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Epilepsy Surgery

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https://www.readbyqxmd.com/read/28434153/machine-learning-xgboost-analysis-of-language-networks-to-classify-patients-with-epilepsy
#1
L Torlay, M Perrone-Bertolotti, E Thomas, M Baciu
Our goal was to apply a statistical approach to allow the identification of atypical language patterns and to differentiate patients with epilepsy from healthy subjects, based on their cerebral activity, as assessed by functional MRI (fMRI). Patients with focal epilepsy show reorganization or plasticity of brain networks involved in cognitive functions, inducing 'atypical' (compared to 'typical' in healthy people) brain profiles. Moreover, some of these patients suffer from drug-resistant epilepsy, and they undergo surgery to stop seizures...
April 22, 2017: Brain Informatics
https://www.readbyqxmd.com/read/28433263/memory-assessment-in-patients-with-temporal-lobe-epilepsy-to-predict-memory-impairment-after-surgery-a-systematic-review
#2
P Parra-Díaz, N García-Casares
INTRODUCTION: Given that surgical treatment of refractory mesial temporal lobe epilepsy may cause memory impairment, determining which patients are eligible for surgery is essential. However, there is little agreement on which presurgical memory assessment methods are best able to predict memory outcome after surgery and identify those patients with a greater risk of surgery-induced memory decline. OBJECTIVE: We conducted a systematic literature review to determine which presurgical memory assessment methods best predict memory outcome...
April 19, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28431291/temporal-pole-abnormalities-detected-by-3-t-mri-in-temporal-lobe-epilepsy-due-to-hippocampal-sclerosis-no-influence-on-seizure-outcome-after-surgery
#3
Sara Casciato, Angelo Picardi, Alfredo D'Aniello, Marco De Risi, Giovanni Grillea, Pier Paolo Quarato, Addolorata Mascia, Liliana G Grammaldo, Giulio Nicolo' Meldolesi, Roberta Morace, Vincenzo Esposito, Giancarlo Di Gennaro
PURPOSE: To assess the clinical significance of temporal pole abnormalities (temporopolar blurring, TB, and temporopolar atrophy, TA) detected by using 3 Tesla MRI in the preoperative workup in patients with temporal lobe epilepsy due to hippocampal sclerosis (TLE-HS) who underwent surgery. METHODS: We studied 78 consecutive patients with TLE-HS who underwent surgery and were followed up for at least 2 years. Based on findings of pre-surgical 3 Tesla MRI, patients were subdivided in subgroups according to the presence of TB or TA...
April 12, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28431290/predicting-success-of-vagus-nerve-stimulation-vns-from-eeg-symmetry
#4
REVIEW
Janneke Hilderink, Marleen C Tjepkema-Cloostermans, Anita Geertsema, Janita Glastra-Zwiers, Cecile C de Vos
PURPOSE: Vagus nerve stimulation (VNS) has shown to be an effective treatment for drug resistant epilepsy, with achieving more than 50% seizure reduction in one third of the treated patients. In order to predict which patients will profit from VNS, we previously found that a low pairwise derived Brain Symmetry Index (pdBSI) could potentially predict good responders to VNS treatment. These findings however have to be validated before they can be generalized. METHODS: 39 patients (age 18-68 years) with medically intractable epilepsy who were referred for an implanted VNS system were included...
