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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
#1
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...
April 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28398014/brain-responsive-neurostimulation-in-patients-with-medically-intractable-mesial-temporal-lobe-epilepsy
#2
Eric B Geller, Tara L Skarpaas, Robert E Gross, Robert R Goodman, Gregory L Barkley, Carl W Bazil, Michael J Berg, Gregory K Bergey, Sydney S Cash, Andrew J Cole, Robert B Duckrow, Jonathan C Edwards, Stephan Eisenschenk, James Fessler, Nathan B Fountain, Alicia M Goldman, Ryder P Gwinn, Christianne Heck, Aamar Herekar, Lawrence J Hirsch, Barbara C Jobst, David King-Stephens, Douglas R Labar, James W Leiphart, W Richard Marsh, Kimford J Meador, Eli M Mizrahi, Anthony M Murro, Dileep R Nair, Katherine H Noe, Yong D Park, Paul A Rutecki, Vicenta Salanova, Raj D Sheth, Donald C Shields, Christopher Skidmore, Michael C Smith, David C Spencer, Shraddha Srinivasan, William Tatum, Paul C Van Ness, David G Vossler, Robert E Wharen, Gregory A Worrell, Daniel Yoshor, Richard S Zimmerman, Kathy Cicora, Felice T Sun, Martha J Morrell
OBJECTIVE: Evaluate the seizure-reduction response and safety of mesial temporal lobe (MTL) brain-responsive stimulation in adults with medically intractable partial-onset seizures of mesial temporal lobe origin. METHODS: Subjects with mesial temporal lobe epilepsy (MTLE) were identified from prospective clinical trials of a brain-responsive neurostimulator (RNS System, NeuroPace). The seizure reduction over years 2-6 postimplantation was calculated by assessing the seizure frequency compared to a preimplantation baseline...
April 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/28396294/chronic-ambulatory-electrocorticography-from-human-speech-cortex
#3
Vikram R Rao, Matthew K Leonard, Jonathan K Kleen, Ben A Lucas, Emily A Mirro, Edward F Chang
Direct intracranial recording of human brain activity is an important approach for deciphering neural mechanisms of cognition. Such recordings, usually made in patients with epilepsy undergoing inpatient monitoring for seizure localization, are limited in duration and depend on patients' tolerance for the challenges associated with recovering from brain surgery. Thus, typical intracranial recordings, similar to most non-invasive approaches in humans, provide snapshots of brain activity in acute, highly constrained settings, limiting opportunities to understand long timescale and natural, real-world phenomena...
April 7, 2017: NeuroImage
https://www.readbyqxmd.com/read/28390806/the-vagal-nerve-stimulation-outcome-and-laryngeal-effect-otolaryngologists-roles-and-perspective
#4
Ahmad I Al Omari, Firas Q Alzoubi, Mohammad M Alsalem, Samah K Aburahma, Diala T Mardini, Paul F Castellanos
INTRODUCTION: Epilepsy is one of the most common neurologic disorders. Vagus nerve stimulation (VNS), first investigated in 1938 and subsequently studied as a potential therapy for epilepsy. The FDA approved the use of VNS in 1997 as an adjunctive non-pharmacologic symptomatic treatment option for refractory epilepsy for adults and adolescents over 12years. VNS can cause laryngeal and voice side effects that can be managed by otolaryngologists safely and effectively. OBJECTIVES: This study is to review the outcomes of vagal nerve stimulator (VNS) implantation in terms of the surgical procedures, complications, seizure frequency, and the clinical effect on larynx and vocal folds motion...
