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Epilepsy Surgery

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https://www.readbyqxmd.com/read/28101478/focal-epileptogenic-lesions-in-adult-patients-with-epilepsy-and-generalized-epileptiform-discharges
#1
Dong Wook Kim, Seo-Young Lee, Sang Kun Lee
BACKGROUND AND PURPOSE: There are reports of successful resective epilepsy surgery for pediatric patients with epilepsy and generalized epileptiform discharges when they had focal epileptogenic lesions identified by MRI. However, there is limited information regarding adult patients with epilepsy who have both generalized epileptiform discharges and focal epileptogenic lesions. METHODS: To investigate the incidence and characteristics of adult patients who have both generalized epileptiform discharges and potentially epileptogenic lesions, we retrospectively analyzed data of clinical features and results of EEG and MRI of all patients with adult-onset epilepsy in a tertiary referral hospital...
December 2016: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/28101477/change-of-patient-selection-strategy-and-improved-surgical-outcome-in-mri-negative-neocortical-epilepsy
#2
Hye-Jin Moon, Dong Wook Kim, Chun-Kee Chung, Jung-Won Shin, Jangsup Moon, Bong Su Kang, Soon-Tae Lee, Keun-Hwa Jung, Kon Chu, Ki-Young Jung, Yong Won Cho, Sang Kun Lee
BACKGROUND AND PURPOSE: It is crucial to make selection strategy to identify surgical candidates among medically refractory MRI-negative neocortical epilepsy patients. In our previous study, we suggested two or more concordance between noninvasive studies (EEG, ictal scalp EEG, interictal FDG-PET, and SPECT) as a new patient selection strategy for MRI-negative neocortical epilepsy surgery. The objective of this study was to evaluate the surgical outcomes of MRI-negative neocortical epilepsy patients before and after the implementation of a new selection strategy...
December 2016: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/28098941/posterior-cortex-epilepsy-surgery-in-childhood-and-adolescence-predictors-of-long-term-seizure-outcome
#3
Georgia Ramantani, Angeliki Stathi, Armin Brandt, Karl Strobl, Susanne Schubert-Bast, Gert Wiegand, Rudolf Korinthenberg, Vera van Velthoven, Josef Zentner, Andreas Schulze-Bonhage, Thomas Bast
OBJECTIVE: We aimed to investigate the long-term seizure outcome of children and adolescents who were undergoing epilepsy surgery in the parietooccipital cortex and determine their predictive factors. METHODS: We retrospectively analyzed the data of 50 consecutive patients aged 11.1 (mean) ± 5.1 (standard deviation) years at surgery. All patients but one had a magnetic resonance imaging (MRI)-visible lesion. Resections were parietal in 40%, occipital in 32%, and parietooccipital in 28% cases; 24% patients additionally underwent a resection of the posterior border of the temporal lobe...
January 18, 2017: Epilepsia
https://www.readbyqxmd.com/read/28098939/a-systematic-review-of-economic-evaluations-of-treatments-for-patients-with-epilepsy
#4
REVIEW
Ben F M Wijnen, Ghislaine A P G van Mastrigt, Silvia M A A Evers, Olga Gershuni, Danielle A J E Lambrechts, Marian H J M Majoie, Debby Postulart, Bert A P Aldenkamp, Reina J A de Kinderen
The increasing number of treatment options and the high costs associated with epilepsy have fostered the development of economic evaluations in epilepsy. It is important to examine the availability and quality of these economic evaluations and to identify potential research gaps. As well as looking at both pharmacologic (antiepileptic drugs [AEDs]) and nonpharmacologic (e.g., epilepsy surgery, ketogenic diet, vagus nerve stimulation) therapies, this review examines the methodologic quality of the full economic evaluations included...
January 18, 2017: Epilepsia
https://www.readbyqxmd.com/read/28096104/recent-developments-in-the-surgical-management-of-paediatric-epilepsy
#5
REVIEW
Vijay M Ravindra, Matthew T Sweney, Robert J Bollo
Among the 1% of children affected by epilepsy, failure of pharmacological therapy and early age of seizure onset can lead to worse long-term cognitive outcomes, mental health disorders and impaired functional status. Surgical management often improves functional and cognitive outcomes in children with medically refractory epilepsy, especially when seizure remission is achieved. However, surgery remains underused in children with drug-resistant epilepsy, creating a large treatment gap. Several recent innovations have led to considerable improvement in surgical technique, including the recent development of minimally invasive diagnostic and therapeutic techniques such as stereotactic EEG, transcranial magnetic stimulation, MRI-guided laser ablation, as well as novel paradigms of neurostimulation...
