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Epilepsy Surgery

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https://www.readbyqxmd.com/read/27921213/pediatric-intracranial-primary-anaplastic-ganglioglioma
#1
Wolf Lüdemann, Rouzbeh Banan, Christian Hartmann, Helmut Bertalanffy, Concezio Di Rocco
BACKGROUND: Primary intracranial anaplastic gangliogliomas are rare tumors in the pediatric patient group. Most of them present with symptoms of elevated pressure or symptomatic epilepsy. Extraaxial location is far more common than axial location. On MRI examination, they mimic pilocytic astrocytomas. The outcome after surgery depends mainly on the possible amount of surgical resection, and oncological therapy is necessary to prevent recurrence of the disease. CASE REPORT: An 11-year-old boy presented with headache and double vision due to obstructive hydrocephalus...
December 5, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27920283/what-can-we-do-for-people-with-drug-resistant-epilepsy-the-2016-wartenberg-lecture
#2
Jerome Engel
Treatment goals for epilepsy are no seizures, no side effects, as soon as possible, but these goals are too often unmet. Approximately 1 million people in the United States continue to have seizures despite adequate treatment with antiseizure drugs, representing 40% of those with epilepsy, and 80% of the cost of epilepsy. Drug-resistant epilepsy (DRE) can be associated with developmental delay in infants and young children, and severe disability and morbidity in older children and adults, as well as a mortality rate 5-10 times that of the general population...
December 6, 2016: Neurology
https://www.readbyqxmd.com/read/27918961/the-promise-of-subtraction-ictal-spect-co-registered-to-mri-for-improved-seizure-localization-in-pediatric-epilepsies-affecting-factors-and-relationship-to-the-surgical-outcome
#3
Catherine Stamoulis, Nishant Verma, Himanshu Kaulas, Jonathan J Halford, Frank H Duffy, Phillip L Pearl, S Ted Treves
OBJECTIVE: Ictal SPECT is promising for accurate non-invasive localization of the epileptogenic brain tissue in focal epilepsies. However, high quality ictal scans require meticulous attention to the seizure onset. In a relatively large cohort of pediatric patients, this study investigated the impact of the timing of radiotracer injection, MRI findings and seizure characteristics on ictal SPECT localizations, and the relationship between concordance of ictal SPECT, scalp EEG and resected area with seizure freedom following epilepsy surgery...
November 30, 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27918346/electrical-stimulation-for-seizure-induction-and-functional-mapping-in-stereoelectroencephalography
#4
Agnès Trébuchon, Patrick Chauvel
The challenge in epilepsy surgery is to remove the epileptogenic zone without compromising postoperative function. Electrical stimulation (ES) was developed to identify with greater anatomical and physiological precision cortical structures essential to language and motor function. Because the language network is widely distributed in the left (dominant) hemisphere, and often varies among patients, brain mapping should delineate eloquent areas at the individual level. Although ES for language is commonly performed during a presurgical investigation, the procedure remains nonstandardized among centers, and differences between grids and intracerebral depth electrodes (stereoelectroencephalography) should be taken into account when comparing results from different series...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27918345/stereoelectroencephalography-interpretation
#5
Juan C Bulacio, Patrick Chauvel, Aileen McGonigal
Intracranial EEG has been in use for more than 50 years in the presurgical evaluation of patients with medically intractable focal epilepsy. The stereoelectroencephalography (SEEG) method has expanded very significantly over the last 5 years, in parallel with the increase in the number of complex cases (i.e., MRI-negative) being referred with medically intractable focal epilepsy to major epilepsy surgery centers. Some centers with extensive experience in subdural electrodes are indeed changing or have changed to SEEG as the principal exploration technique, which suggests that SEEG might offer specific benefits through its approach to accurately localizing the epileptogenic zone...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27918344/implantation-of-stereoelectroencephalography-electrodes-a-systematic-review
#6
Francesco Cardinale, Giuseppe Casaceli, Fabio Raneri, Jonathan Miller, Giorgio Lo Russo
BACKGROUND: Stereoelectroencephalography (SEEG) was developed by Talairach and Bancaud in Paris in the late 1950s. Subsequently, the Talairach methodology was adopted at a number of additional centers in Europe and Canada. Technical aspects remained essentially unchanged for the following 30 years. Only in the last two decades, because of advancements in image-guided surgery systems, robotics, and computer-aided planning, use of SEEG has become more widespread, and reports describing these new developments have been published...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27916450/dramatic-response-after-functional-hemispherectomy-in-a-patient-with-epileptic-encephalopathy-carrying-a-de-novo-col4a1-mutation
#7
Naomi Hino-Fukuyo, Atsuo Kikuchi, Masaki Iwasaki, Yuko Sato, Yuki Kubota, Tomoko Kobayashi, Tojo Nakayama, Kazuhiro Haginoya, Natsuko Arai-Ichinoi, Tetsuya Niihori, Ryo Sato, Tasuku Suzuki, Hiroki Kudo, Ryo Funayama, Keiko Nakayama, Yoko Aoki, Shigeo Kure
We describe the first case of a successful functional hemispherectomy in a patient with epileptic encephalopathy and a de novo collagen type IV alpha 1 (COL4A1) mutation. A 4-year-old girl was COL4A1 mutation-positive and suffered from drug-resistant epilepsy, hemiplegia, and developmental delay. Magnetic resonance imaging detected no porencephaly, and she had no cataract or renal abnormality. Following a presurgical evaluation for epilepsy, she underwent a functional hemispherectomy. She has been seizure free with no intracranial hemorrhage or other perioperative complications...
