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Epilepsy Surgery

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https://www.readbyqxmd.com/read/28822872/different-mossy-fiber-sprouting-patterns-in-ilae-hippocampal-sclerosis-types
#1
Barbara Schmeiser, Jinmei Li, Armin Brandt, Josef Zentner, Soroush Doostkam, Thomas M Freiman
OBJECTIVE: Hippocampal sclerosis (HS) is the most prevalent pathology in temporal lobe epilepsy (TLE) characterized by segmental neuronal cell loss in the cornu ammonis (CA) 1-4. In addition, migration of granule cells and reorganization of their axons is observed, known as granule cell dispersion (GCD) and mossy fiber sprouting (MFS). The loss of mossy fibers` (MF) target cells in CA4 and CA3 was considered to be causative for MFS. The ILAE HS (International League Against Epilepsy) classification identifies three subtypes with different cell loss patterns in CA1-4...
August 8, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28817568/an-optimal-strategy-for-epilepsy-surgery-disruption-of-the-rich-club
#2
Marinho A Lopes, Mark P Richardson, Eugenio Abela, Christian Rummel, Kaspar Schindler, Marc Goodfellow, John R Terry
Surgery is a therapeutic option for people with epilepsy whose seizures are not controlled by anti-epilepsy drugs. In pre-surgical planning, an array of data modalities, often including intra-cranial EEG, is used in an attempt to map regions of the brain thought to be crucial for the generation of seizures. These regions are then resected with the hope that the individual is rendered seizure free as a consequence. However, post-operative seizure freedom is currently sub-optimal, suggesting that the pre-surgical assessment may be improved by taking advantage of a mechanistic understanding of seizure generation in large brain networks...
August 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28804898/epilepsy-surgery-of-low-grade-epilepsy-associated-neuroepithelial-tumors-a-retrospective-nationwide-italian-study
#3
Marco Giulioni, Gianluca Marucci, Veronica Pelliccia, Francesca Gozzo, Carmen Barba, Giuseppe Didato, Flavio Villani, Giancarlo Di Gennaro, Pier Paolo Quarato, Vincenzo Esposito, Alessandro Consales, Matteo Martinoni, Gianfranco Vornetti, Corrado Zenesini, Carlo Efisio Marras, Nicola Specchio, Luca De Palma, Raffaele Rocchi, Flavio Giordano, Giovanni Tringali, Paolo Nozza, Gabriella Colicchio, Guido Rubboli, Giorgio Lo Russo, Renzo Guerrini, Paolo Tinuper, Francesco Cardinale, Massimo Cossu
OBJECTIVE: To analyze the attitude and results of Italian epilepsy surgery centers in the surgical management of "low grade epilepsy associated neuroepithelial tumors" (LEATs). METHODS: We conducted a retrospective study enrolling 339 consecutive patients with LEATs who underwent surgery between January 2009 and June 2015 at eight Italian epilepsy surgery centers. We compared demographic, clinical, pathologic, and surgical features of patients with favorable (Engel class I) and unfavorable (Engel class II, III, and IV) seizure outcome...
August 14, 2017: Epilepsia
https://www.readbyqxmd.com/read/28802988/does-education-play-a-role-in-language-reorganization-after-surgery-in-drug-refractory-temporal-lobe-epilepsy-an-fmri-based-study
#4
Kapil Chaudhary, Bhargavi Ramanujam, S Senthil Kumaran, P Sarat Chandra, Ashima Nehra Wadhawan, Ajay Garg, Manjari Tripathi
OBJECTIVES: Patients with drug refractory epilepsy (DRE) and a high level of education may differ in their language recovery after surgery. Our aim was to determine whether there were differences in the extent of improvement and pattern of reorganization of language functions on functional magnetic resonance imaging (fMRI) after surgery to treat refractory temporal lobe epilepsy (TLE) between patients with more than 12 years of formal education versus those with a shorter period of regular schooling...
July 29, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28799517/imaging-biomarkers-of-anti-epileptic-drug-action-insights-from-magnetic-resonance-imaging
#5
Lorenzo Caciagli, Fenglai Xiao, Britta Wandschneider, Matthias J Koepp
BACKGROUND: Approximately one third of patients with epilepsy are refractory to medical treatment. Adverse effects associated with anti-epileptic drugs (AEDs) are considered to affect quality of life often more than seizures themselves. Neuroimaging techniques, particularly magnetic resonance imaging (MRI), have proven instrumental in clinical decision making in relation to epilepsy surgery, but may also provide further insights into the mechanisms underlying treatment response and side effects associated with AEDs...
