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https://www.readbyqxmd.com/read/28910805/infection-and-erosion-rates-in-trials-of-a-cranially-implanted-neurostimulator-do-not-increase-with-subsequent-neurostimulator-placements
#1
Peter B Weber, Ritu Kapur, Ryder P Gwinn, Richard S Zimmerman, Tracy A Courtney, Martha J Morrell
BACKGROUND/AIMS: The RNS® System utilizes a cranially implanted neurostimulator attached to leads placed at the seizure focus to provide brain responsive stimulation for the treatment of medically intractable partial onset epilepsy. Infection and erosion rates related to the cranial implant site were assessed overall and by neurostimulator procedure to determine whether rates increased with additional procedures. METHODS: Infection and erosion rates were calculated as (1) chance per neurostimulator procedure, (2) incidence per patient implant year, and (3) rates for initial and each subsequent neurostimulator implant (generalized estimating equation)...
September 15, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28899023/the-circadian-profile-of-epilepsy-improves-seizure-forecasting
#2
Philippa J Karoly, Hoameng Ung, David B Grayden, Levin Kuhlmann, Kent Leyde, Mark J Cook, Dean R Freestone
It is now established that epilepsy is characterized by periodic dynamics that increase seizure likelihood at certain times of day, and which are highly patient-specific. However, these dynamics are not typically incorporated into seizure prediction algorithms due to the difficulty of estimating patient-specific rhythms from relatively short-term or unreliable data sources. This work outlines a novel framework to develop and assess seizure forecasts, and demonstrates that the predictive power of forecasting models is improved by circadian information...
August 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28862995/intracranial-eeg-fluctuates-over-months-after-implanting-electrodes-in-human-brain
#3
Hoameng Ung, Steven N Baldassano, Hank Bink, Abba M Krieger, Shawniqua Williams, Flavia Vitale, Chengyuan Wu, Dean Freestone, Ewan Nurse, Kent Leyde, Kathryn A Davis, Mark Cook, Brian Litt
OBJECTIVE: Implanting subdural and penetrating electrodes in the brain causes acute trauma and inflammation that affect intracranial electroencephalographic (iEEG) recordings. This behavior and its potential impact on clinical decision-making and algorithms for implanted devices have not been assessed in detail. In this study we aim to characterize the temporal and spatial variability of continuous, prolonged human iEEG recordings. APPROACH: Intracranial electroencephalography from 15 patients with drug-refractory epilepsy, each implanted with 16 subdural electrodes and continuously monitored for an average of 18 months, was included in this study...
September 1, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28861464/organic-electronics-for-high-resolution-electrocorticography-of-the-human-brain
#4
Dion Khodagholy, Jennifer N Gelinas, Zifang Zhao, Malcolm Yeh, Michael Long, Jeremy D Greenlee, Werner Doyle, Orrin Devinsky, György Buzsáki
Localizing neuronal patterns that generate pathological brain signals may assist with tissue resection and intervention strategies in patients with neurological diseases. Precise localization requires high spatiotemporal recording from populations of neurons while minimizing invasiveness and adverse events. We describe a large-scale, high-density, organic material-based, conformable neural interface device ("NeuroGrid") capable of simultaneously recording local field potentials (LFPs) and action potentials from the cortical surface...
November 2016: Science Advances
https://www.readbyqxmd.com/read/28842304/establishment-of-a-rhesus-monkey-model-of-chronic-temporal-lobe-epilepsy-using-repetitive-unilateral-intra-amygdala-kainic-acid-injections
#5
Yajie Chi, Bolin Wu, Jianwei Guan, Kuntai Xiao, Ziming Lu, Xiao Li, Yuting Xu, Shan Xue, Qiang Xu, Junhua Rao, Yanwu Guo
OBJECTIVE: Temporal lobe epilepsy (TLE) is a common type of acquired epilepsy refractory to medical treatment. As such, establishing animal models of this disease is critical to developing new and effective treatment modalities. Because of their small head size, rodents are not suitable for comprehensive electroencephalography (EEG) evaluation via scalp or subdural electrodes. Therefore, a larger primate model that closely recapitulates signs of TLE is needed; here we describe a rhesus monkey model resembling chronic TLE...
September 6, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28777178/sleep-disordered-breathing
#6
Nancy R Foldvary-Schaefer, Tina E Waters
PURPOSE OF REVIEW: Sleep-disordered breathing encompasses a broad spectrum of sleep-related breathing disorders, including obstructive sleep apnea (OSA), central sleep apnea, as well as sleep-related hypoventilation and hypoxemia. Diagnostic criteria have been updated in the International Classification of Sleep Disorders, Third Edition and the American Academy of Sleep Medicine Manual for Scoring Sleep and Associated Events. Neurologic providers should have basic knowledge and skills to identify at-risk patients, as these disorders are associated with substantial morbidity, the treatment of which is largely reversible...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28777037/applications-of-a-robotic-stereotactic-arm-for-pediatric-epilepsy-and-neurooncology-surgery
#7
Brandon A Miller, Afshin Salehi, David D Limbrick, Matthew D Smyth
OBJECTIVE The ROSA device is a robotic stereotactic arm that uses a laser system to register the patient's head or spine with MR or CT images. In this study, the authors analyze their experience with this system in pediatric neurosurgical applications and present selected cases that exemplify the usefulness of this system. METHODS The authors reviewed all cases that utilized the ROSA system at their institution. Patient demographics, pathology, complications, electrode placement, laser ablation, and biopsy accuracy were analyzed...
August 4, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28718878/deep-brain-and-cortical-stimulation-for-epilepsy
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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...
September 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28591480/laser-interstitial-thermal-therapy-a-first-line-treatment-for-seizures-due-to-hypothalamic-hamartoma
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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