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Epilepsy, seizure, neuromodulation

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https://www.readbyqxmd.com/read/28092511/the-concept-of-effective-inflow-application-to-interictal-localization-of-the-epileptogenic-focus-from-ieeg
#1
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/27992323/the-concept-of-effective-inflow-application-to-interictal-localization-of-the-epileptogenic-focus-from-ieeg
#2
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/27992003/neuromodulation-in-refractory-epilepsy-brazilian-specialists-consensus
#3
Vera Cristina Terra, Isabella D'Andrea-Meira, Ricardo Amorim, Francisco Arruda, Andrea Julião de Oliveira, Luciano De Paola, Adélia Maria de Miranda Henriques-Souza
Epilepsy is a potentially devastating brain disorder characterized by a predisposition to spontaneous epileptic seizures. In patients with medically refractory epilepsy, new non-pharmacological therapeutic approaches may be considered. In this scenario, palliative surgery such as vagus nerve stimulation (VNS) or deep brain stimulation (DBS) may be indicated in a subset of patients. In this paper we make recommendations for the use of VNS and DBS in patients in Brazil with refractory epilepsy.
December 2016: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/27974275/quality-of-life-metrics-with-vagus-nerve-stimulation-for-epilepsy-from-provider-survey-data
#4
Dario J Englot, Kevin H Hassnain, John D Rolston, Stephen C Harward, Saurabh R Sinha, Michael M Haglund
OBJECTIVE: Drug-resistant epilepsy is a devastating disorder associated with diminished quality of life (QOL). Surgical resection leads to seizure freedom and improved QOL in many epilepsy patients, but not all individuals are candidates for resection. In these cases, neuromodulation-based therapies such as vagus nerve stimulation (VNS) are often used, but most VNS studies focus exclusively on reduction of seizure frequency. QOL changes and predictors with VNS remain poorly understood...
December 11, 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27965623/transcranial-alternating-current-stimulation-a-potential-risk-for-genetic-generalized-epilepsy-patients-study-case
#5
Daniel San-Juan, Carlos Ignacio Sarmiento, Axel Hernandez-Ruiz, Ernesto Elizondo-Zepeda, Gabriel Santos-Vázquez, Gerardo Reyes-Acevedo, Héctor Zúñiga-Gazcón, Carol Marina Zamora-Jarquín
Transcranial alternating current stimulation (tACS) is a re-emergent neuromodulation technique that consists in the external application of oscillating electrical currents that induces changes in cortical excitability. We present the case of a 16-year-old female with pharmaco-resistant juvenile myoclonic epilepsy to 3 antiepileptic's drugs characterized by 4 myoclonic and 20 absence seizures monthly. She received tACS at 1 mA at 3 Hz pulse train during 60 min over Fp1-Fp2 (10-20 EEG international system position) during 4 consecutive days using an Endeavor™ IOM Systems device(®) (Natus Medical Incorporated, Middleton, WI, USA)...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27913320/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 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/27384886/transcranial-direct-current-stimulation-as-treatment-in-epilepsy
#7
Markus Gschwind, Margitta Seeck
INTRODUCTION: Neuromodulation (NM) is a complementary therapy for patients with drug-resistant epilepsy. Vagal nerve stimulation and deep brain stimulation of the anterior thalamus are established techniques and have shown their efficacy in lowering seizure frequency, but they are invasive and rarely render patients seizure-free. Non-invasive NM techniques are therefore increasingly investigated in a clinical context. AREAS COVERED: Current knowledge about transcranial direct-current stimulation (tDCS) and other non-invasive NM in patients with epilepsy, based on the available animal and clinical studies from PubMed search...
July 18, 2016: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/27322347/modern-management-of-seizures-and-epilepsy
#8
Markus Gschwind, Margitta Seeck
Complete seizure control is achieved in 40-50% of all epileptic patients with drug treatment, as reported in most epidemiological studies. Many effective antiepileptic drugs with a favourable profile are available in Switzerland, allowing treatment tailored to the patient's needs. Unfortunately, up to 40-50% of all patients will eventually relapse (pharmacoresistant epilepsy). These patients run a high risk of additional morbidity and mortality. Possible pharmacoresistant epilepsy should be considered early in the disease, when there is a lack of response to the first antiepileptic drug, since only 14% of those will respond to a second drug, and only 2% to a third drug if the second fails too...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27206422/seizure-outcomes-in-nonresective-epilepsy-surgery-an-update
#9
REVIEW
Dario J Englot, Harjus Birk, Edward F Chang
In approximately 30 % of patients with epilepsy, seizures are refractory to medical therapy, leading to significant morbidity and increased mortality. Substantial evidence has demonstrated the benefit of surgical resection in patients with drug-resistant focal epilepsy, and in the present journal, we recently reviewed seizure outcomes in resective epilepsy surgery. However, not all patients are candidates for or amenable to open surgical resection for epilepsy. Fortunately, several nonresective surgical options are now available at various epilepsy centers, including novel therapies which have been pioneered in recent years...