January 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28092511/the-concept-of-effective-inflow-application-to-interictal-localization-of-the-epileptogenic-focus-from-ieeg
#6
Ioannis Vlachos, Balu Krishnan, David Treiman, Konstantinos Tsakalis, Dimitris Kugiumtzis, Leon D Iasemidis
GOAL: Accurate determination of the epileptogenic focus is of paramount diagnostic and therapeutic importance in epilepsy. The current gold standard for focus localization is from ictal (seizure) onset and thus requires the occurrence and recording of multiple typical seizures of a patient. Localization of the focus from seizure-free (interictal) periods remains a challenging problem, especially in the absence of interictal epileptiform activity. METHODS: By exploring the concept of effective inflow, we developed a focus localization algorithm (FLA) based on directed connectivity between brain sites...
November 29, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28090508/laser-applications-in-surgery
#7
REVIEW
Beina Azadgoli, Regina Y Baker
In modern medicine, lasers are increasingly utilized for treatment of a variety of pathologies as interest in less invasive treatment modalities intensifies. The physics behind lasers allows the same basic principles to be applied to a multitude of tissue types using slight modifications of the system. Multiple laser systems have been studied within each field of medicine. The term "laser" was combined with "surgery," "ablation," "lithotripsy," "cancer treatment," "tumor ablation," "dermatology," "skin rejuvenation," "lipolysis," "cardiology," "atrial fibrillation (AF)," and "epilepsy" during separate searches in the PubMed database...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28088805/a-retrospective-analysis-of-stereoelectroencephalography-and-subdural-electroencephalography-for-preoperative-evaluation-of-intractable-epilepsy
#8
Meihua Yang, Yuanshi Ma, Wei Li, Xianjun Shi, Zhi Hou, Ning An, Chunqing Zhang, Lihong Liu, Hui Yang, Dong Zhang, Shiyong Liu
BACKGROUND: Different methods for intracranial electrode recording have various advantages and disadvantages, and controversy exists regarding the complications of stereoelectroencephalography (SEEG) and subdural EEG. OBJECTIVE: The purpose of this study was to determine the efficacy and safety of SEEG by comparing it with subdural EEG. METHODS: Data from 100 patients who underwent SEEG (n = 48) and subdural EEG (n = 52) to evaluate the epileptogenic zone were collected from June 2011 to June 2015...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28087827/neuropsychological-outcome-following-frontal-lobectomy-for-pharmacoresistant-epilepsy-in-adults
#9
Robyn M Busch, Darlene P Floden, Lisa Ferguson, Shamseldeen Mahmoud, Audrina Mullane, Stephen Jones, Lara Jehi, William Bingaman, Imad M Najm
OBJECTIVE: This retrospective cohort study characterized cognitive and motor outcomes in a large sample of adults who underwent frontal lobe resections for treatment of pharmacoresistant epilepsy. METHODS: Ninety patients who underwent unilateral frontal lobe resection for epilepsy (42 language-dominant hemisphere/48 nondominant hemisphere) between 1989 and 2014 completed comprehensive preoperative and postoperative neuropsychological evaluations that included measures of verbal and nonverbal intellectual functioning, attention/working memory, processing speed, language, executive functioning, verbal and visual memory, and motor functioning...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28078313/unilobar-surgery-for-symptomatic-epileptic-spasms
#10
Carmen Barba, Roberto Mai, Laura Grisotto, Francesca Gozzo, Simona Pellacani, Laura Tassi, Stefano Francione, Flavio Giordano, Francesco Cardinale, Renzo Guerrini
OBJECTIVE: To assess factors associated with favorable seizure outcome after surgery for symptomatic epileptic spasms and improve knowledge on pathophysiology of this seizure type. METHODS: Inclusion criteria were: (1) age between 6 months and 15 years at surgery; (2) active epileptic spasms; (3) follow-up after surgery >1 year. RESULTS: We retrospectively studied 80 children (aged 1.3 ± 2 years at seizure onset; 5.8 ± 4 years at surgery, 11...
