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Epilepsy device

A Yu Lubnin
We present an analytical review of various neurosurgical interventions in conscious patients. An analysis of the literature indicates growing interest in this problem. Craniotomy in conscious patients has been extensively used in resection of space-occupying cerebral lesions in the eloquent hemispheric areas and in epilepsy surgery. In recent years, there have been a number of reports on interventions in conscious patients with other neurosurgical pathologies, which may be regarded as a new emerging tendency in neurosurgery and neuroanesthesiology...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Martin Holtkamp, Lars Büntjen, Friedhelm C Schmitt
New treatment approaches in epilepsy - such as novel antiepileptic drugs and neurostimulation - generally at first are assessed in animal models in regard to feasibility, efficacy and safety. The aim of this review was to elucidate and summarize the available literature on in vivo experimental studies on radiofrequency thermoablation and laser interstitial thermal therapy. We have found two in vivo studies on radiofrequency ablation of an acute seizure focus, one assessed the conventional transcranial and the other one a transvenous approach...
March 3, 2018: Epilepsy Research
Kemal Sasaki, Tomoko Nakagawa, Shiro Sugiura, Motohiro Ebisawa, Komei Ito
BACKGROUND: The unintentional usage of adrenaline auto-injectors may cause injury to caregivers or patients. To prevent such incidents, we assessed the causative factors of these incidents. METHODS: The Anaphylaxis Working Group of the Japanese Society of Pediatric Allergy and Clinical Immunology requested that society members register cases in which adrenaline auto-injectors were unintentionally used. One hundred cases were reported from June 2015 to March 2016...
March 5, 2018: Allergology International: Official Journal of the Japanese Society of Allergology
Hank Bink, Madineh Sedigh-Sarvestani, Ivan Fernandez-Lamo, Lohith Kini, Hoameng Ung, Duygu Kuzum, Flavia Vitale, Brian Litt, Diego Contreras
New devices that use targeted electrical stimulation to treat refractory localization-related epilepsy have shown great promise, though it is not well known which targets most effectively prevent the initiation and spread of seizures. To better understand how the brain transitions from healthy to seizing on a local scale, we induced focal epileptiform activity in the visual cortex of five anesthetized cats with local application of the GABAA blocker picrotoxin while simultaneously recording local field potentials on a high-resolution electrocorticography array and laminar depth probes...
February 28, 2018: Journal of Neurophysiology
Richárd Fiáth, Katharina T Hofer, Vivien Csikós, Domonkos Horváth, Tibor Nánási, Kinga Tóth, Frederick Pothof, Christian Böhler, Maria Asplund, Patrick Ruther, István Ulbert
Stereo-electroencephalography depth electrodes, regularly implanted into drug-resistant patients with focal epilepsy to localize the epileptic focus, have a low channel count (6-12 macro- or microelectrodes), limited spatial resolution (0.5-1 cm) and large contact area of the recording sites (~mm2). Thus, they are not suited for high-density local field potential and multiunit recordings. In this paper, we evaluated the long-term electrophysiological recording performance and histocompatibility of a neural interface consisting of 32 microelectrodes providing a physical shape similar to clinical devices...
February 26, 2018: Biomedizinische Technik. Biomedical Engineering
Alvin Y Chan, Lilit Mnatsakanyan, Mona Sazgar, Indranil Sen-Gupta, Jack J Lin, Frank P K Hsu, Sumeet Vadera
BACKGROUND: Responsive neurostimulation (RNS) is a relatively new treatment option that has been shown to be effective for patients with medically refractory focal epilepsy when resection is not possible, especially in bilateral mesial temporal onset. Robotic devices are becoming increasingly popular for use in stereotactic procedures such as stereoelectroencephalography, but have yet to be used when implanting RNS devices. OBJECTIVE: To show that these 2 forms of advanced technology were compatible and could be used effectively in patient care...