August 9, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28799142/what-to-do-in-failed-hemispherotomy-our-clinical-series-and-review-of-the-literature
#6
REVIEW
Andrea Bartoli, Y El Hassani, B Jenny, S Momjian, C M Korff, M Seeck, S Vulliemoz, K Schaller
Hemispherotomy is an established surgical technique to cure or palliate selected, mostly young patients suffering from refractory epilepsy. However, a few patients continue to have seizures despite the surgical hemispherical disconnection. We present a case series of patients who underwent redo hemispherotomy after a first unsuccessful hemispherical disconnection and provide a roadmap for subsequent workup and treatment. The institutional database of epilepsy surgery was reviewed. Twenty-four patients who underwent hemispherotomies for refractory epilepsy were identified between 2007 and 2016...
August 10, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28797975/characterisation-of-a-factual-knowledge-associated-brain-memory-area-by-functional-mr-imaging-and-implementation-in-tumour-and-epilepsy-brain-surgery
#7
Peter Grummich, Oliver Ganslandt, Michael Buchfelder, Karl Roessler
BACKGROUND: The role of the dominant hippocampus in verbal and episodical memory recall had been extensively investigated. However, there are categories of memory estimated independent of hippocampal function. Particularly, factual knowledge is solely constituted from written or spoken input independent from undertaken experience, but the temporal structures involved are not well defined yet. METHODS: In this retrospective study we mapped the activity of factual knowledge recall using functional MR imaging in 60 patients scheduled for tumour or epilepsy surgery and in 18 patients resected within or close to the left mesial temporal lobe...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28797973/frontal-fibers-connecting-the-superior-frontal-gyrus-to-broca-s-area-a-cortico-cortical-evoked-potential-study
#8
Satoshi Ookawa, Rei Enatsu, Aya Kanno, Satoko Ochi, Yukinori Akiyama, Tamaki Kobayashi, Yukihiro Yamao, Takayuki Kikuchi, Riki Matsumoto, Takeharu Kunieda, Nobuhiro Mikuni
BACKGROUND: The frontal aslant tract (FAT) is a deep frontal pathway connecting the superior frontal gyrus (SFG) to Broca's area. This fiber is assumed to be associated with language functions, especially speech initiation and spontaneity. OBJECTIVE: The aim of this study was to electrophysiologically investigate this network using cortico-cortical evoked potentials (CCEPs). METHOD: Eight patients with brain tumors or medically intractable focal epilepsies who underwent frontal craniotomy over the language dominant side were enrolled in this study...
August 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28782512/quantitative-expression-and-localization-of-gabab-receptor-protein-subunits-in-hippocampi-from-patients-with-refractory-temporal-lobe-epilepsy
#9
REVIEW
Mariam A Sheilabi, Dev Battacharyya, Laura Caetano, Maria Thom, Markus Reuber, John S Duncan, Alessandra P Princivalle
This study investigates GABAB protein expression and mRNA levels in three types of specimens. Two types of specimens from patients with temporal lobe epilepsy (TLE), secondary to hippocampal sclerosis, sclerotic hippocampal samples (TLE-HS), and tissue from the structurally preserved non-spiking ipsilateral superior temporal gyrus (TLE-STG) removed from the same patient during epilepsy surgery; and third specimen is hippocampal tissue from individuals with no history of epilepsy (post-mortem controls, PMC)...
August 3, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28782373/correlating-resting-state-functional-mri-connectivity-by-independent-component-analysis-based-epileptogenic-zones-with-intracranial-eeg-localized-seizure-onset-zones-and-surgical-outcomes-in-prospective-pediatric-intractable-epilepsy-study
#10
Varina Boerwinkle, Deepankar Mohanty, Stephen Foldes, Danielle Guffey, Charles G Minard, Lucia Mirea, Aditya Vedantam, Jeffery S Raskin, Sandi Lam, Margaret Bond, P David Adelson, Angus A Wilfong, Daniel J Curry
OBJECTIVE: Prospective investigation determining agreement between the epileptogenic zone(s) (EZ) localization by resting state functional MRI (rs-fMRI) and the seizure onset zone(s) (SOZ) identified by intracranial EEG (ic-EEG) using novel differentiating and ranking criteria of rs-fMRI abnormal independent components in a consecutive heterogeneous pediatric intractable epilepsy population prospectively was conducted. METHODS: The EZ criteria were developed from an initial cohort of 350 patients evaluated for epilepsy surgery over a 3-year period...
