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https://www.readbyqxmd.com/read/28419330/seizure-outcomes-in-occipital-lobe-and-posterior-quadrant-epilepsy-surgery-a-systematic-review-and-meta-analysis
#1
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
#2
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
#3
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/28414666/just-a-puff-of-smoke
#4
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413272/an-analysis-of-perioperative-adverse-neurological-events-associated-with-anesthetic-management-at-a-tertiary-care-center-of-a-developing-country
#5
Fauzia Anis Khan, Sobia Khan, Gauhar Afshan
BACKGROUND AND AIMS: Existing literature on neurological complications related to anesthesia is reported from affluent countries but the trends may vary in less affluent countries. MATERIAL AND METHODS: The objective was to find the associated factors contributing to neurological adverse events occurring within 48 h of anesthesia and surgery. The existing departmental morbidity and mortality database was reviewed from 1992 to 2012 for major adverse neurological events...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412559/interictal-ripples-nested-in-epileptiform-discharge-help-to-identify-the-epileptogenic-zone-in-neocortical-epilepsy
#6
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
#7
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
#8
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
#9
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/28410464/surgical-outcomes-in-two-different-age-groups-with-focal-cortical-dysplasia-type-ii-any-real-difference
#10
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
#11
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
#12
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/28403398/systematic-review-of-the-systemic-concentrations-of-local-anaesthetic-after-transversus-abdominis-plane-block-and-rectus-sheath-block
#13
J Rahiri, J Tuhoe, D Svirskis, N J Lightfoot, P B Lirk, A G Hill
Background.: Safe and efficacious modalities of perioperative analgesia are essential for enhanced recovery after surgery. Truncal nerve blocks are one potential adjunct for analgesia of the abdominal wall, and in recent years their popularity has increased. Transversus abdominis plane block (TAPB) and rectus sheath block (RSB) have been shown to reduce morphine consumption and improve pain relief after abdominal surgery. These blocks typically require large volumes of local anaesthetic (LA)...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28399506/timing-and-type-of-hemispherectomy-for-rasmussen-s-encephalitis-analysis-of-45-patients
#14
Yuguang Guan, Sichang Chen, Changqing Liu, Xiuyu Du, Yao Zhang, Shuai Chen, Jie Wang, Tianfu Li, Guoming Luan
OBJECTIVE: To describe the surgery outcomes of RE patients in one centerto identify the indication for surgical treatment that results in the most favorable outcome. METHOD: Forty-five RE patients from a single center were retrospectively reviewed. Preoperative evaluations included assessments of clinical manifestations, cognitive status, a physical examination, MRI, positron emission tomography (PET), electroencephalography (EEG), and magnetoencephalography (MEG)...
March 22, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28399413/personality-traits-of-children-before-and-after-epilepsy-surgery
#15
Olga Braams, Renske Schappin, Joost Meekes, Peter C van Rijen, Onno van Nieuwenhuizen, Kees P Braun, Aag Jennekens-Schinkel
We studied how children with epilepsy (CWE) who are candidates for epilepsy surgery, perceive themselves with respect to overarching personality traits and whether the traits change after surgery. We explored influences of demographic and illness variables. A total of 23 CWE [mean age at inclusion 12.8 (sd 2.3); 12 girls] participated. Using the Dutch Personality Questionnaire Juniors (DPQ-J), we assessed 20 of the CWE shortly before epilepsy surgery and compared the results to those of 39 age- and gender-matched healthy controls...
April 3, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28398008/source-localization-of-ictal-epileptic-activity-based-on-high-density-scalp-eeg-data
#16
Petros Nemtsas, Gwenael Birot, Francesca Pittau, Christoph M Michel, Karl Schaller, Serge Vulliemoz, Vasilios K Kimiskidis, Margitta Seeck
OBJECTIVE: Electrical source imaging (ESI) is a well-established approach to localizing the epileptic focus in drug-resistant focal epilepsy. So far, ESI has been used primarily on interictal events. Emerging evidence suggests that ictal ESI is also feasible and potentially useful. We aimed to investigate the diagnostic accuracy of ESI on ictal events using high-density electroencephalography (EEG). METHODS: We performed ictal ESI on 14 patients (9 with temporal lobe epilepsy) admitted for presurgical evaluation who presented seizures during a long-term (≥18 h) high-density EEG recording (13 with 256 electrodes and one with 128 electrodes), and subsequently 8 of them underwent epilepsy surgery (postoperative follow-up >1 year)...