April 4, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28387951/brain-responsive-neurostimulation-in-patients-with-medically-intractable-seizures-arising-from-eloquent-and-other-neocortical-areas
#5
Barbara C Jobst, Ritu Kapur, Gregory L Barkley, Carl W Bazil, Michel J Berg, Gregory K Bergey, Jane G Boggs, Sydney S Cash, Andrew J Cole, Michael S Duchowny, Robert B Duckrow, Jonathan C Edwards, Stephan Eisenschenk, A James Fessler, Nathan B Fountain, Eric B Geller, Alica M Goldman, Robert R Goodman, Robert E Gross, Ryder P Gwinn, Christianne Heck, Aamr A Herekar, Lawrence J Hirsch, David King-Stephens, Douglas R Labar, W R Marsh, Kimford J Meador, Ian Miller, Eli M Mizrahi, Anthony M Murro, Dileep R Nair, Katherine H Noe, Piotr W Olejniczak, Yong D Park, Paul Rutecki, Vicenta Salanova, Raj D Sheth, Christopher Skidmore, Michael C Smith, David C Spencer, Shraddha Srinivasan, William Tatum, Paul Van Ness, David G Vossler, Robert E Wharen, Gregory A Worrell, Daniel Yoshor, Richard S Zimmerman, Tara L Skarpaas, Martha J Morrell
OBJECTIVE: Evaluate the seizure-reduction response and safety of brain-responsive stimulation in adults with medically intractable partial-onset seizures of neocortical origin. METHODS: Patients with partial seizures of neocortical origin were identified from prospective clinical trials of a brain-responsive neurostimulator (RNS System, NeuroPace). The seizure reduction over years 2-6 postimplantation was calculated by assessing the seizure frequency compared to a preimplantation baseline...
April 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/28386925/vagus-nerve-stimulation-surgical-technique-of-implantation-and-revision-and-related-morbidity
#6
Flavio Giordano, Anna Zicca, Carmen Barba, Renzo Guerrini, Lorenzo Genitori
Indications for vagus nerve stimulation (VNS) therapy include focal, multifocal epilepsy, drop attacks (tonic/atonic seizures), Lennox-Gastaut syndrome, tuberous sclerosis complex (TSC)-related multifocal epilepsy, and unsuccessful resective surgery. Surgical outcome is about 50-60% for seizures control, and may also improve mood, cognition, and memory. On this basis, VNS has also been proposed for the treatment of major depression and Alzheimer's' disease. The vagus nerve stimulator must be implanted with blunt technique on the left side to avoid cardiac side effects through the classic approach for anterior cervical discectomy...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28369748/reasons-for-discontinuation-of-reversible-contraceptive-methods-by-women-with-epilepsy
#7
Hannah B Mandle, Kaitlyn E Cahill, Kristen M Fowler, W Allen Hauser, Anne R Davis, Andrew G Herzog
OBJECTIVE: To report the reasons for discontinuation of contraceptive methods by women with epilepsy (WWE). METHODS: These retrospective data come from a web-based survey regarding the contraceptive practices of 1,144 WWE in the community, ages 18-47 years. We determined the frequencies of contraceptive discontinuations and the reasons for discontinuation. We compared risk ratios for rates of discontinuation among contraceptive methods and categories. We used chi-square analysis to test the independence of discontinuation reasons among the various contraceptive methods and categories and when stratified by antiepileptic drug (AED) categories...
April 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/28324954/hardware-friendly-seizure-detection-with-a-boosted-ensemble-of-shallow-decision-trees
#8
Mahsa Shoaran, Masoud Farivar, Azita Emami
Efficient on-chip learning is becoming an essential element of implantable biomedical devices. Despite a substantial literature on automated seizure detection algorithms, hardware-friendly implementation of such techniques is not sufficiently addressed. In this paper, we propose to employ a gradientboosted ensemble of decision trees to achieve a reasonable trade-off between detection accuracy and implementation cost. Combined with the proposed feature extraction model, we show that these classifiers quickly become competitive with more complex learning models previously proposed for hardware implementation, with only a small number of low-depth (d <; 4) "shallow" trees...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28291867/development-and-validation-of-a-brain-phantom-for-therapeutic-cooling-devices
#9
Ryan D M Packett, Philip J Brown, Gautam S S Popli, F Scott Gayzik
Tissue cooling has been proven as a viable therapy for multiple conditions and injuries and has been applied to the brain to treat epilepsy and concussions, leading to improved long-term outcomes. To facilitate the study of temperature reduction as a function of various cooling methods, a thermal brain phantom was developed and analyzed. The phantom is composed of a potassium-neutralized, superabsorbent copolymer hydrogel. The phantom was tested in a series of cooling trials using a cooling block and 37 deg water representing nondirectional blood flow ranging up to 6 gph, a physiologically representative range based on the prototype volume...
