The United States Stereotactic EEG Survey: Current Practice and Future Opportunities

Purpose: Stereotactic EEG (SEEG) is being increasingly used in the intracranial evaluation of refractory epilepsy in the United States. A 2022 survey of SEEG practices among National Association of Epilepsy Centers tertiary referral (NAEC level IV) centers found largely similar practices across institutions. However, a few significant differences were noted in technical and patient care practice, and in the level of SEEG background training. In the year since publication, we review the identified challenges facing SEEG practice and suggest specific corrective action. Conclusions: Stereotactic EEG has rapidly become the principal method for intracranial EEG monitoring in epilepsy surgery centers in the United States. The rate of adoption of SEEG is currently higher than the growth of invasive monitoring overall. Most report similar indications for SEEG, although significant variability exists in personnel expertise and technical and patient care practice. Consensus statements, guidelines, and review of postgraduate training curricula are urgently needed to benchmark SEEG practice and develop appropriate skillsets in the next generation of practitioners in the United States.