January 2017: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/28074282/unique-findings-of-subependymal-giant-cell-astrocytoma-within-cortical-tubers-in-patients-with-tuberous-sclerosis-complex-a-histopathological-evaluation
#11
Joel S Katz, Hyman Frankel, Tracy Ma, David Zagzag, Benjamin Liechty, Bruria Ben Zeev, Michal Tzadok, Orrin Devinsky, Howard L Weiner, Jonathan Roth
INTRODUCTION: Tuberous sclerosis is associated with three central nervous system pathologies: cortical/subcortical tubers, subependymal nodules (SENs), and subependymal giant cell astrocytomas (SEGAs). Tubers are associated with epilepsy, which is often medication-resistant and often leads to resective surgery. Recently, mammalian target of rapamycin inhibitors (mTORi) have been shown to be effective reducing seizure burden in some patients with tuberous sclerosis complex (TSC)-related refractory epilepsy...
January 10, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28067998/multimodal-fiber-probe-spectroscopy-allows-detecting-epileptogenic-focal-cortical-dysplasia-in-children
#12
Suresh Anand, Riccardo Cicchi, Flavio Giordano, Valerio Conti, Anna Maria Buccoliero, Renzo Guerrini, Francesco Saverio Pavone
We evaluated the diagnostic capability of a multimodal spectroscopic approach for classifying normal brain tissue and epileptogenic focal cortical dysplasia in children. We employed fluorescence spectroscopy at two excitation wavelengths (378 nm and 445 nm) and Raman spectroscopy (at 785 nm excitation) for acquiring fluorescence and Raman spectra from 10 normal brains, 16 focal cortical dysplasia specimens and 1 cortical tuber tissue sites using a custom-built multimodal optical point spectroscopic system. We used principal component analysis combined with leave-one-sample-out-cross-validation for tissue classification...
January 9, 2017: Journal of Biophotonics
https://www.readbyqxmd.com/read/28067423/current-standards-of-neuropsychological-assessment-in-epilepsy-surgery-centers-across-europe
#13
Viola Lara Vogt, Marja Äikiä, Antonio Del Barrio, Paul Boon, Csaba Borbély, Ema Bran, Kees Braun, Evelien Carette, Maria Clark, Judith Helen Cross, Petia Dimova, Daniel Fabo, Nikolaos Foroglou, Stefano Francione, Anna Gersamia, Antonio Gil-Nagel, Alla Guekht, Sue Harrison, Hrvoje Hecimovic, Einar Heminghyt, Edouard Hirsch, Alena Javurkova, Reetta Kälviäinen, Nicole Kavan, Anna Kelemen, Vasilios K Kimiskidis, Margarita Kirschner, Catherine Kleitz, Teia Kobulashvili, Mary H Kosmidis, Selin Yagci Kurtish, Mathieu Lesourd, Sofia Ljunggren, Morten Ingvar Lossius, Kristina Malmgren, Ruta Mameniskiené, Patricia Martin-Sanfilippo, Petr Marusic, Marijke Miatton, Çiğdem Özkara, Federica Pelle, Guido Rubboli, Sarah Rudebeck, Philippe Ryvlin, Monique van Schooneveld, Elisabeth Schmid, Pia-Magdalena Schmidt, Margitta Seeck, Bernhard J Steinhoff, Sara Shavel-Jessop, Oana Tarta-Arsene, Eugen Trinka, Gerd Viggedal, Anne-Sophie Wendling, Juri-Alexander Witt, Christoph Helmstaedter
We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup...
January 9, 2017: Epilepsia
https://www.readbyqxmd.com/read/28060326/network-analysis-of-foramen-ovale-electrode-recordings-in-drug-resistant-temporal-lobe-epilepsy-patients
#14
Ancor Sanz-García, Lorena Vega-Zelaya, Jesús Pastor, Cristina V Torres, Rafael G Sola, Guillermo J Ortega
Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control seizures. However, a significant minority of patients continues to exhibit post-operative seizures, even in those cases in which the suspected source of seizures has been correctly localized and resected. The protocol presented here combines a clinical procedure routinely employed during the pre-operative evaluation of temporal lobe epilepsy (TLE) patients with a novel technique for network analysis...
December 18, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28060325/interictal-high-frequency-oscillations-detected-with-simultaneous-magnetoencephalography-and-electroencephalography-as-biomarker-of-pediatric-epilepsy
#15
Christos Papadelis, Eleonora Tamilia, Steven Stufflebeam, Patricia E Grant, Joseph R Madsen, Phillip L Pearl, Naoaki Tanaka
Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency Oscillations (HFOs) have emerged as potential presurgical biomarkers for the identification of the EZ in addition to Interictal Epileptiform Discharges (IEDs) and ictal activity. Although they are promising to localize the EZ, they are not yet suited for the diagnosis or monitoring of epilepsy in clinical practice. Primary barriers remain: the lack of a formal and global definition for HFOs; the consequent heterogeneity of methodological approaches used for their study; and the practical difficulties to detect and localize them noninvasively from scalp recordings...
