Evidence map›Paper›PMID 41973515›Full record

ArticleEpilepsia2026

Cortical and etiological determinants of stimulation-induced seizures in children undergoing stereo-EEG.

Daniela Chiarello, Mattia Mercier, Giusy Carfi-Pavia, Concetta Luisi, Chiara Pepi, Alessandro De Benedictis, Carlo Efisio Marras, Nicola Specchio, Luca de Palma

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In one paragraph

Article in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Daniela ChiarelloNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, Scientific Institute for Research and Health Care, Full Member of European Reference Network on Rare and Complex Epilepsies EpiCARE, Rome, Italy.ORCID https://orcid.org/0000-0002-0150-9453
Mattia MercierNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, Scientific Institute for Research and Health Care, Full Member of European Reference Network on Rare and Complex Epilepsies EpiCARE, Rome, Italy.ORCID https://orcid.org/0000-0003-4239-8267
Giusy Carfi-PaviaNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, Scientific Institute for Research and Health Care, Full Member of European Reference Network on Rare and Complex Epilepsies EpiCARE, Rome, Italy.ORCID https://orcid.org/0000-0001-5383-113X
Concetta LuisiNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, Scientific Institute for Research and Health Care, Full Member of European Reference Network on Rare and Complex Epilepsies EpiCARE, Rome, Italy.ORCID https://orcid.org/0000-0003-2310-9992
Chiara PepiNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, Scientific Institute for Research and Health Care, Full Member of European Reference Network on Rare and Complex Epilepsies EpiCARE, Rome, Italy.ORCID https://orcid.org/0000-0003-0880-6140
Alessandro De BenedictisNeurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.ORCID https://orcid.org/0000-0002-5414-198X
Carlo Efisio MarrasNeurosurgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.ORCID https://orcid.org/0000-0003-0790-8903
Nicola SpecchioNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, Scientific Institute for Research and Health Care, Full Member of European Reference Network on Rare and Complex Epilepsies EpiCARE, Rome, Italy.ORCID https://orcid.org/0000-0002-8120-0287
Luca de PalmaNeurology, Epilepsy and Movement Disorders Unit, Bambino Gesù Children's Hospital, Scientific Institute for Research and Health Care, Full Member of European Reference Network on Rare and Complex Epilepsies EpiCARE, Rome, Italy.ORCID https://orcid.org/0000-0002-0714-8230

Funding

Ministero della Salute Current research FundsMinistero della Salute MNESYS (PE0000006)
6 · The paper itself

Abstract

objectiveElectrical stimulation during stereo-electroencephalography (SEEG) is used for functional mapping and seizure induction in epilepsy surgery candidates. However, its effects in pediatric populations remain underexplored. The aim of this study is to characterize stimulation-induced seizures (SISs) in children undergoing SEEG and evaluate associations with stimulation parameters, cortical architecture, etiology, and surgical outcome.

methodsWe retrospectively analyzed 78 children with drug-resistant focal epilepsy (median age at epilepsy onset=2.8 years ± SD=4.4) who underwent SEEG with low-frequency (1-3 Hz) and/or high-frequency (50 Hz) stimulation. SISs were categorized as low-frequency seizures (LF-ISs) or high-frequency seizures (HF-ISs) and analyzed by anatomic site, cytoarchitectonics, cortical hierarchy, and etiology. Post-surgical outcomes were assessed using Engel classification.

resultsSISs occurred in 43.6% of patients (LF-IS: 21.8%, HF-IS: 32.1%). Focal cortical dysplasia type II (FCD II)-particularly FCD IIb-was significantly associated with SISs (LFS: p = .016; HFS: p = .001). Interictal SEEG biomarkers such as brushes and suppression predicted SISs (p = .002). LF-ISs predominantly involved the orbitofrontal and insular regions, whereas HF-ISs clustered in the cingulate and central areas (p = .029). Stimulation type correlated with cortical hierarchy (p = .005) but not cytoarchitecture. SISs were marginally associated with favorable surgical outcome (Engel class Ia; p = .046). SIGNIFICANCE: This is the first study to systematically assess SISs in a pediatric cohort. Findings suggest that SISs-especially in FCD II and heteromodal cortical areas-may serve as biomarkers of epileptogenicity and predictors of surgical outcome. These insights can guide SEEG planning and interpretation in pediatric epilepsy surgery.

Indexed as

Cerebral CortexDrug Resistant EpilepsyElectric StimulationElectroencephalographyFocal Cortical DysplasiaSeizuresBrain MappingChildChild, PreschoolFemaleHumansMaleRetrospective StudiesStereotaxic Techniquescortical hierarchyfocal cortical dysplasiaintracranial stimulationpediatric epilepsystereo‐electroencephalographystimulation‐induced seizures

Identifiers

PMID41973515
PMCPMC13360900

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