March 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Sanjeet S Grewal, Krzysztof R Gorny, Christopher P Favazza, Robert E Watson, Timothy J Kaufmann, Jamie J Van Gompel
BACKGROUND AND IMPORTANCE: Laser interstitial thermal therapy (LiTT) has increasingly been used as a treatment option for medically refractory epilepsy, tumors, and radiation necrosis. The use of LiTT requires intraoperative magnetic resonance (MR) thermography. This can become an issue in patients with other implanted therapeutic devices such as pacemakers and vagal nerve stimulators due to concerns regarding increases in the specific absorption rate (SAR). This is a technical case report demonstrating a successfully and safely performed LiTT in a 1...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
Alexander I Tröster
In the USA, the Food and Drug Administration (FDA) has approved deep brain stimulation (DBS) devices for the treatment of Parkinson's disease (PD), essential tremor (ET), dystonia, and obsessive compulsive disorder (OCD). DBS has been approved for these same conditions in Europe, but, additionally the European Commission (EC) has granted the Conformité Européenne (CE) Mark for DBS as adjunctive treatment for partial-onset seizures in adults with medically refractory epilepsy. In this issue of EJN Budman and colleagues [1] briefly review the range of neurologic conditions that might constitute promising new indications for DBS...
February 12, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Lance Watkins, Rohit Shankar, Josemir W Sander
Sudden Unexpected Death in Epilepsy (SUDEP) is a significant cause of death for people with chronic epilepsy. Good practice guidance in the UK and the USA expect SUDEP to be discussed with the individual. The event rarity, methodological variance and lack of robust research into the pathological mechanisms, associated risk factors, and management strategies have created a challenge on how and what to discuss. There are some significant associations which allows for risk assessment and mitigation. Areas covered: The current understanding of static and modifiable risk factors for SUDEP and how to manage these more effectively are reviewed...
February 9, 2018: Expert Review of Neurotherapeutics
Malgosia A Kokoszka, Fedor Panov, Maite La Vega-Talbott, Patricia E McGoldrick, Steven M Wolf, Saadi Ghatan
The responsive neurostimulation (RNS) system, an adjunctive treatment for pharmacoresistant partial-onset seizures with 1 or 2 foci, has been available to patients aged 18 years or older since the device's FDA approval in 2013. Herein, the authors describe their off-label application of this technology in 2 pediatric patients and the consequent therapeutic benefit without surgical complications or treatment side effects. A 14-year-old nonambulatory, nonverbal male with severe developmental delay was considered for RNS therapy for medically and surgically refractory epilepsy with bilateral seizure onsets in the setting of a normal radiological examination and a known neuropathological diagnosis of type I cortical dysplasia...
February 2, 2018: Journal of Neurosurgery. Pediatrics
Syed A Quadri, Muhammad Waqas, Inamullah Khan, Muhammad Adnan Khan, Sajid S Suriya, Mudassir Farooqui, Brian Fiani
Since Lynn and colleagues first described the use of focused ultrasound (FUS) waves for intracranial ablation in 1942, many strides have been made toward the treatment of several brain pathologies using this novel technology. In the modern era of minimal invasiveness, high-intensity focused ultrasound (HIFU) promises therapeutic utility for multiple neurosurgical applications, including treatment of tumors, stroke, epilepsy, and functional disorders. Although the use of HIFU as a potential therapeutic modality in the brain has been under study for several decades, relatively few neuroscientists, neurologists, or even neurosurgeons are familiar with it...
February 2018: Neurosurgical Focus
Matilde Inglese, Lazar Fleysher, Niels Oesingmann, Maria Petracca
Magnetic resonance imaging (MRI) is of paramount importance for the early diagnosis of multiple sclerosis (MS) and MRI findings are part of the MS diagnostic criteria. There is a growing interest in the use of ultra-high-field strength -7 Tesla- (7T) MRI to investigate, in vivo, the pathological substrate of the disease. Areas covered: An overview of 7T MRI applications in MS focusing on increased sensitivity for lesion detection, specificity of the central vein sign and better understanding of MS pathophysiology and discuss the implications for disease diagnosis, monitoring and treatment planning...
January 25, 2018: Expert Review of Neurotherapeutics
Philippa Karoly, Daniel M Goldenholz, Mark Cook
PURPOSE OF REVIEW: The estimation of seizure frequency is a cornerstone of clinical management of epilepsy and the evaluation of new therapies. Current estimation approaches are significantly limited by several factors. Comparing patient diaries and objective estimates (through both inpatient video-EEG monitoring of and long-term ambulatory EEG studies) reveal that patients document seizures inaccurately. So far, few practical alternative methods of estimation have been available. RECENT FINDINGS: We review the systems of counting currently utilized and their limitations, as well as the limitations imposed by problems defining clinical events...