December 6, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28060294/manipulation-of-epileptiform-electrocorticograms-ecogs-and-sleep-in-rats-and-mice-by-acupuncture
#16
Pei-Lu Yi, Shuo-Bin Jou, Yi-Jou Wu, Fang-Chia Chang
Ancient Chinese literature has documented that acupuncture possesses efficient therapeutic effects on epilepsy and insomnia. There is, however, little research to reveal the possible mechanisms behind these effects. To investigate the effect of acupuncture on epilepsy and sleep, several issues need to be addressed. The first is to identify the acupoints, which correspond between humans, rats, and mice. Furthermore, the depth of insertion of the acupuncture needle, the degree of needle twist in manual needle acupuncture, and the stimulation parameters for electroacupuncture (EA) need to be determined...
December 22, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28059648/validation-of-effectiveness-of-keyhole-clipping-in-nonfrail-elderly-patients-with-unruptured-intracranial-aneurysms
#17
Kentaro Mori, Kojiro Wada, Naoki Otani, Arata Tomiyama, Terushige Toyooka, Kazuya Fujii, Kosuke Kumagai, Satoru Takeuchi, Satoshi Tomura, Takuji Yamamoto, Yasuaki Nakao, Hajime Arai
OBJECTIVE Advanced age is known to be associated with a poor prognosis after surgical clipping of unruptured intracranial aneurysms (UIAs). Keyhole clipping techniques have been introduced for less invasive treatment of UIAs. In this study, the authors compared the complications and clinical and radiological outcomes after keyhole clipping between nonfrail elderly patients (≥ 70 years) and nonelderly patients. METHODS Keyhole clipping (either supraorbital or pterional) was performed to treat 260 cases of relatively small (≤ 10 mm) anterior circulation UIAs...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28057660/protocol-for-intraoperative-assessment-of-the-human-cerebrovascular-glycocalyx
#18
R H L Haeren, H Vink, J Staals, M A M J van Zandvoort, J Dings, J J van Overbeeke, G Hoogland, K Rijkers, O E M G Schijns
INTRODUCTION: Adequate functioning of the blood-brain barrier (BBB) is important for brain homoeostasis and normal neuronal function. Disruption of the BBB has been described in several neurological diseases. Recent reports suggest that an increased permeability of the BBB also contributes to increased seizure susceptibility in patients with epilepsy. The endothelial glycocalyx is coating the luminal side of the endothelium and can be considered as the first barrier of the BBB. We hypothesise that an altered glycocalyx thickness plays a role in the aetiology of temporal lobe epilepsy (TLE), the most common type of epilepsy...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28055074/surgical-treatment-of-nonlesional-neocortical-epilepsy-long-term-longitudinal-study
#19
Dong Wook Kim, Sang Kun Lee, Hye-Jin Moon, Ki-Young Jung, Kon Chu, Chun-Ki Chung
Importance: The proportion of surgery for nonlesional neocortical epilepsy has recently increased, with a decrease in surgery for mesial temporal lobe epilepsy. However, there are only a few studies regarding the long-term surgical outcome and the potential prognostic factors for patients with nonlesional neocortical epilepsy. Objective: To evaluate the long-term surgical outcome and to identify possible prognostic factors in patients with nonlesional neocortical epilepsy...
January 3, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28054328/magnetoencephalography-and-new-imaging-modalities-in-epilepsy
#20
REVIEW
Jessica Falco-Walter, Christian Owen, Mishu Sharma, Christopher Reggi, Mandy Yu, Travis R Stoub, Michael A Stein
The success of epilepsy surgery is highly dependent on correctly identifying the entire epileptogenic region. Current state-of-the-art for localizing the extent of surgically amenable areas involves combining high resolution three-dimensional magnetic resonance imaging (MRI) with electroencephalography (EEG) and magnetoencephalography (MEG) source modeling of interictal epileptiform activity. Coupling these techniques with newer quantitative structural MRI techniques, such as cortical thickness measurements, however, may improve the extent to which the abnormal epileptogenic region can be visualized...
January 4, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
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