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https://www.readbyqxmd.com/read/28718878/deep-brain-and-cortical-stimulation-for-epilepsy
#1
REVIEW
Mathieu Sprengers, Kristl Vonck, Evelien Carrette, Anthony G Marson, Paul Boon
BACKGROUND: Despite optimal medical treatment, including epilepsy surgery, many epilepsy patients have uncontrolled seizures. Since the 1970s interest has grown in invasive intracranial neurostimulation as a treatment for these patients. Intracranial stimulation includes both deep brain stimulation (DBS) (stimulation through depth electrodes) and cortical stimulation (subdural electrodes). This is an updated version of a previous Cochrane review published in 2014. OBJECTIVES: To assess the efficacy, safety and tolerability of DBS and cortical stimulation for refractory epilepsy based on randomized controlled trials (RCTs)...
July 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28715338/closed-loop-neurostimulators-a-survey-and-a-seizure-predicting-design-example-for-intractable-epilepsy-treatment
#2
Hossein Kassiri, Sana Tonekaboni, M Tariqus Salam, Nima Soltani, Karim Abdelhalim, Jose Luis Perez Velazquez, Roman Genov
First, existing commercially available open-loop and closed-loop implantable neurostimulators are reviewed and compared in terms of their targeted application, physical size, system-level features, and performance as a medical device. Next, signal processing algorithms as the primary strength point of the closed-loop neurostimulators are reviewed, and various design and implementation requirements and trade-offs are discussed in details along with quantitative examples. The review results in a set of guidelines for algorithm selection and evaluation...
July 17, 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28714112/wearables-in-epilepsy-and-parkinson-s-disease-a-focus-group-study
#3
A Ozanne, D Johansson, U Hällgren Graneheim, K Malmgren, F Bergquist, M Alt Murphy
OBJECTIVES: Wearable sensors that measure movement and physiological variables are attractive for clinical evaluation of neurological diseases such as epilepsy and Parkinson's disease (PD). The aim of this study was to explore perceptions regarding the use of wearable technology in disease monitoring and management as reported by individuals with epilepsy and Parkinson's disease as well as health professionals working with these patient groups. MATERIALS AND METHODS: Six patient groups (n=25) and two groups with health professionals (n=15) participated in this qualitative, descriptive study with focus group interviews...
July 16, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28689344/neurological-results-of-the-modified-treatment-of-epilepsy-by-stimulation-of-the-vagus-nerve
#4
Michael Vaiman, Eli Heyman, Gad Lotan
INTRODUCTION: The vagus nerve stimulation (VNS) is used for treatment of drug-resistant epilepsy but laryngeal side effects are common. We tried to improve VNS by modifying the implantation procedure. The aim was to reduce the rate of side effects that have prevented using VNS to its full capacity. METHODS: We operated on 74 pediatric patients for VNS device implantation using a modified surgical protocol incorporating lower neck incision for electrode placement and 36 patients who were operated by standard technique were used for control group...
July 8, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28665820/magnetoencephalographic-recordings-in-infants-using-a-standard-sized-array-technical-adequacy-and-diagnostic-yield
#5
Sumiya Shibata, John C Mosher, Prakash Kotagal, Ajay Gupta, Andreas V Alexopoulos, Richard C Burgess
PURPOSE: Although a few magnetoencephalography (MEG) systems have been built specifically for infants (<2 years), most children are routinely examined using MEG systems designed primarily to accommodate adult subjects. The practicality of the adult MEG device has not been systematically reviewed in infants with epilepsy. The aim of this study is to investigate whether infant epilepsy patients, whose heads are small relative to the sensor helmet, can have clinically successful MEG recordings using the conventional adult-size MEG device...
