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Extraoperative mapping

AmiLyn M Taplin, Adriana de Pesters, Peter Brunner, Dora Hermes, John C Dalfino, Matthew A Adamo, Anthony L Ritaccio, Gerwin Schalk
In this case report, we investigated the utility and practicality of passive intraoperative functional mapping of expressive language cortex using high-resolution electrocorticography (ECoG). The patient presented here experienced new-onset seizures caused by a medium-grade tumor in very close proximity to expressive language regions. In preparation of tumor resection, the patient underwent multiple functional language mapping procedures. We examined the relationship of results obtained with intraoperative high-resolution ECoG, extraoperative ECoG utilizing a conventional subdural grid, extraoperative electrical cortical stimulation (ECS) mapping, and functional magnetic resonance imaging (fMRI)...
2016: Epilepsy & Behavior Case Reports
Siby Gopinath, Arun Grace Roy, Kollencheri Puthenveetil Vinayan, Anand Kumar, Manjit Sarma, Ramiah Rajeshkannan, Ashok Pillai
OBJECTIVES: We present a case series of patients who underwent perirolandic resection for medically refractory focal epilepsy due to focal cortical dysplasia (FCD). Our aim was to specifically evaluate the outcome of a surgical strategy intended for seizure freedom while preserving primary motor cortex function. MATERIALS AND METHODS: Thirteen patients undergoing perirolandic resection for pharmacoresistant focal epilepsy between 2010 and 2015 who demonstrated histological evidence of FCD were selected from a prospectively maintained database...
November 2, 2015: International Journal of Surgery
Christoph Kapeller, Milena Korostenskaja, Robert Prueckl, Po-Ching Chen, Ki Heyeong Lee, Michael Westerveld, Christine M Salinas, Jane C Cook, James E Baumgartner, Christoph Guger
PURPOSE: To evaluate the use of the cortiQ-based mapping system (g.tec medication engineering GmbH, Austria) for real-time functional mapping (RTFM) and to compare it to results from electrical cortical stimulation mapping (ESM) and functional magnetic resonance imaging (fMRI). METHODS: Electrocorticographic activity was recorded in 3 male patients with intractable epilepsy by using cortiQ mapping system and analyzed in real time. Activation related to motor, sensory, and receptive language tasks was determined by evaluating the power of the high gamma frequency band (60-170 Hz)...
June 2015: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Stjepana Kovac, Philippe Kahane, Beate Diehl
Direct electrical cortical stimulation (CS) is widely used to map eloquent cortex. It can be applied extraoperatively in patients undergoing intracranial EEG recordings using chronically implanted electrodes (subdural, depth or a combination), or it can be used intraoperatively. Seizures can be induced by CS but there is controversy regarding the utility of CS induced seizures in defining the epileptogenic zone and hence practice varies considerably between centres. Some centres use seizures induced by direct CS routinely to aid in defining the epileptogenic zone...
January 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Jorge Gonzalez-Martinez, Deepak Lachhwani
The stereoelectroencephalophraphy (SEEG) method was developed in France by Jean Tailarach and Jean Bancaud during the 50s and has been mostly used in France and Italy, as the method of choice for extraoperative invasive mapping in refractory focal epilepsy. Subsequently, for more than 60 years, SEEG has shown to be a valuable tool for preoperative decision-making in focal epilepsy. Nevertheless, there are few reports addressing the utility and safety of the SEEG methodology applied to children and adolescents...
November 2014: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Demitre Serletis, Juan Bulacio, William Bingaman, Imad Najm, Jorge González-Martínez
OBJECT: Stereoelectroencephalography (SEEG) is a methodology that permits accurate 3D in vivo electroclinical recordings of epileptiform activity. Among other general indications for invasive intracranial electroencephalography (EEG) monitoring, its advantages include access to deep cortical structures, its ability to localize the epileptogenic zone when subdural grids have failed to do so, and its utility in the context of possible multifocal seizure onsets with the need for bihemispheric explorations...