August 7, 2017: Brain Connectivity
https://www.readbyqxmd.com/read/28779553/very-high-frequency-oscillations-novel-biomarkers-of-the-epileptogenic-zone
#11
Milan Brázdil, Martin Pail, Josef Halámek, Filip Plešinger, Jan Cimbálník, Robert Roman, Petr Klimeš, Pavel Daniel, Jan Chrastina, Eva Brichtová, Ivan Rektor, Gregory A Worrell, Pavel Jurák
OBJECTIVE: In the present study, we aimed to investigate depth EEG recordings in a large cohort of patients with drug resistant epilepsy and to focus on interictal very high frequency oscillations (VHFOs) between 500 Hz and 2 kHz. We hypothesized that interictal VHFOs are more specific biomarkers for epileptogenic zone compared to traditional HFOs. METHODS: Forty patients with focal epilepsy who underwent presurgical stereo-electroencephalography (SEEG) were included in the study...
August 5, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28777037/applications-of-a-robotic-stereotactic-arm-for-pediatric-epilepsy-and-neurooncology-surgery
#12
Brandon A Miller, Afshin Salehi, David D Limbrick, Matthew D Smyth
OBJECTIVE The ROSA device is a robotic stereotactic arm that uses a laser system to register the patient's head or spine with MR or CT images. In this study, the authors analyze their experience with this system in pediatric neurosurgical applications and present selected cases that exemplify the usefulness of this system. METHODS The authors reviewed all cases that utilized the ROSA system at their institution. Patient demographics, pathology, complications, electrode placement, laser ablation, and biopsy accuracy were analyzed...
August 4, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28776646/postoperative-seizure-freedom-does-not-normalize-altered-connectivity-in-temporal-lobe-epilepsy
#13
Luigi Maccotta, Mayra A Lopez, Babatunde Adeyemo, Beau M Ances, Brian K Day, Lawrence N Eisenman, Joshua L Dowling, Eric C Leuthardt, Bradley L Schlaggar, Robert Edward Hogan
OBJECTIVES: Specific changes in the functional connectivity of brain networks occur in patients with epilepsy. Yet whether such changes reflect a stable disease effect or one that is a function of active seizure burden remains unclear. Here, we longitudinally assessed the connectivity of canonical cognitive functional networks in patients with intractable temporal lobe epilepsy (TLE), both before and after patients underwent epilepsy surgery and achieved seizure freedom. METHODS: Seventeen patients with intractable TLE who underwent epilepsy surgery with Engel class I outcome and 17 matched healthy controls took part in the study...
August 3, 2017: Epilepsia
https://www.readbyqxmd.com/read/28774708/epileptologist-s-view-laser-interstitial-thermal-ablation-for-treatment-of-temporal-lobe-epilepsy
#14
Joon Y Kang, Michael R Sperling
A procedure called laser interstitial thermal ablation has been utilized to treat drug resistant epilepsy. With this technique, a probe is stereotactically inserted into a target structure responsible for seizures, such as mesial temporal lobe, hypothalamic hamartoma, or a small malformation of cortical development, and the tip is then heated by application of laser energy to ablate structures adjacent to the probe tip. This procedure has the advantage of selectively targeting small lesions responsible for seizures, and is far less invasive than open surgery with shorter hospitalization, less pain, and rapid return to normal activities...
July 25, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28768920/neuronavigation-guided-frameless-stereoelectroencephalography-seeg
#15
Ayataka Fujimoto, Tohru Okanishi, Sotaro Kanai, Keishiro Sato, Mitsuyo Nishimura, Hideo Enoki
Stereoelectroencephalography (SEEG) is an invasive surgical procedure used to identify epileptogenic zones. The combination of both subdural grids and depth electrodes (DEs) is currently used for invasive intracranial monitoring in many epilepsy centers. To perform DE implantation, some centers use frame-based stereotactic techniques and others use stereotactic robotic techniques. However, not all epilepsy centers have access to these tools. We hypothesized that DE implantation using a neuronavigation system can be utilized for subsequent epilepsy surgery...