June 29, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28619068/late-onset-jaw-and-teeth-pain-mimicking-trigeminal-neuralgia-associated-with-chronic-vagal-nerve-stimulation-case-series-and-review-of-the-literature
#6
Gabriela Timarova, Andrej Šteňo
BACKGROUND: Vagal nerve stimulation (VNS) for refractory epilepsy is well established. Trigeminal neuralgia itself is a common disease in adults, and thus, late-onset pain in the trigeminal region under VNS, which is extremely rare, may not be recognized as caused by VNS. CASE PRESENTATION: Two patients with drug-resistant symptomatic epilepsy treated with chronic VNS experienced stimulation-related pain in the lower and upper jaw and teeth on the side of stimulation...
June 15, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28601605/rapid-focal-cooling-attenuates-cortical-seizures-in-a-primate-epilepsy-model
#7
Guoping Ren, Jiaqing Yan, Guoxian Tao, Yunmeng Gan, Donghong Li, Xi Yan, Yongjuan Fu, Leiming Wang, Weimin Wang, Zhiming Zhang, Feng Yue, Xiaofeng Yang
Rapid focal cooling is an attractive nondestructive strategy to control and possibly prevent focal seizures. However, the temperature threshold necessary to abort seizures in primates is still unknown. Here, we explored this issue in a primate epilepsy model and observed the effect of rapid cooling on different electroencephalogram frequency bands, aiming at providing necessary experimental data for future clinical translational studies and exploring the mechanism of focal cooling in terminating seizures. We induced focal neocortical seizures using microinjection of 4-aminopyridine into premotor cortex in five anesthetized cynomolgus monkeys...
June 7, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28591480/laser-interstitial-thermal-therapy-a-first-line-treatment-for-seizures-due-to-hypothalamic-hamartoma
#8
REVIEW
Victor X Du, Shashank V Gandhi, Harold L Rekate, Ashesh D Mehta
Successful treatment of hypothalamic hamartoma (HH) can result in the resolution of its sequelae including epilepsy and rage attacks. Risks and morbidity of open surgical management of this lesion have motivated the development of laser interstitial thermal therapy (LITT) as a less invasive treatment approach to the disease. Although overall morbidity and risk would appear to be lower, complications related to LITT therapy have been reported, and the longer-term follow-up that is now possible after initial experience helps address the question of whether LITT provides equivalent efficacy compared to other treatment options...
June 2017: Epilepsia
https://www.readbyqxmd.com/read/28572790/photolysis-of-caged-gaba-rapidly-terminates-seizures-in-vivo-concentration-and-light-intensity-dependence
#9
Dan Wang, Zhixin Yu, Jiaqing Yan, Fenqin Xue, Guoping Ren, Chenxi Jiang, Weimin Wang, Yueshan Piao, Xiaofeng Yang
The therapy of focal epilepsy remains unsatisfactory for as many as 25% of patients. The photolysis of caged-γ-aminobutyric acid (caged-GABA) represents a novel and alternative option for the treatment of intractable epilepsy. Our previous experimental results have demonstrated that the use of blue light produced by light-emitting diode to uncage ruthenium-bipyridine-triphenylphosphine-c-GABA (RuBi-GABA) can rapidly terminate paroxysmal seizure activity both in vitro and in vivo. However, the optimal concentration of RuBi-GABA, and the intensity of illumination to abort seizures, remains unknown...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28572789/impaired-baroreflex-sensitivity-after-bilateral-convulsive-seizures-in-patients-with-focal-epilepsy
#10
Kevin G Hampel, Christian E Elger, Rainer Surges
BACKGROUND: Sudden unexpected death in epilepsy (SUDEP) is probably due to an autonomic failure in the early postictal phase after bilateral convulsive seizures (BCS) in the majority of cases. The baroreflex sensitivity (BRS) is an established and reliable biomarker of autonomic function and sudden cardiac death. OBJECTIVE: To investigate whether postictal BRS depends on seizure type. METHODS: Beat-to-beat systemic blood pressure and heart rate were continuously and non-invasively recorded with the ccNexfin(®) device in patients with focal epilepsy undergoing video-EEG monitoring...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28543780/intranasal-midazolam-versus-rectal-diazepam-for-the-management-of-canine-status-epilepticus-a-multicenter-randomized-parallel-group-clinical-trial
#11
M Charalambous, S F M Bhatti, L Van Ham, S Platt, N D Jeffery, A Tipold, J Siedenburg, H A Volk, D Hasegawa, A Gallucci, G Gandini, M Musteata, E Ives, A E Vanhaesebrouck
BACKGROUND: Intranasal administration of benzodiazepines has shown superiority over rectal administration for terminating emergency epileptic seizures in human trials. No such clinical trials have been performed in dogs. OBJECTIVE: To evaluate the clinical efficacy of intranasal midazolam (IN-MDZ), via a mucosal atomization device, as a first-line management option for canine status epilepticus and compare it to rectal administration of diazepam (R-DZP) for controlling status epilepticus before intravenous access is available...