April 4, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28428738/improved-localization-of-seizure-onset-zones-using-spatiotemporal-constraints-and-time-varying-source-connectivity
#5
Juan D Martinez-Vargas, Gregor Strobbe, Kristl Vonck, Pieter van Mierlo, German Castellanos-Dominguez
Presurgical evaluation of brain neural activity is commonly carried out in refractory epilepsy patients to delineate as accurately as possible the seizure onset zone (SOZ) before epilepsy surgery. In practice, any subjective interpretation of electroencephalographic (EEG) recordings is hindered mainly because of the highly stochastic behavior of the epileptic activity. We propose a new method for dynamic source connectivity analysis that aims to accurately localize the seizure onset zones by explicitly including temporal, spectral, and spatial information of the brain neural activity extracted from EEG recordings...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28427025/psychiatric-symptoms-after-temporal-epilepsy-surgery-a-one-year-follow-up-study
#6
Carmen Iranzo-Tatay, Teresa Rubio-Granero, Antonio Gutierrez, Mercedes Garcés, Rebeca Conde, Asier Gómez-Ibáñez, Sergio Arques-Egea, Lucia Sancho-Miñana, David Hervas-Marín, Vicente Villanueva
Psychiatric symptoms must be considered in patients with refractory temporal lobe epilepsy after epilepsy surgery. The main objectives of our study were to describe clinical and socio-demographical characteristics of a cohort of patients with pharmacoresistant temporal lobe epilepsy who underwent temporal lobe epilepsy surgery, and moreover, to evaluate possible risk factors for developing psychiatric symptoms. In order to achieve those goals, we conducted a prospective evaluation of psychopathology throughout the first year after surgery in a clinical sample of 72 patients, by means of three clinical rated measures; the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), and the Brief Psychiatric Rating Scale (BPRS)...
April 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28421657/core-outcome-sets-in-women-s-and-newborn-health-a-systematic-review
#7
James M N Duffy, Rachel Rolph, Chris Gale, Martin Hirsch, Khalid S Khan, Sue Ziebland, Richard J McManus
BACKGROUND: Variation in outcome collection and reporting is a serious hindrance to progress in our specialty, over eighty journals have come together to support the development, dissemination, and implementation of core outcome sets. OBJECTIVE: This study systematically reviewed and characterised registered, progressing, or completed core outcome sets relevant to women's and newborn health. SEARCH STRATEGY: Systematic search using the Core Outcome Measures in Effectiveness Trial initiative and the Core Outcomes in Women's and Newborn Health initiative databases...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28419357/stereoelectroencephalography-using-magnetic-resonance-angiography-for-avascular-trajectory-planning-technical-report
#8
Krasimir Minkin, Kaloyan Gabrovski, Marin Penkov, Yuri Todorov, Rositsa Tanova, Yoana Milenova, Kiril Romansky, Petia Dimova
BACKGROUND: Stereoelectroencephalography (SEEG) requires high-quality angiographic studies because avascular trajectory planning is a prerequisite for the safety of this procedure. Some epilepsy surgery groups have begun to use computed tomography angiography and magnetic resonance T1-weighted sequence with contrast enhancement for this purpose. OBJECTIVE: To present the first series of patients with avascular trajectory planning of SEEG based on magnetic resonance angiography (MRA)...
April 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28419330/seizure-outcomes-in-occipital-lobe-and-posterior-quadrant-epilepsy-surgery-a-systematic-review-and-meta-analysis
#9
Stephen C Harward, William C Chen, John D Rolston, Michael M Haglund, Dario J Englot
BACKGROUND: Occipital lobe epilepsy (OLE) is an uncommon but debilitating focal epilepsy syndrome with seizures often refractory to medical management. While surgical resection has proven a viable treatment, previous studies examining postoperative seizure freedom rates are limited by small sample size and patient heterogeneity, thus exhibiting significant variability in their results. OBJECTIVE: To review the medical literature on OLE so as to investigate rates and predictors of both seizure freedom and visual outcomes following surgery...
April 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28419327/epilepsy-surgeries-requiring-an-operculoinsular-cortectomy-operative-technique-and-results
#10
Alain Bouthillier, Dang Khoa Nguyen
BACKGROUND: Epilepsy surgeries requiring an operculoinsulectomy pose significant difficulties because the perisylvian area is highly vascular, deep, and functional. OBJECTIVE: To report the operative technique and results of epilepsy surgeries requiring an operculoinsular cortectomy at our institution. METHODS: The data of all consecutive patients who had undergone an epilepsy surgery requiring an operculoinsular cortectomy with a minimum follow-up of 1 yr were reviewed...