November 2014: Journal of Neurosurgery
Johanna Derix, Olga Iljina, Johanna Weiske, Andreas Schulze-Bonhage, Ad Aertsen, Tonio Ball
Exchange of thoughts by means of expressive speech is fundamental to human communication. However, the neuronal basis of real-life communication in general, and of verbal exchange of ideas in particular, has rarely been studied until now. Here, our aim was to establish an approach for exploring the neuronal processes related to cognitive "idea" units (IUs) in conditions of non-experimental speech production. We investigated whether such units corresponding to single, coherent chunks of speech with syntactically-defined borders, are useful to unravel the neuronal mechanisms underlying real-world human cognition...
2014: Frontiers in Human Neuroscience
Sandra Serafini, Jordan M Komisarow, William Gallentine, Mohamad A Mikati, Melanie J Bonner, Peter G Kranz, Michael M Haglund, Gerald Grant
The cerebral organization of language in epilepsy patients has been studied with invasive procedures such as Wada testing and electrical cortical stimulation mapping and more recently with noninvasive neuroimaging techniques, such as functional MRI. In the setting of a chronic seizure disorder, clinical variables have been shown to contribute to cerebral language reorganization underscoring the need for language lateralization and localization procedures. We present a 14-year-old pediatric patient with a refractory epilepsy disorder who underwent two neurosurgical resections of a left frontal epileptic focus separated by a year...
2013: Brain Sciences
Marla J Hamberger, Alicia C Williams, Catherine A Schevon
OBJECTIVE: Extraoperative electrical stimulation mapping (ESM) to identify functional cortex is performed prior to neurosurgical resection at epilepsy surgery programs worldwide. However, the procedure remains unstandardized, with no established clinical guidelines. We sought to determine the current range in ESM practice parameters across established epilepsy surgery centers. METHODS: We developed and distributed a 31-question survey to 220 epilepsy centers worldwide regarding current practice parameters of ESM...
June 2014: Epilepsia
Anna M Bank, Catherine A Schevon, Marla J Hamberger
Extraoperative electrocortical stimulation mapping (ESM) is used to identify functional cortex prior to epilepsy surgery, with the goal of preserving function postoperatively. Although attempts are made to avoid stimulation-evoked seizure activity, the clinical impact of these events with regard to safety, clinical utility, functional outcome, and even disruption to the procedure itself is unknown. We conducted a retrospective review of 57 patients with pharmacoresistant focal epilepsy who underwent intracranial electrode implantation and ESM...
May 2014: Epilepsy & Behavior: E&B
Jorge Gonzalez-Martinez, Jeffrey Mullin, Sumeet Vadera, Juan Bulacio, Gwyneth Hughes, Stephen Jones, Rei Enatsu, Imad Najm
OBJECT: Despite its long-reported successful record, with almost 60 years of clinical use, the technical complexity regarding the placement of stereoelectroencephalography (SEEG) depth electrodes may have contributed to the limited widespread application of the technique in centers outside Europe. The authors report on a simplified and novel SEEG surgical technique in the extraoperative mapping of refractory focal epilepsy. METHODS: The proposed technique was applied in patients with medically refractory focal epilepsy...
March 2014: Journal of Neurosurgery
Hugues Duffau
In nontumoral epilepsy surgery, the main goal for all preoperative investigation is to first determine the epileptogenic zone, and then to analyze its relation to eloquent cortex, in order to control seizures while avoiding adverse postoperative neurologic outcome. To this end, in addition to neuropsychological assessment, functional neuroimaging and scalp electroencephalography, extraoperative recording, and electrical mapping, especially using subdural strip- or grid-electrodes, has been reported extensively...
December 2013: Epilepsia
Iván Sánchez Fernández, Tobias Loddenkemper
Patients with refractory focal epilepsy are thoroughly evaluated to identify an area of cortex that, if removed or disconnected, will lead to seizure freedom. Clinical semiology, neuroimaging, and scalp electroencephalogram provide an approximation of this area, whereas intracranial recording may permit a more precise localization and investigation of a selected cortical area. Intraoperative electrocorticography delineates the irritative zone, and subdural electrode implantation also permits cortical stimulation of eloquent areas...
December 2013: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Stjepana Kovac, Catherine A Scott, Vesela Maglajlija, Nathan Toms, Roman Rodionov, Anna Miserocchi, Andrew W McEvoy, Beate Diehl
OBJECTIVE: Extraoperative cortical stimulation (CS) for mapping of eloquent cortex in patients prior to epilepsy surgery is not standardized across centres. Two different techniques are in use, referred to as bipolar and monopolar CS. We compared the ability of bipolar versus monopolar CS to identify eloquent cortex and their safety profile in patients undergoing subdural EEG recordings. METHODS: Five patients undergoing intracranial EEG recordings and extraoperative CS...