August 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28765064/treatment-of-epilepsy-in-patients-with-myasthenia-gravis-is-really-harder-than-it-looks
#16
Paulo José Lorenzoni, Renata Dal-Prá Ducci, Tallulah Spina Tensini, Giuliano Dalledone, Claudia Suemi Kamoi Kay, Luciano de Paola, Lineu Cesar Werneck, Rosana Herminia Scola, Carlos Silvado
The relationship between myasthenia gravis (MG) and epilepsy has been rarely reported. As consequence, there are no specific guidelines for the management of these conditions when they mutually occur. We reported on three patients in whom epilepsy and MG are coexisting, but in different clinical settings. Two patients were treated with antiepileptic drugs which improved their symptoms. One patient has controlled the seizures after a successful anterior temporal lobectomy with no appreciable consequences to her MG...
July 29, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28755546/temporal-spatial-characteristics-of-phase-amplitude-coupling-in-electrocorticogram-for-human-temporal-lobe-epilepsy
#17
Ruihua Zhang, Ye Ren, Chunyan Liu, Na Xu, Xiaoli Li, Fengyu Cong, Tapani Ristaniemi, YuPing Wang
OBJECTIVE: Neural activity of the epileptic human brain contains low- and high-frequency oscillations in different frequency bands, some of which have been used as reliable biomarkers of the epileptogenic brain areas. However, the relationship between the low- and high-frequency oscillations in different cortical areas during the period from pre-seizure to post-seizure has not been completely clarified. METHODS: We recorded electrocorticogram data from the temporal lobe and hippocampus of seven patients with temporal lobe epilepsy...
September 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28749544/combined-electroencephalography-functional-magnetic-resonance-imaging-and-electrical-source-imaging-improves-localization-of-pediatric-focal-epilepsy
#18
Maria Centeno, Tim M Tierney, Suejen Perani, Elhum A Shamshiri, Kelly St Pier, Charlotte Wilkinson, Daniel Konn, Serge Vulliemoz, Frédéric Grouiller, Louis Lemieux, Ronit M Pressler, Christopher A Clark, J Helen Cross, David W Carmichael
OBJECTIVE: Surgical treatment in epilepsy is effective if the epileptogenic zone (EZ) can be correctly localized and characterized. Here we use simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) data to derive EEG-fMRI and electrical source imaging (ESI) maps. Their yield and their individual and combined ability to (1) localize the EZ and (2) predict seizure outcome were then evaluated. METHODS: Fifty-three children with drug-resistant epilepsy underwent EEG-fMRI...
July 27, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28744852/phenomenological-network-models-lessons-for-epilepsy-surgery
#19
Jurgen Hebbink, Hil Meijer, Geertjan Huiskamp, Stephan van Gils, Frans Leijten
The current opinion in epilepsy surgery is that successful surgery is about removing pathological cortex in the anatomic sense. This contrasts with recent developments in epilepsy research, where epilepsy is seen as a network disease. Computational models offer a framework to investigate the influence of networks, as well as local tissue properties, and to explore alternative resection strategies. Here we study, using such a model, the influence of connections on seizures and how this might change our traditional views of epilepsy surgery...
July 26, 2017: Epilepsia
https://www.readbyqxmd.com/read/28739219/systematic-review-of-hardware-related-complications-of-deep-brain-stimulation-do-new-indications-pose-an-increased-risk
#20
Onanong Jitkritsadakul, Roongroj Bhidayasiri, Suneil K Kalia, Mojgan Hodaie, Andres M Lozano, Alfonso Fasano
INTRODUCTION: Deep Brain Stimulation (DBS) is an effective treatment extended broadly to many neurological and psychiatric disorders. Nevertheless, complications may arise during DBS procedures or following implantation due to implanted hardware. This may result in both minor and major adverse events that may necessitate hardware removal and/or compromise maximal therapeutic benefit for the patient. OBJECTIVES AND METHODS: To identify relevant literature on hardware-related complications from DBS procedures by performing a systematic review, and propose how to identify at-risk group and possible preventive approaches...
July 13, 2017: Brain Stimulation
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