April 2018: Current Opinion in Neurology
Evangelos Kogias, Petros Evangelou, Barbara Schmeiser, Peter C Reinacher, Dirk-Matthias Altenmüller
OBJECTIVE: We share our experience with extratemporal MRI-negative epilepsies that received "image-guided" resection with the use of neuronavigation after invasive presurgical video-EEG monitoring. We describe and discuss our technique of image generation, navigation system registration, and surgical resection. In addition, we evaluate seizure outcome with respect to the preoperatively planned versus achieved resection. PATIENTS AND METHODS: Seven patients with 3 T MRI-negative extratemporal epilepsy received navigation-guided resective surgery...
March 2018: Clinical Neurology and Neurosurgery
Aashish Jain, Dheeraj Arora, Yatin Mehta
The prevalence of epilepsy worldwide is around 0.5%-2% of the population. Antiepileptic medications are the first line of treatment in most of the cases but approximately 25%-30% epilepsy patients are refractory to the single or combination therapy. The surgical option for temporal lobe epilepsy is temporal lobectomy, which has its inherent risk of neurological deficits after the surgery. Patients who are either refractory to combination therapy or do not want surgical temporal lobectomy are the candidates for electrical stimulation therapy...
January 2018: Annals of Cardiac Anaesthesia
Steven C Schachter
PURPOSE OF REVIEW: As the number of patients diagnosed with epilepsy continues to rise and the pharmacological and device-based treatment options for epilepsy increase, determining when to stop antiepileptic drug (AED) treatment continues to be an important issue for patient management and counseling. RECENT FINDINGS: This review focuses on outcomes following AED withdrawal in seizure-free adults with epilepsy. Practical considerations are also discussed because, despite the importance of this topic, relatively little progress has been made in the past year regarding the identification of patients whose risk for recurrent seizures after AED withdrawal is no higher than that of the general population...
January 10, 2018: Current Opinion in Neurology
Maxime O Baud, Jonathan K Kleen, Emily A Mirro, Jason C Andrechak, David King-Stephens, Edward F Chang, Vikram R Rao
Epilepsy is defined by the seemingly random occurrence of spontaneous seizures. The ability to anticipate seizures would enable preventative treatment strategies. A central but unresolved question concerns the relationship of seizure timing to fluctuating rates of interictal epileptiform discharges (here termed interictal epileptiform activity, IEA), a marker of brain irritability observed between seizures by electroencephalography (EEG). Here, in 37 subjects with an implanted brain stimulation device that detects IEA and seizures over years, we find that IEA oscillates with circadian and subject-specific multidien (multi-day) periods...
January 8, 2018: Nature Communications
Bruce Simon, Justyna Blake
Stimulation of the cervical vagus nerve with implanted vagus nerve stimulation (iVNS) has been used clinically for more than 20 years to treat patients with epilepsy. More recently, a non-invasive cervical vagus nerve stimulation (nVNS), gammaCore, was developed, which has been purported to also stimulate the vagus nerve without the cost and morbidity associated with an iVNS system. gammaCore has been used to acutely treat various types of primary headaches, including migraine and cluster headaches (CH), and for the prevention of episodic, chronic, and menstrual migraines and CH...
November 2017: American Journal of Managed Care
Ying Gu, Evy Cleeren, Jonathan Dan, Kasper Claes, Wim Van Paesschen, Sabine Van Huffel, Borbála Hunyadi
A wearable electroencephalogram (EEG) device for continuous monitoring of patients suffering from epilepsy would provide valuable information for the management of the disease. Currently no EEG setup is small and unobtrusive enough to be used in daily life. Recording behind the ear could prove to be a solution to a wearable EEG setup. This article examines the feasibility of recording epileptic EEG from behind the ear. It is achieved by comparison with scalp EEG recordings. Traditional scalp EEG and behind-the-ear EEG were simultaneously acquired from 12 patients with temporal, parietal, or occipital lobe epilepsy...
December 23, 2017: Sensors
Sonya B Dumanis, Jaqueline A French, Christophe Bernard, Gregory A Worrell, Brandy E Fureman
The Epilepsy Innovation Institute (Ei2) is a new research program of the Epilepsy Foundation designed to be an innovation incubator for epilepsy. Ei2 research areas are selected based on community surveys that ask people impacted by epilepsy what they would like researchers to focus on. In their 2016 survey, unpredictability was selected as a top issue regardless of seizure frequency or severity. In response to this need, Ei2 launched the My Seizure Gauge challenge, with the end goal of creating a personalized seizure advisory system device...
November 2017: ENeuro
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