April 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28414967/pharmacodynamics-of-remifentanil-induced-intracranial-spike-activity-in-mesial-temporal-lobe-epilepsy
#11
Troels Wesenberg Kjaer, Hans Hogenhaven, Andrea P Lee, Flemming Find Madsen, Bo Jespersen, Jannick Brennum, Lennart Derm, Finn Borgbjerg Moltke
Patients with medically refractory epilepsy may benefit from resective epilepsy surgery. However even the best centers experience surgical failures. It is therefore important to find techniques that may aid in neurosurgical planning of epileptic focus resection. Recordings of electrical brain activity with EEG during seizures reveal abnormal cortical hypersynchronization. Between seizures the EEG often shows interictal depolarizing phenomena such as spikes reflecting an irritable focus of the brain. In the present study we investigated the effect of intravenous remifentanil on the spike activity in the temporal neocortex and hippocampus...
March 31, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28412559/interictal-ripples-nested-in-epileptiform-discharge-help-to-identify-the-epileptogenic-zone-in-neocortical-epilepsy
#12
Shuang Wang, Norman K So, Bo Jin, Irene Z Wang, Juan C Bulacio, Rei Enatsu, Shenyi Dai, Zhong Chen, Jorge Gonzalez-Martinez, Imad M Najm
OBJECTIVE: This study aimed to identify the subtype of interictal ripples that help delineate the epileptogenic zone in neocortical epilepsy. METHODS: Totally 25 patients with focal neocortical epilepsy who had invasive electroencephalography (EEG) evaluation and subsequent surgery were included. They were followed up for at least 2years. Interictal ripples (80-250Hz) and fast ripples (250-500Hz) during slow-wave sleep were identified. Neocortical ripples were defined as type I ripples when they were superimposed on epileptiform discharges, and as type II ripples when they occurred independently...
March 25, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28411522/breaking-the-age-barrier-epilepsy-surgery-in-septuagenarians
#13
Vineet Punia, Ahmed Abdelkader, Andrey Stojic
Resective epilepsy surgery (RES) has traditionally been offered to young patients (<50years). The reservation about offering RES to the elderly is multifactorial with their advanced age and comorbidities being the primary reason. The elderly age group (≥65years of age) is one of the fastest growing populations. The arbitrary age limits for RES need reconsideration in the face of an ever increasing elderly population. Considering such changes in demographics, we report the first case series in the literature of seven septuagenarians who underwent RES in the form of anterior temporal lobectomy (ATL)...
April 12, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28411517/pre-and-post-surgical-psychiatric-assessments-and-intervention-by-major-epilepsy-centers-in-japan-nationwide-survey
#14
Hiroko Goji, Toshihiko Fukuchi, Kousuke Kanemoto
BACKGROUND: Although psychiatric issues following epilepsy surgery are now widely recognized as a major problem, actual awareness of these issues by epilepsy centers remains to be elucidated. This is the first known report regarding the use of psychiatric assessments and interventions by epilepsy centers throughout Japan. PARTICIPANTS AND METHODS: At the beginning of 2016, we sent a questionnaire regarding psychiatric assessments performed before and after epilepsy surgery, psychiatric intervention after surgery, and future plans for dealing with psychiatric issues in relation to epilepsy surgery, which consisted of a total of 24 items, to all members of the Japan Epilepsy Center Association (JEPICA)...
April 12, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28411414/laser-interstitial-thermotherapy-litt-in-epilepsy-surgery
#15
REVIEW
Christian Hoppe, Juri-Alexander Witt, Christoph Helmstaedter, Thomas Gasser, Hartmut Vatter, Christian E Elger
Besides other innovative stereotactic procedures (radiofrequency thermocoagulation, focused ultrasound, gamma knife) laser interstitial thermotherapy (LiTT) provides minimally invasive destruction of pathological soft tissues which could be especially relevant for epilepsy surgeries involving adult and pediatric patients. Unlike standard resections, no craniotomy is required; just a tiny borehole trepanation is sufficient. Damage to cortical areas when accessing deep lesions can be minimized or completely avoided, and treating epileptogenic foci near eloquent or even vital brain areas becomes possible...