July 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28523978/closed-loop-neuromodulation-systems-next-generation-treatments-for-psychiatric-illness
#12
Meng-Chen Lo, Alik S Widge
Despite deep brain stimulation's positive early results in psychiatric disorders, well-designed clinical trials have yielded inconsistent clinical outcomes. One path to more reliable benefit is closed-loop therapy: stimulation that is automatically adjusted by a device or algorithm in response to changes in the patient's electrical brain activity. These interventions may provide more precise and patient-specific treatments. This article first introduces the available closed-loop neuromodulation platforms, which have shown clinical efficacy in epilepsy and strong early results in movement disorders...
April 2017: International Review of Psychiatry
https://www.readbyqxmd.com/read/28521270/prediction-of-seizure-outcome-improved-by-fast-ripples-detected-in-low-noise-intraoperative-corticogram
#13
Tommaso Fedele, Georgia Ramantani, Sergey Burnos, Peter Hilfiker, Gabriel Curio, Thomas Grunwald, Niklaus Krayenbühl, Johannes Sarnthein
OBJECTIVE: Fast ripples (FR, 250-500Hz) in the intraoperative corticogram have recently been proposed as specific predictors of surgical outcome in epilepsy patients. However, online FR detection is restricted by their low signal-to-noise ratio. Here we propose the integration of low-noise EEG with unsupervised FR detection. METHODS: Pre- and post-resection ECoG (N=9 patients) was simultaneously recorded by a commercial device (CD) and by a custom-made low-noise amplifier (LNA)...
July 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28516343/therapeutic-dormancy-to-delay-postsurgical-glioma-recurrence-the-past-present-and-promise-of-focal-hypothermia
#14
REVIEW
Didier Wion
Surgery precedes both radiotherapy and chemotherapy as the first-line therapy for glioma. However, despite multimodal treatment, most glioma patients die from local recurrence in the resection margin. Glioma surgery is inherently lesional, and the response of brain tissue to surgery includes hemostasis, angiogenesis, reactive gliosis and inflammation. Unfortunately, these processes are also associated with tumorigenic side-effects. An increasing amount of evidence indicates that the response to a surgery-related brain injury is hijacked by residual glioma cells and participates in the local regeneration of tumor tissues at the resection margin...
May 17, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28502271/quality-of-sample-size-estimation-in-trials-of-medical-devices-high-risk-devices-for-neurological-conditions-as-example
#15
Britta Olberg, Matthias Perleth, Katja Felgentraeger, Sandra Schulz, Reinhard Busse
BACKGROUND: The aim of this study was to assess the quality of reporting sample size calculation and underlying design assumptions in pivotal trials of high-risk medical devices (MDs) for neurological conditions. METHODS: Systematic review of research protocols for publicly registered randomized controlled trials (RCTs). In the absence of a published protocol, principal investigators were contacted for additional data. To be included, trials had to investigate a high-risk MD, registered between 2005 and 2015, with indications stroke, headache disorders, and epilepsy as case samples within central nervous system diseases...