December 1, 2016: Brain & Development
https://www.readbyqxmd.com/read/27915489/drug-resistant-epilepsy-in-children-with-partial-onset-epilepsy-treated-with-carbamazepine
#8
Gewalin Aungaroon, Katherine D Holland, Paul S Horn, Shannon M Standridge, Christina Mackell Imming
: Drug-resistant epilepsy in children with partial onset epilepsy treated with carbamazepine Objective: To evaluate the outcome, including drug-resistant epilepsy in children with newly diagnosed partial onset epilepsy treated with carbamazepine (CBZ). METHODS: A retrospective medical records review and telephone questionnaire was undertaken on a total of 100 subjects. RESULTS: Long-term follow up was obtained on 79 children with a mean duration of 7...
December 4, 2016: International Journal of Neuroscience
https://www.readbyqxmd.com/read/27913322/automatic-detection-and-classification-of-high-frequency-oscillations-in-depth-eeg-signals
#9
Nisrine Jrad, Amar Kachenoura, Isabelle Merlet, Fabrice Bartolomei, Anca Nica, Arnaud Biraben, Fabrice Wendling
GOAL: Interictal High Frequency Oscillations (HFOs [30-600 Hz]) have proven to be relevant biomarkers in epilepsy. In this paper, four categories of HFOs are considered: Gamma ([30- 80 Hz]), High-Gamma ([80-120 Hz]), Ripples ([120-250 Hz]) and Fast-Ripples ([250-600 Hz]). A universal detector of the four types of HFOs is proposed. It has the advantages of i) classifying HFOs, and thus being robust to inter- and intra-subject variability; ii) rejecting artefacts, thus being specific. METHODS: Gabor atoms are tuned to cover the physiological bands...
November 29, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27913320/the-concept-of-effective-inflow-application-to-interictal-localization-of-the-epileptogenic-focus-from-ieeg
#10
Ioannis Vlachos, Balu Krishnan, David Treiman, Konstantinos Tsakalis, Dimitris Kugiumtzis, Leon Iassemidis
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/27913266/cost-utility-of-video-electroencephalography-monitoring-followed-by-surgery-in-adults-with-drug-resistant-focal-epilepsy-in-thailand
#11
Pimprapa Kitwitee, Kanjana Unnwongse, Teeradej Srikijvilaikul, Tinonkorn Yadee, Chulaporn Limwattananon
OBJECTIVES: This study assessed, whether video-electroencephalography (VEEG) monitoring followed by surgery was cost-effective in adult patients with drug-resistant focal epilepsy under Thai healthcare context, as compared to continued medical treatment without VEEG. METHODS: Total cost (in Thai Baht, THB) and effectiveness (in quality-adjusted life years, QALYs) were estimated over a lifetime horizon, using a decision tree and a Markov model. Data on short-term surgical outcomes, direct health care costs, and utilities, were collected from Thai patients in a specialized hospital...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913233/epilepsy-surgery-in-the-developing-world-facts-and-challenges
#12
EDITORIAL
Dattatraya Muzumdar
No abstract text is available yet for this article.
November 29, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27912169/non-harmonicity-in-high-frequency-components-of-the-intra-operative-corticogram-to-delineate-epileptogenic-tissue-during-surgery
#13
Evelien E Geertsema, Maryse A van 't Klooster, Nicole E C van Klink, Frans S S Leijten, Peter C van Rijen, Gerhard H Visser, Stiliyan N Kalitzin, Maeike Zijlmans
OBJECTIVE: We aimed to test the potential of auto-regressive model residual modulation (ARRm), an artefact-insensitive method based on non-harmonicity of the high-frequency signal, to identify epileptogenic tissue during surgery. METHODS: Intra-operative electrocorticography (ECoG) of 54 patients with refractory focal epilepsy were recorded pre- and post-resection at 2048Hz. The ARRm was calculated in one-minute epochs in which high-frequency oscillations (HFOs; fast ripples, 250-500Hz; ripples, 80-250Hz) and spikes were marked...
November 17, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27912111/can-ictal-meg-obviate-the-need-for-phase-ii-monitoring-in-people-with-drug-refractory-epilepsy-a-prospective-observational-study
#14
Bhargavi Ramanujam, Kamal Bharti, Vibhin Viswanathan, Ajay Garg, Madhavi Tripathi, Chandrashekhar Bal, P Sarat Chandra, Manjari Tripathi
PURPOSE: To determine if ictal-magnetoencephalography (ictal-MEG) source localization (SL) added information towards delineating the ictal-onset zone (IOZ), whether and how it helped final decision-making in epilepsy-surgery. METHODS: Definite focal clusters on ictal-MEG were available for 32 DRE-patients, data was analyzed (single equivalent current dipole (ECD) model), SL done. Clinical history, long-term video-EEG (VEEG) monitoring, epilepsy-protocol MRI, FDG-PET, ictal-SPECT and interictal-MEG were discussed at the multispeciality Epilepsy Surgery Case-conference (ESC)...