April 6, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28410466/history-of-surgery-for-temporal-lobe-epilepsy
#16
REVIEW
Ali A Asadi-Pooya, Cyrus Rostami
The history of epilepsy and its treatment goes back to ancient times when it included medicinal herbs, lifestyle modifications, and even surgery. Trepanation is considered the oldest surgical procedure for the treatment of epilepsy. The first series of temporal lobectomies for the treatment of drug-resistant epilepsy were reported by Penfield and Flanigin (1950). During the years since then, neuroimaging and other technologies have had remarkable and revolutionary progress. This progress has resulted in tremendous advancements in understanding the underlying causes and pathophysiology of epilepsies...
April 11, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28410464/surgical-outcomes-in-two-different-age-groups-with-focal-cortical-dysplasia-type-ii-any-real-difference
#17
Jorge Luis Ramírez-Molina, Roberta Di Giacomo, Valeria Mariani, Francesco Deleo, Francesco Cardinale, Angélica María Uscátegui-Daccarett, Pablo Lorenzana, Laura Tassi
OBJECTIVE: Focal Cortical Dysplasias (FCDs) represent a common architectural cortical disorder underlying drug-resistant focal epilepsy. So far, studies aimed at evaluating whether age at surgery is a factor influencing surgical outcome are lacking, so that data on the comparison between patients harboring Type II FCD operated at younger age and those operated at adult age are still scarce. We compared presurgical clinical features and surgical outcomes of patients with histopathologically diagnosed Type II FCD undergoing surgery at an earlier age with those operated after 20 years of age...
April 11, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28407526/the-impact-of-antidepressants-on-seizure-frequency-and-depressive-and-anxiety-disorders-of-patients-with-epilepsy-is-it-worth-investigating
#18
Ramses Ribot, Bichun Ouyang, Andres M Kanner
PURPOSE: Depression and anxiety disorders in patients with epilepsy (PWE) remain under-recognized and under-treated, despite being the most common psychiatric co-morbidities. Selective serotonin re-uptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are considered first-line treatment for primary depression and anxiety disorders. We performed this study to investigate if SSRIs and SNRIs could affect the seizure frequency of PWE and to assess whether such effect is independent of the response of the mood and anxiety disorders to these drugs...
April 10, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28407524/age-at-surgery-as-a-predictor-of-cognitive-improvements-in-patients-with-drug-resistant-temporal-epilepsy
#19
Irene Cano-López, Juan Francisco Vázquez, Anabel Campos, Antonio Gutiérrez, Mercedes Garcés, Asier Gómez-Ibáñez, Rebeca Conde, Esperanza González-Bono, Vicente Villanueva
Temporal lobe epilepsy (TLE) surgery is an effective procedure that can produce cognitive changes. However, the prognostic factors related with cognitive outcomes need to be better understood. The aim of the present study is to know if age at surgery is a reliable predictor of verbal memory competence and considering factors such as: hemisphere; type of surgery; pre-surgical seizure frequency; and epilepsy duration. Sixty-one typically dominant patients with drug-resistant TLE (34 with left TLE [L-TLE] and 27 with right TLE [R-TLE]) underwent a neuropsychological assessment before and a year after surgery...
April 10, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28406124/comparison-of-patients-with-and-without-intellectual-disability-under-general-anesthesia-a-retrospective-study
#20
T Sitilci, S Demirgan, C Akcay, N Kahraman, B G Koseoglu, M A Erdem, A B Cankaya
BACKGROUND AND PURPOSE: We analyzed and retrospectively compared patients with and without intellectual disability (ID) who underwent oral surgery under general anesthesia at Istanbul University, Faculty of Dentistry, Department of General Anesthesia, between October 2012 and June 2013 with regard to the following categories: Demographic features, American Society of Anesthesiologists (ASA) classification, Mallampati score, type of anesthetic drug used during the operation, type of intubation used, any difficulties with tracheal intubation, presence of systemic diseases, and recovery times after ending general anesthesia...
April 2017: Nigerian Journal of Clinical Practice
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