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Epilepsy Surgery

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https://www.readbyqxmd.com/read/28644979/intraoperative-fast-ripples-independently-predict-postsurgical-epilepsy-outcome-comparison-with-other-electrocorticographic-phenomena
#1
Shaun A Hussain, Gary W Mathern, Phoebe Hung, Julius Weng, Raman Sankar, Joyce Y Wu
In the surgical management of epilepsy, the resection of cortex exhibiting interictal fast ripples (250-500Hz) on electrocorticography has been linked to postoperative seizure-freedom. Although fast ripples appear to accurately identify the epileptogenic zone-the minimum tissue that must be removed at surgery to achieve seizure-freedom-it has not been established that fast ripples are a superior biomarker in comparison with multimodal presurgical neuroimaging and other electrocorticography abnormalities. Hence, in the prediction of postoperative seizure-freedom, we compared the value of fast ripples with other intraoperative electocorticography abnormalities including focal slowing, paroxysmal fast activity, intermittent spike discharges, continuous epileptiform discharges, focal attenuation, and intraoperative seizures, as well as complete resection of the lesion defined by MRI and other neuroimaging...
June 16, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28644202/the-insula-in-temporal-plus-epilepsy
#2
Carmen Barba, Lorella Minotti, Anne-Sophie Job, Philippe Kahane
Temporal lobe epilepsy (TLE) surgery is the most common type of surgical treatment offered to patients with drug-resistant focal seizures. However, the proportion of patients experiencing long-term freedom from seizures after TLE surgery remains suboptimal. Temporal plus epilepsy, which is characterized by a primary temporal epileptogenic zone extending to neighboring regions, has been demonstrated to be a major predictor of TLE surgery failures. In the context of the temporoperisylvian epilepsies, i.e., the most common type of temporal plus epilepsy, a possible role of the insula has often been hypothesized...
July 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28643843/perisylvian-including-insular-childhood-epilepsy-presurgical-workup-and-surgical-outcome
#3
Elena Freri, Sara Matricardi, Francesca Gozzo, Massimo Cossu, Tiziana Granata, Laura Tassi
OBJECTIVE: To report the presurgical workup, surgical procedures, and outcomes in a series of pediatric patients with drug-resistant epilepsy involving the perisylvian/insular regions. METHODS: We retrospectively assessed 16 pediatric patients affected by drug-resistant focal epilepsy involving perisylvian/insular regions, who consecutively underwent tailored resective surgery. All patients underwent a detailed presurgical workup, which included the analysis of the anatomoelectroclinical correlations with scalp electroencephalography (EEG) and/or with stereo-electroencephalography (SEEG), brain magnetic resonance imaging (MRI), and comprehensive cognitive and neuropsychological evaluations...
June 23, 2017: Epilepsia
https://www.readbyqxmd.com/read/28638240/perioperative-management-of-neurological-conditions
#4
REVIEW
Manjeet Singh Dhallu, Ahmed Baiomi, Madhavi Biyyam, Sridhar Chilimuri
Perioperative care of the patients with neurological diseases can be challenging. Most important consideration is the management and understanding of pathophysiology of these disorders and evaluation of new neurological changes that occur perioperatively. Perioperative generally refers to 3 phases of surgery: preoperative, intraoperative, and postoperative. We have tried to address few commonly encountered neurological conditions in clinical practice, such as delirium, stroke, epilepsy, myasthenia gravis, and Parkinson disease...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28637636/epilepsy-after-cerebral-infection-review-of-the-literature-and-the-potential-for-surgery
#5
Georgia Ramantani, Hans Holthausen
The risk of unprovoked seizures in population-based cohorts of cerebral infection survivors is 7-8% in developed countries, rising to considerably higher rates in resource-poor countries. The main risk factors for epilepsy after cerebral infection, besides acute seizures, are infection-associated brain lesions and status epilepticus during the acute phase. Despite the high prevalence of pharmacoresistant epilepsies after cerebral infections, especially in patients with MRI-identifiable lesions, only a small minority undergoes epilepsy surgery...