May 1, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28268493/automatic-seizure-detection-using-correlation-integral-with-nonlinear-adaptive-denoising-and-kalman-filter
#10
Hongda Wang, Chiu-Sing Choy
The ability of correlation integral for automatic seizure detection using scalp EEG data has been re-examined in this paper. To facilitate the detection performance and overcome the shortcoming of correlation integral, nonlinear adaptive denoising and Kalman filter have been adopted for pre-processing and post-processing. The three-stage algorithm has achieved 84.6% sensitivity and 0.087/h false detection rate, which are comparable to many machine learning based methods, but at much lower computational cost...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28251589/neurostimulation-devices-used-in-treatment-of-epilepsy
#11
REVIEW
Evren Burakgazi Dalkilic
Epilepsy is a chronic neurological disorder frequently requiring lifelong treatment. In 70% of epilepsy patients, seizures are well controlled by antiepileptic medications. About 30% of epilepsy patients remain refractory to medical treatments and may need surgical interventions for better seizure control. Unfortunately and not infrequently, surgical intervention is not feasible due to various reasons such as multiple seizure foci, not resectable focus because of eloquent cortex location, or inability to tolerate surgery due to ongoing concomitant medical conditions...
February 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28242084/understanding-death-in-children-with-epilepsy
#12
REVIEW
Elizabeth J Donner, Peter Camfield, Linda Brooks, Jeffrey Buchhalter, Carol Camfield, Tobias Loddenkemper, Elaine Wirrell
Death in children with epilepsy is profoundly disturbing, with lasting effects on the family, community, and health care providers. The overall risk of death for children with epilepsy is about ten times that of the general population. However, the risk of premature death for children without associated neurological comorbidities is similar to that of the general population, and most deaths are related to the cause of the epilepsy or associated neurologic disability, not seizures. The most common cause of seizure-related death in children with epilepsy is sudden unexpected death in epilepsy (SUDEP)...
January 31, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28237319/epilepsy-treatment-in-adults-and-adolescents-expert-opinion-2016
#13
REVIEW
Jerry J Shih, Julia B Whitlock, Nicole Chimato, Emily Vargas, Steven C Karceski, Ryan D Frank
INTRODUCTION: There are over twenty anti-seizure medications and anti-seizure devices available commercially in the United States. The multitude of treatment options for seizures can present a challenge to clinicians, especially those who are not subspecialists in the epilepsy field. Many clinical questions are not adequately answered in double-blind randomized controlled studies. In the presence of a knowledge gap, many clinicians consult a respected colleague with acknowledged expertise in the field...