May 21, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/26984452/current-topics-in-epilepsy-surgery
#10
Naotaka Usui
This article reviews the current topics in the field of epilepsy surgery. Each type of epilepsy is associated with a different set of questions and goals. In mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS), postoperative seizure outcome is satisfactory. A recent meta-analysis revealed superior seizure outcome after anterior temporal lobectomy compared with selective amygdalohippocampectomy; in terms of cognitive outcome; however, amygdalohippocampectomy may be beneficial. In temporal lobe epilepsy with normal magnetic resonance imaging (MRI), postoperative seizure outcome is not as favorable as it is in MTLE with HS; further improvement of seizure outcome in these cases is necessary...
May 15, 2016: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/26977314/neuromodulation-therapy-with-vagus-nerve-stimulation-for-intractable-epilepsy-a-2-year-efficacy-analysis-study-in-patients-under-12-years-of-age
#11
Suresh Gurbani, Sirichai Chayasirisobhon, Leslie Cahan, SooHo Choi, Bruce Enos, Jane Hwang, Meei Lin, Jeffrey Schweitzer
To study the efficacy of vagus nerve stimulation (VNS) therapy as an adjunctive treatment for intractable epilepsy in patients under 12 years of age, we analyzed 2-year postimplant data of 35 consecutive patients. Of the 35 patients, 18 (51.4%) at 6 months, 18 (51.4%) at 12 months, and 21 (60.1%) at 24 months showed ≥50% reduction in seizure frequency (responders). Although incremental seizure freedom was noted, no patient remained seizure-free throughout the 3 study periods. Partial response (≥50% seizure reduction in 2 or less study periods) was seen in 8 (22...
2016: Epilepsy Research and Treatment
https://www.readbyqxmd.com/read/26950169/low-dose-radiosurgery-or-hypofractionated-stereotactic-radiotherapy-as-treatment-option-in-refractory-epilepsy-due-to-epileptogenic-lesions-in-eloquent-areas-preliminary-report-of-feasibility-and-safety
#12
Jan P Boström, Daniel Delev, Carlos Quesada, Guido Widman, Hartmut Vatter, Christian E Elger, Rainer Surges
PURPOSE: The eradication of epileptogenic lesions (e.g. focal cortical dysplasia) can be used for treatment of drug-resistant focal epilepsy, but in highly eloquent cortex areas it can also lead to a permanent neurological deficit. In such cases the neuromodulation effect of low-dose high-precision irradiation of circumscribed lesions may represent an alternative therapy. METHOD: A total of 10 patients with eloquent localized lesions causing pharmacoresistant focal epilepsy were prospectively identified...
March 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/26940222/deep-brain-stimulation-for-intractabile-epilepsy
#13
Roberta Morace, Giancarlo DI Gennaro, Pierpaolo Quarato, Alfredo D'Aniello, Addolorata Amascia, Liliana Grammaldo, Marco DE Risi, Antonio Sparano, Michelangelo DE Angelis, Francesco DI Cola, Domenico Solari, Vincenzo Esposito
INTRODUCTION: Deep brain stimulation (DBS) is currently considered a promising neuromodulation therapy for refractory epilepsy not suitable for resective surgery. Several anatomical targets and different stimulation approaches have been proposed in order to obtain satisfactory seizures reduction. As expected, according with different patterns of neural pathways involvement, the efficacy of each anatomical target stimulation in reducing seizure frequency varies among the different epileptic syndromes...
June 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/26908034/vagus-nerve-stimulation-therapy-in-partial-epilepsy-a-review
#14
REVIEW
Mariangela Panebianco, Chiara Zavanone, Sophie Dupont, Domenico A Restivo, Antonino Pavone
Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked epileptic seizures. The majority of people given a diagnosis of epilepsy have a good prognosis, but 20-30 % will develop drug-resistant epilepsy. Vagus nerve stimulation (VNS) is a neuromodulatory treatment that is used as an adjunctive therapy for treating people with medically refractory epilepsy. It consists of chronic intermittent electrical stimulation of the vagus nerve, delivered by a programmable pulse generator (Neuro-Cybernetic Prosthesis)...