June 19, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28637635/stereotactic-bilateral-transfrontal-minimal-radiofrequency-thermocoagulation-of-the-amygdalohippocampal-complex-for-bilateral-medial-temporal-lobe-epilepsy-a-retrospective-study-of-12-patients
#6
Quanjun Zhao, Tiejun Shi, Shaojie Cui, Zhaohui Wu, Wei Wang, Yunfeng Jia, Zengmin Tian, Fuli Wang, Feng Yin, Hulin Zhao, Xia Xiao, Haiying Wang, Changlan Cai, Huimin Luo
Some patients with temporal lobe epilepsy have bilateral discharges and a few have bilateral medial temporal sclerosis. Stereotactic bilateral radiofrequency thermocoagulation (RFTC) of the amygdalohippocampal complex can terminate seizures or reduce seizure severity in patients with bilateral medial temporal lobe epilepsy (BMTLE). To explore the safety and efficacy of bilateral transfrontal minimal RFTC of the amygdalohippocampal complex for the treatment of BMTLE. A total of 12 BMTLE patients were treated with bilateral transfrontal minimal RFTC of the amygdalohippocampal complex under limited coagulations...
June 19, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28637175/multiple-subpial-transections-for-medically-refractory-epilepsy-a-disaggregated-review-of-patient-level-data
#7
John D Rolston, Hansen Deng, Doris D Wang, Dario J Englot, Edward F Chang
BACKGROUND: Multiple subpial transections (MST) are a treatment for seizure foci in nonresectable eloquent areas. OBJECTIVE: To systematically review patient-level data regarding MST. METHODS: Studies describing patient-level data for MST procedures were extracted from the Medline and PubMed databases, yielding a synthetic cohort of 212 patients from 34 studies. Data regarding seizure outcome, patient demographics, seizure type, surgery type, and complications were extracted and analyzed...
June 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28633983/corrigendum-to-cost-utility-of-video-electroencephalography-monitoring-followed-by-surgery-in-adults-with-drug-resistant-focal-epilepsy-in-thailand-world-neurosurgery-98-2017-750-760
#8
Pimprapa Kitwitee, Kanjana Unnwongse, Teeradej Srikijvilaikul, Tinonkorn Yadee, Chulaporn Limwattananon
No abstract text is available yet for this article.
June 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28631453/propofol-dexmedetomidine-versus-propofol-remifentanil-conscious-sedation-for-awake-craniotomy-during-epilepsy-surgery
#9
Abd-Elazeem Elbakry, Ezzeldin Ibrahim
BACKGROUND: Conscious sedation during awake craniotomy requires balanced anaesthesia technique to achieve optimum sedation and analgesia. This technique should be done without causing respiratory depression or loss of consciousness. The present study aims at evaluating the effect of propofol-dexmedetomidine versus propofol-remifentanil conscious sedation during awake craniotomy for epilepsy surgery. METHODS: Sixty patients undergoing awake craniotomy for epilepsy surgery were randomly divided into two groups, PD group and PR group...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28628556/real-time-imaging-of-epileptic-seizures-in-rats-using-electrical-impedance-tomography
#10
Lei Wang, Yang Sun, Xinmin Xu, Xiuzhen Dong, Feng Gao
The presence of multiple or diffuse lesions on imaging is a contraindication to surgery for patients with intractable epilepsy. Theoretically, as a functional imaging technique, electrical impedance tomography (EIT) can accurately image epileptic foci. However, most current studies are limited to examining epileptic spikes and few studies use EIT for real-time imaging of seizure activity. Moreover, little is known about changes in electrical impedance during seizures. In this study, we used EIT to monitor seizure progression in real time and analyzed changes in electrical impedance during seizures...