February 22, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28226868/hardware-friendly-seizure-detection-with-a-boosted-ensemble-of-shallow-decision-trees
#14
Mahsa Shoaran, Masoud Farivar, Azita Emami, Mahsa Shoaran, Masoud Farivar, Azita Emami, Masoud Farivar, Azita Emami, Mahsa Shoaran
Efficient on-chip learning is becoming an essential element of implantable biomedical devices. Despite a substantial literature on automated seizure detection algorithms, hardware-friendly implementation of such techniques is not sufficiently addressed. In this paper, we propose to employ a gradientboosted ensemble of decision trees to achieve a reasonable trade-off between detection accuracy and implementation cost. Combined with the proposed feature extraction model, we show that these classifiers quickly become competitive with more complex learning models previously proposed for hardware implementation, with only a small number of low-depth (d <; 4) "shallow" trees...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226667/automatic-seizure-detection-using-correlation-integral-with-nonlinear-adaptive-denoising-and-kalman-filter
#15
Hongda Wang, Chiu-Sing Choy, Hongda Wang, Chiu-Sing Choy, Hongda Wang, Chiu-Sing Choy
The ability of correlation integral for automatic seizure detection using scalp EEG data has been re-examined in this paper. To facilitate the detection performance and overcome the shortcoming of correlation integral, nonlinear adaptive denoising and Kalman filter have been adopted for pre-processing and post-processing. The three-stage algorithm has achieved 84.6% sensitivity and 0.087/h false detection rate, which are comparable to many machine learning based methods, but at much lower computational cost...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225164/effects-of-focal-brain-cooling-on-extracellular-concentrations-of-neurotransmitters-in-patients-with-epilepsy
#16
Sadahiro Nomura, Takao Inoue, Hirochika Imoto, Eiichi Suehiro, Yuichi Maruta, Yuya Hirayama, Michiyasu Suzuki
OBJECTIVE: Brain hypothermia controls epileptic discharge and reduces extracellular concentrations of glutamate (Glu), an excitatory neurotransmitter. We aimed to determine the effects of focal brain cooling (FBC) on levels of γ-aminobutyric acid (GABA), which is a major inhibitory neurotransmitter. The relationship between Glu or GABA concentrations and the severity of epileptic symptoms was also analyzed. METHODS: Patients with intractable epilepsy underwent FBC at lesionectomized (n = 11) or hippocampectomized (n = 8) regions at 15°C for 30 min using custom-made cooling devices...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28185967/intraoperative-ct-and-nexframe-guided-placement-of-bilateral-hippocampal-based-responsive-neurostimulation-a-technical-note
#17
Kunal Gupta, Jeffrey S Raskin, Ahmed M Raslan
INTRODUCTION: Surgical resection of a lesion that correlates with seizure onset in patients with epilepsy can dramatically improve seizure burden and quality of life. For bilateral hippocampal lesions, bilateral resection comes with a risk of severe cognitive deficits. Responsive neurostimulation (RNS) devices offers a new modality to treat multifocal lesions in a reversible manner, including bilateral hippocampal stimulation. We describe technical aspects of Nexframe-assisted placement of bilateral NeuroPace mesial temporal electrodes, and case examples...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28160877/management-of-adult-onset-seizures
#18
REVIEW
Amy Z Crepeau, Joseph I Sirven
Epilepsy is a common yet heterogeneous disease. As a result, management often requires complex decision making. The ultimate goal of seizure management is for the patient to have no seizures and no considerable adverse effects from the treatment. Antiepileptic drugs are the mainstay of therapy, with more than 20 medications currently approved in the United States. Antiepileptic drug selection requires an understanding of the patient's epilepsy, along with consideration of comorbidities and potential for adverse events...
February 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28152451/can-natural-ways-to-stimulate-the-vagus-nerve-improve-seizure-control
#19
REVIEW
Alan W C Yuen, Josemir W Sander
The vagus nerve (VN) is the longest cranial nerve, innervating the neck, thorax and abdomen, with afferent fibers transmitting a range of interoceptive stimuli and efferent fibres to somatic structures and autonomic preganglions. Over the last few decades, electrical stimulation of the VN using implanted devices (VNS) has been developed leading to its approval for the treatment of epilepsy and depression. More recently, non-invasive devices to stimulation the VN have been developed. The VN has many functions and the activity that is most amenable to assessment is its effect in controlling the cardiac rhythm...
February 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28122902/predictors-of-unintended-pregnancy-in-women-with-epilepsy
#20
Andrew G Herzog, Hannah B Mandle, Kaitlyn E Cahill, Kristen M Fowler, W Allen Hauser
OBJECTIVE: To determine whether rates of unintended pregnancy in women with epilepsy (WWE) vary by contraceptive category and when stratified by antiepileptic drug (AED) category. METHODS: These retrospective data come from the Epilepsy Birth Control Registry (EBCR) web-based survey of 1,144 WWE in the community, 18-47 years of age, who provided demographic, epilepsy, AED, contraceptive, and pregnancy data. Participants indicated whether pregnancies were intended or unintended, as well as the type of contraceptive and AED used at conception...
February 21, 2017: Neurology
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