May 15, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/28496112/-tornado-theranostic-one-step-rna-detector-microfluidic-disc-for-the-direct-detection-of-microrna-134-in-plasma-and-cerebrospinal-fluid
#16
Hazel McArdle, Eva M Jimenez-Mateos, Rana Raoof, Eadaoin Carthy, David Boyle, Hany ElNaggar, Norman Delanty, Hajo Hamer, Muejgdan Dogan, Tessa Huchtemann, Peter Kӧrtvelyessy, Felix Rosenow, Robert J Forster, David C Henshall, Elaine Spain
Diagnosis of seizure disorders such as epilepsy currently relies on clinical examination and electroencephalogram recordings and is associated with substantial mis-diagnosis. The miRNA, miR-134 (MIR134 in humans), has been found to be elevated in brain tissue after experimental status epilepticus and in human epilepsy cells and their detection in biofluids may serve as unique biomarkers. miRNAs from unprocessed human plasma and human cerebrospinal fluid samples were used in a novel electrochemical detection based on electrocatalytic platinum nanoparticles inside a centrifugal microfluidic device where the sandwich assay is formed using an event triggered release system, suitable for the rapid point-of-care detection of low abundance biomarkers of disease...
May 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28463617/robot-assisted-procedures-in-pediatric-neurosurgery
#17
Alessandro De Benedictis, Andrea Trezza, Andrea Carai, Elisabetta Genovese, Emidio Procaccini, Raffaella Messina, Franco Randi, Silvia Cossu, Giacomo Esposito, Paolo Palma, Paolina Amante, Michele Rizzi, Carlo Efisio Marras
OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28459961/crowdsourcing-seizure-detection-algorithm-development-and-validation-on-human-implanted-device-recordings
#18
Steven N Baldassano, Benjamin H Brinkmann, Hoameng Ung, Tyler Blevins, Erin C Conrad, Kent Leyde, Mark J Cook, Ankit N Khambhati, Joost B Wagenaar, Gregory A Worrell, Brian Litt
There exist significant clinical and basic research needs for accurate, automated seizure detection algorithms. These algorithms have translational potential in responsive neurostimulation devices and in automatic parsing of continuous intracranial electroencephalography data. An important barrier to developing accurate, validated algorithms for seizure detection is limited access to high-quality, expertly annotated seizure data from prolonged recordings. To overcome this, we hosted a kaggle.com competition to crowdsource the development of seizure detection algorithms using intracranial electroencephalography from canines and humans with epilepsy...
June 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28450153/epidural-focal-brain-cooling-abolishes-neocortical-seizures-in-cats-and-non-human-primates
#19
Takao Inoue, Masami Fujii, Hiroyuki Kida, Toshitaka Yamakawa, Yuichi Maruta, Tatsuji Tokiwa, Yeting He, Sadahiro Nomura, Yuji Owada, Takeshi Yamakawa, Michiyasu Suzuki
Focal brain cooling (FBC) is under investigation in preclinical trials of intractable epilepsy (IE), including status epilepticus (SE). This method has been studied in rodents as a possible treatment for epileptic disorders, but more evidence from large animal studies is required. To provide evidence that FBC is a safe and effective therapy for IE, we investigated if FBC using a titanium cooling plate can reduce or terminate focal neocortical seizures without having a significant impact on brain tissue. Two cats and two macaque monkeys were chronically implanted with an epidural FBC device over the somatosensory and motor cortex...
April 24, 2017: Neuroscience Research
https://www.readbyqxmd.com/read/28410885/successful-implantation-and-immediate-activation-of-vagus-nerve-stimulation-vns-during-pregnancy-in-a-patient-with-intractable-epilepsy-a-case-illustration-and-review-of-the-literature
#20
N Jazebi, N Moghimi, R Lall, E Osadebey, J Ortega-Barnett, T Masel
While Vagus Nerve Stimulation (VNS) is proven to be a safe and effective adjunctive therapy in the general population with medically intractable seizures, little is published about its implantation during pregnancy. Here we illustrate the case of a 21year old primigravid woman with medically refractory seizures who underwent safe and successful VNS implantation and immediate activation of the device in her 32nd week of pregnancy, resulting in dramatically improved seizure control and subsequent delivery of a healthy baby...
August 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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