June 16, 2017: Neuroreport
https://www.readbyqxmd.com/read/28628538/memory-rehabilitation-strategies-in-nonsurgical-temporal-lobe-epilepsy-a-review
#11
Alessandra Del Felice, Marzia Alderighi, Matteo Martinato, Davide Grisafi, Anna Bosco, Pamela J Thompson, Josemir W Sander, Stefano Masiero
People with temporal lobe epilepsy (TLE) who have not undergone epilepsy surgery often complain of memory deficits. Cognitive rehabilitation is employed as a remedial intervention in clinical settings, but research is limited and findings concerning efficacy and the criteria for choosing different approaches have been inconsistent. We aimed to appraise existing evidence on memory rehabilitation in nonsurgical individuals with temporal lobe epilepsy and to ascertain the effectiveness of specific strategies. A scoping review was preferred given the heterogeneous nature of the interventions...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28627088/astrogliosis-and-impaired-aquaporin-4-and-dystrophin-systems-in-idiopathic-normal-pressure-hydrocephalus
#12
Per Kristian Eide, Hans-Arne Hansson
AIMS: Idiopathic normal pressure hydrocephalus (iNPH) is one subtype of dementia that may improve following drainage of cerebrospinal fluid (CSF). This prospective observational study explored whether expression of the water channel aquaporin-4 (AQP4) and the anchoring molecule dystrophin 71 (Dp71) are altered at astrocytic perivascular endfeet and in adjacent neuropil of iNPH patient. Observations were related to measurements of pulsatile and static intracranial pressure (ICP). METHODS: The study included iNPH patients undergoing overnight monitoring of the pulsatile/static ICP, in whom a biopsy was taken from the frontal cerebral cortex during placement of the ICP sensor...
June 19, 2017: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/28626979/electro-clinical-criteria-and-surgical-outcome-is-there-a-difference-between-mesial-and-lesional-temporal-lobe-epilepsy
#13
M Wassenaar, F S S Leijten, G-J de Haan, S G Uijl, J W Sander
OBJECTIVES: Mesial temporal lobe epilepsy syndrome (MTLE) with specific electrophysiological and clinical characteristics and hippocampal sclerosis (HS) on MRI is considered the prototype of a syndrome with good surgical prognosis. Ictal onset zones in MTLE have been found to extend outside the hippocampus and neocortical seizures often involve mesial structures. It can, thus, be questioned whether MTLE with HS is different from lesional temporal epilepsies with respect to electro-clinical characteristics and surgical prognosis...
June 18, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28625946/educational-needs-of-epileptologists-regarding-psychiatric-comorbidities-of-the-epilepsies-a-descriptive-quantitative-survey
#14
Marco Mula, Esper Cavalheiro, Alla Guekht, Andres M Kanner, Hyang Woon Lee, Cigdem Ozkara, Alfredo Thomson, Sarah J Wilson
Psychiatric disorders are relatively frequent comorbidities in epilepsy and they have an impact on morbidity, mortality, and quality of life. This is a report from the Task Force on Education of the ILAE Commission on Neuropsychiatry based on a survey about educational needs of epileptologists regarding management of the psychiatric comorbidities of epilepsy. The Task Force designed a quantitative questionnaire to survey the self-perceived confidence of child and adult epileptologists and psychiatrists in managing major psychiatric comorbidities of epilepsy to identify: (1) critical areas of improvement from a list of skills that are usually considered necessary for effective management of these conditions, and (2) the preferred educational format for improving these skills...
June 19, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28625584/the-role-of-prophylactic-antiepileptic-drugs-for-seizure-prophylaxis-in-meningioma-surgery-a-systematic-review
#15
REVIEW
Abdurrahman I Islim, Stephen McKeever, Ter-Er Kusu-Orkar, Michael D Jenkinson
Meningiomas are the commonest type of primary brain tumours. Whilst most patients are seizure-free prior to surgery, antiepileptic drugs are frequently administered to reduce the risk of developing post-operative seizures. However, evidence to support their efficacy in providing this outcome is sparse. To this end, we performed a systematic review to assess the impact of prophylactic antiepileptic drugs on post-operative epilepsy rates in seizure-naïve patients undergoing craniotomy for resection of meningiomas...
