medication withdrawal. Postictal behavior was characterized by agitation, wandering, and, in two cases, resistive aggression when nursing staff attempted to intervene. None of the pat

Abstract Epilepsy surgery remains the most effective treatment for focal drug‐resistant epilepsy, and stereoelectroencephalography (SEEG) is increasingly used to define the epileptogenic‐zone network (EZN) and guide curative or palliative interventions. While SEEG is considered a safe invasive procedure, adverse events arising during monitoring itself are rarely described. We report three exceptional cases of postictal self‐removal of intracerebral electrodes during SEEG monitoring. Among 591 implanted patients between January 2000 and October 2025 at Timone Hospital, Marseille, three patients (0.5%) met the inclusion criteria. All were young right‐handed men with normal neurocognitive development, focal drug‐resistant epilepsy and no psychiatric comorbidity. Self‐removal occurred during the postictal phase of spontaneous seizures—two following focal‐to‐bilateral tonic–clonic seizures and one after a focal impaired‐awareness seizure—on the second day of monitoring under complete or partial antiseizure medication withdrawal. Postictal behavior was characterized by agitation, wandering, and, in two cases, resistive aggression when nursing staff attempted to intervene. None of the pat

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