October 31, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27907826/extent-of-mossy-fiber-sprouting-in-patients-with-mesiotemporal-lobe-epilepsy-correlates-with-neuronal-cell-loss-and-granule-cell-dispersion
#15
Barbara Schmeiser, Josef Zentner, Marco Prinz, Armin Brandt, Thomas M Freiman
OBJECTIVE: The most frequent finding in temporal lobe epilepsy is hippocampal sclerosis, characterized by selective cell loss of hippocampal subregions CA1 and CA4 as well as mossy fiber sprouting (MFS) towards the supragranular region and granule cell dispersion. Although selective cell loss is well described, its impact on mossy fiber sprouting and granule cell dispersion remains unclear. MATERIALS AND METHODS: In a single center series, we examined 319 human hippocampal specimens, collected in a 15-years period...
November 22, 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27905093/magnetic-resonance-imaging-guided-laser-interstitial-thermal-therapy-for-treatment-of-drug-resistant-epilepsy
#16
Joon Y Kang, Michael R Sperling
Surgery is the most effective treatment for drug-resistant epilepsy. Long-term studies demonstrate that about 60% to 80% of patients become seizure-free after anterior temporal lobectomy and a majority of patients (about 95%) report significant seizure reduction after surgery. In the last few years, there has been significant advances in minimally invasive surgical techniques to treat drug-resistant epilepsy. These minimally invasive procedures have significant advantages over open surgery in that they produce less immediate discomfort and disability, while allowing for greater preservation of functional tissue...
November 30, 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/27903764/epilepsy-and-music-practical-notes
#17
REVIEW
M Maguire
Music processing occurs via a complex network of activity far beyond the auditory cortices. This network may become sensitised to music or may be recruited as part of a temporal lobe seizure, manifesting as either musicogenic epilepsy or ictal musical phenomena. The idea that sound waves may directly affect brain waves has led researchers to explore music as therapy for epilepsy. There is limited and low quality evidence of an antiepileptic effect with the Mozart Sonata K.448. We do not have a pathophysiological explanation for the apparent dichotomous effect of music on seizures...
November 30, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27903016/predicting-tissue-breaking-strengths-in-the-epileptic-brain-with-t2-relaxometry-application-of-pulsed-water-jet-dissection-system-for-epilepsy-surgery
#18
Yoko Takahashi, Masaki Iwasaki, Atsuhiro Nakagawa, Shiho Sato, Nobukazu Nakasato, Teiji Tominaga
Background The piezo actuator-driven pulsed water jet (ADPJ) system is a novel surgical instrument that enables dissection of tissue without thermal damage. Using the ADPJ system in epilepsy surgery requires prediction of the tissue breaking strength of the epileptic brain. The aim of this study was to elucidate whether magnetic resonance imaging T2 relaxometry could predict the breaking strength. Methods A total of 12 patients with drug-resistant temporal lobe epilepsy who received surgical treatment were included in the study...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27897304/-the-role-of-diffusion-tensor-imaging-in-the-pre-surgical-study-of-temporal-lobe-epilepsy
#19
M A Garcia-Pallero, C V Torres, R Manzanares-Soler, E Camara, R G Sola
INTRODUCTION: Diffusion tensor imaging (DTI) is a non-invasive technique that can be used to assess the integrity of the white matter in the brain. AIMS: To investigate the usefulness of DTI in patients with temporal lobe epilepsy (TLE) and to observe its relationship with lateralisation of the epileptogenic focus in these patients. PATIENTS AND METHODS: We analysed 11 patients diagnosed with TLE in accordance with the pre-surgical protocol of our epilepsy unit, and who were seizure-free two years after performing a temporal lobectomy plus amygdalohippocampectomy (Spencer technique)...
December 16, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27894944/surface-projected-flair-supr-flair-analysis-a-novel-tool-for-advanced-imaging-of-epilepsy
#20
Francesco Cardinale, Stefano Francione, Luciana Gennari, Alberto Citterio, Maurizio Sberna, Laura Tassi, Roberto Mai, Ivana Sartori, Lino Nobili, Massimo Cossu, Laura Castana, Giorgio Lo Russo, Nadia Colombo
OBJECTIVE: The objective of this pilot retrospective study is to describe the SUrface-PRojected FLuid-Attenuation-Inversion-Recovery (SUPR-FLAIR) analysis, a novel method mainly aimed at revealing cortical areas with subtle signal hyper-intensity. METHODS: Images from 101 healthy controls and ten patients suffering from drug-resistant partial epilepsy were retrospectively post-processed. Brain surface was reconstructed from a 3D T1-weighted fast field echo (3D T1W-FFE) MRI scan...
November 25, 2016: World Neurosurgery
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