September 2016: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/26818103/trigeminal-nerve-stimulation-for-comorbid-posttraumatic-stress-disorder-and-major-depressive-disorder
#15
Ian A Cook, Michelle Abrams, Andrew F Leuchter
OBJECTIVES: External stimulation of the trigeminal nerve (eTNS) is an emerging neuromodulation therapy for epilepsy and depression. Preliminary studies suggest it has an excellent safety profile and is associated with significant improvements in seizures and mood. Neuroanatomical projections of the trigeminal system suggest eTNS may alter activity in structures regulating mood, anxiety, and sleep. In this proof-of-concept trial, the effects of eTNS were evaluated in adults with posttraumatic stress disorder (PTSD) and comorbid unipolar major depressive disorder (MDD) as an adjunct to pharmacotherapy for these commonly co-occurring conditions...
April 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/26645965/rates-and-predictors-of-seizure-freedom-with-vagus-nerve-stimulation-for-intractable-epilepsy
#16
Dario J Englot, John D Rolston, Clinton W Wright, Kevin H Hassnain, Edward F Chang
BACKGROUND: Neuromodulation-based treatments have become increasingly important in epilepsy treatment. Most patients with epilepsy treated with neuromodulation do not achieve complete seizure freedom, and, therefore, previous studies of vagus nerve stimulation (VNS) therapy have focused instead on reduction of seizure frequency as a measure of treatment response. OBJECTIVE: To elucidate rates and predictors of seizure freedom with VNS. METHODS: We examined 5554 patients from the VNS therapy Patient Outcome Registry, and also performed a systematic review of the literature including 2869 patients across 78 studies...
September 2016: Neurosurgery
https://www.readbyqxmd.com/read/26615114/neuromodulation-for-epilepsy
#17
REVIEW
Vibhor Krishna, Francesco Sammartino, Nicholas Kon Kam King, Rosa Qui Yue So, Richard Wennberg
Several palliative neuromodulation treatment modalities are currently available for adjunctive use in the treatment of medically intractable epilepsy. Over the past decades, a variety of different central and peripheral nervous system sites have been identified, clinically and experimentally, as potential targets for chronic, nonresponsive therapeutic neurostimulation. Currently, the main modalities in clinical use, from most invasive to least invasive, are anterior thalamus deep brain stimulation, vagus nerve stimulation, and trigeminal nerve stimulation...
January 2016: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/26544593/reduced-d2-d3-receptor-binding-of-extrastriatal-and-striatal-regions-in-temporal-lobe-epilepsy
#18
COMPARATIVE STUDY
Viviane E Bernedo Paredes, Hans-Georg Buchholz, Martin Gartenschläger, Markus Breimhorst, Mathias Schreckenberger, Konrad J Werhahn
OBJECTIVE: Dopamine is an endogenous neuromodulator in cortical circuits and the basal ganglia. In animal models of temporal lobe epilepsy (TLE), seizure threshold is modulated to some extent by dopamine, with D1-receptors having a pro- and D2-receptors an anticonvulsant effect. We aimed to extend our previously reported results on decreased D2/D3 receptor binding in the lateral epileptogenic temporal lobe and to correlate them with demographic and seizure variables to gain a more comprehensive understanding of the underlying involvement of the dopaminergic system in the epileptogenesis of TLE...
2015: PloS One
https://www.readbyqxmd.com/read/26516808/safe-simultaneous-use-of-sacral-neuromodulation-and-vagal-nerve-stimulation
#19
Ted M Roth
INTRODUCTION: The potential for costimulation with competitive effects between implanted electronic devices remains speculative both at the level at the implanted device and with active programming but also at the retrograde site of action. We present a patient with an implanted vagal nerve stimulator for refractory epilepsy who underwent successful staged sacral neuromodulation (SNS) and benefits from both technologies. CASE: This is a case report of a 42-year-old female patient with a history notable for medically intractable epilepsy, temporal lobectomy, and vagal nerve stimulation who subsequently underwent staged SNS for refractory overactive bladder syndrome...
January 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/26381061/combined-electrophysiological-and-biosensor-approaches-to-study-purinergic-regulation-of-epileptiform-activity-in-cortical-tissue
#20
Bruno G Frenguelli, Mark J Wall
BACKGROUND: Cortical brain slices offer a readily accessible experimental model of a region of the brain commonly affected by epilepsy. The diversity of recording techniques, seizure-promoting protocols and mutant mouse models provides a rich diversity of avenues of investigation, which is facilitated by the regular arrangement of distinct neuronal populations and afferent fibre pathways, particularly in the hippocampus. NEW METHOD AND RESULTS: We have been interested in the regulation of seizure activity in hippocampal and neocortical slices by the purines, adenosine and ATP...
February 15, 2016: Journal of Neuroscience Methods
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