April 2014: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Tianyi Qian, Wenjing Zhou, Zhipei Ling, Shangkai Gao, Hesheng Liu, Bo Hong
OBJECT: Electrocorticography (ECoG) is a powerful tool for presurgical functional mapping. Power increase in the high gamma band has been observed from ECoG electrodes on the surface of the sensory motor cortex during the execution of body movements. In this study the authors aim to validate the clinical usage of high gamma activity in presurgical mapping by comparing ECoG mapping with traditional direct electrical cortical stimulation (ECS) and functional MRI (fMRI) mapping. METHODS: Seventeen patients with epilepsy participated in an ECoG motor mapping experiment...
July 2013: Journal of Neurosurgery
Naoyuki Matsuzaki, Csaba Juhász, Eishi Asano
OBJECTIVE: The lower-order visual cortex in the medial-occipital region is suggested to send feed-forward signals to the higher-order visual cortex including ventral-occipital-temporal and dorsal-occipital regions. We determined how stimulation-elicited cortical-signals propagate between lower- and higher-order visual cortices, and whether the magnitudes of stimulation-elicited cortical-signals recorded in the higher-order visual cortex differed from those recorded in the lower-order one...
July 2013: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Jorge Gonzalez-Martinez, Juan Bulacio, Andreas Alexopoulos, Lara Jehi, William Bingaman, Imad Najm
PURPOSE: Stereo-electroencephalography (SEEG) enables precise recordings from deep cortical structures, multiple noncontiguous lobes, as well as bilateral explorations while avoiding large craniotomies. Despite a long reported successful record, its application in the United States has not been widely adopted. We report on our initial experience with the SEEG methodology in the extraoperative mapping of refractory focal epilepsy in patients who were not considered optimal surgical candidates for other methods of invasive monitoring...
February 2013: Epilepsia
Erik C Brown, Otto Muzik, Robert Rothermel, Naoyuki Matsuzaki, Csaba Juhász, Aashit K Shah, Marie D Atkinson, Darren Fuerst, Sandeep Mittal, Sandeep Sood, Vaibhav A Diwadkar, Eishi Asano
Reverse speech has often been used as a control task in brain-mapping studies of language utilizing various non-invasive modalities. The rationale is that reverse speech is comparable to forward speech in terms of auditory characteristics, while omitting the linguistic components. Thus, it may control for non-language auditory functions. This finds some support in fMRI studies indicating that reverse speech resulted in less blood-oxygen-level-dependent (BOLD) signal intensity in perisylvian regions than forward speech...
May 1, 2012: NeuroImage
Stjepana Kovac, Catherine A Scott, Vesela Maglajlija, Roman Rodionov, Andrew W McEvoy, Beate Diehl
PURPOSE: To characterize properties and stimulation thresholds of extraoperative cortical stimulation with respect to the anatomic area stimulated. METHODS: Analysis of 1,496 bipolar extraoperative cortical stimulations with respect to stimulation threshold, anatomic area stimulated, afterdischarges (ADs), and latencies to observe a clinical sign on video analysis. RESULTS: Cortical stimulation mapping stimulus thresholds to induce clinical motor responses are lower when compared with stimulus thresholds to induce nonmotor responses (P < 0...
December 2011: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Sandrine de Ribaupierre, Martine Fohlen, Christine Bulteau, Georg Dorfmüller, Olivier Delalande, Olivier Dulac, Catherine Chiron, Lucie Hertz-Pannier
PURPOSE: Presurgical language mapping in dominant hemisphere epilepsy to evaluate the risk of postoperative deficit is particularly difficult in children. Extraoperative invasive cortical stimulation can show some areas critical to language, but not all of them, due to scarce sampling, poor cooperation, cortical immaturity, or network reorganization, whereas functional magnetic resonance imaging (fMRI) displays entire networks involved in, but not necessarily critical to, language. In a homogeneous series of children with epilepsy, we compared the contributions of language fMRI and depth electrode stimulations to optimize language mapping...
January 2012: Epilepsia
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