June 15, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28623753/precuneal-epilepsy-clinical-features-and-surgical-outcome
#16
Adil Harroud, Olivier Boucher, Thi Phuoc Yen Tran, Louis Harris, Jeffery Hall, François Dubeau, Ismail Mohamed, Alain Bouthillier, Dang Khoa Nguyen
OBJECTIVE: The precuneus is a complex and highly connected structure located in the medial portion of the superior parietal lobule. The clinical presentation of precuneal epilepsy is poorly characterized, mostly because these patients have seldom been distinguished from those with other types of parietal lobe epilepsy. The present study aims to improve the understanding of precuneal epilepsy by detailing its clinical features and surgical outcomes. METHODS: Six previously unreported cases of drug-resistant precuneal epilepsy investigated between 2002 and 2014 were retrospectively studied...
June 14, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28623728/epilepsy-surgery-in-patients-older-than-50-years-effectiveness-safety-and-predictors-of-outcome
#17
Piergiorgio d' Orio, Veronica Pelliccia, Francesca Gozzo, Francesco Cardinale, Laura Castana, Giorgio Lo Russo, Gabriella Bottini, Pina Scarpa, Massimo Cossu
PURPOSE: Surgery is an effective treatment for drug resistant focal epilepsy. Predictors of seizure outcome have been extensively addressed in the general population but similar data on older patients are still lacking. The aim of this study is to evaluate effectiveness and safety of surgery for patients over 50 years and to investigate variables associated to seizure outcome. METHODS: We performed a single center retrospective study including 50 patients over 50 years treated surgically for drug resistant focal epilepsy between 1997 and 2014...
June 10, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28623489/comparing-the-intracarotid-amobarbital-test-and-functional-mri-for-the-presurgical-evaluation-of-language-in-epilepsy
#18
REVIEW
Andreu Massot-Tarrús, Seyed Reza Mousavi, Seyed M Mirsattari
Surgery is the treatment of choice for drug-resistant temporal lobe epilepsy (TLE). However, such surgery frequently causes deficits in language function, especially if performed on the dominant hemisphere. In recent years, the intracarotid amobarbital test (IAT) has been gradually replaced by functional magnetic resonance imaging (fMRI) in the preoperative identification of language areas to estimate the risk of postoperative language decline. In this paper, we review the neural substrates for language processing, how language impairment can result both from TLE itself and from surgical attempts to treat it...
July 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28621626/a-multimodal-concept-for-invasive-diagnostics-and-surgery-based-on-neuronavigated-voxel-based-morphometric-mri-postprocessing-data-in-previously-nonlesional-epilepsy
#19
Daniel Delev, Carlos M Quesada, Alexander Grote, Jan P Boström, Christian Elger, Hartmut Vatter, Rainer Surges
OBJECTIVE Diagnosis and surgical treatment of refractory and apparent nonlesional focal epilepsy is challenging. Morphometric MRI voxel-based and other postprocessing methods can help to localize the epileptogenic zone and thereby support the planning of further invasive electroencephalography (EEG) diagnostics, and maybe resective epilepsy surgery. METHODS The authors developed an algorithm to implement regions of interest (ROI), based on postprocessed MRI data, into a neuronavigation tool. This was followed by stereotactic ROI-guided implantation of depth electrodes and ROI-navigated resective surgery...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28620830/anatomy-driven-multiple-trajectory-planning-admtp-of-intracranial-electrodes-for-epilepsy-surgery
#20
Rachel Sparks, Vejay Vakharia, Roman Rodionov, Sjoerd B Vos, Beate Diehl, Tim Wehner, Anna Miserocchi, Andrew W McEvoy, John S Duncan, Sebastien Ourselin
PURPOSE: Epilepsy is potentially curable with resective surgery if the epileptogenic zone (EZ) can be identified. If non-invasive imaging is unable to elucidate the EZ, intracranial electrodes may be implanted to identify the EZ as well as map cortical function. In current clinical practice, each electrode trajectory is determined by time-consuming manual inspection of preoperative imaging to find a path that avoids blood vessels while traversing appropriate deep and superficial regions of interest (ROIs)...
June 15, 2017: International Journal of Computer Assisted Radiology and Surgery
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