April 11, 2017: Epilepsia
https://www.readbyqxmd.com/read/28396294/chronic-ambulatory-electrocorticography-from-human-speech-cortex
#17
Vikram R Rao, Matthew K Leonard, Jonathan K Kleen, Ben A Lucas, Emily A Mirro, Edward F Chang
Direct intracranial recording of human brain activity is an important approach for deciphering neural mechanisms of cognition. Such recordings, usually made in patients with epilepsy undergoing inpatient monitoring for seizure localization, are limited in duration and depend on patients' tolerance for the challenges associated with recovering from brain surgery. Thus, typical intracranial recordings, similar to most non-invasive approaches in humans, provide snapshots of brain activity in acute, highly constrained settings, limiting opportunities to understand long timescale and natural, real-world phenomena...
April 7, 2017: NeuroImage
https://www.readbyqxmd.com/read/28393415/the-insertion-of-electrodes-in-the-brain-for-electrophysiological-recording-or-chronic-stimulation-is-not-associated-with-any-biochemically-detectable-neuronal-injury
#18
Marios S Themistocleous, Damianos E Sakas, Efstathios Boviatsis, George Tagaris, Andreas Kouyialis, Christina Psachoulia, Pantelis Stathis
OBJECTIVE: The aim of this study was to evaluate the degree of brain tissue injury that could be potentially induced by the introduction of a) microrecording electrodes, b) macrostimulation electrodes, or c) chronic stimulation electrodes. We aimed to evaluate whether the use of five simultaneous microrecording tracks is associated with any brain injury not detectable by conventional imaging such as CT or MRI. MATERIALS AND METHODS: The study included 61 patients who underwent surgery for implantation of 121 DBS leads...
April 10, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28389411/complications-after-surgery-for-mesial-temporal-lobe-epilepsy-associated-with-hippocampal-sclerosis
#19
Bertrand Mathon, Vincent Navarro, Franck Bielle, Vi-Huong Nguyen-Michel, Alexandre Carpentier, Michel Baulac, Philippe Cornu, Claude Adam, Sophie Dupont, Stéphane Clemenceau
BACKGROUND: Hippocampal sclerosis is the most common cause of drug-resistant epilepsy amenable for surgical treatment and seizure control. This study aimed to analyze morbidities related to surgery of mesial temporal lobe epilepsy associated with hippocampal sclerosis and to identify possible risk factors for complications. METHODS: A retrospective analysis of postoperative complications was made for 389 operations performed between 1990 and 2015 on patients aged 15 to 67 years (mean 36...
April 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28387951/brain-responsive-neurostimulation-in-patients-with-medically-intractable-seizures-arising-from-eloquent-and-other-neocortical-areas
#20
Barbara C Jobst, Ritu Kapur, Gregory L Barkley, Carl W Bazil, Michel J Berg, Gregory K Bergey, Jane G Boggs, Sydney S Cash, Andrew J Cole, Michael S Duchowny, Robert B Duckrow, Jonathan C Edwards, Stephan Eisenschenk, A James Fessler, Nathan B Fountain, Eric B Geller, Alica M Goldman, Robert R Goodman, Robert E Gross, Ryder P Gwinn, Christianne Heck, Aamr A Herekar, Lawrence J Hirsch, David King-Stephens, Douglas R Labar, W R Marsh, Kimford J Meador, Ian Miller, Eli M Mizrahi, Anthony M Murro, Dileep R Nair, Katherine H Noe, Piotr W Olejniczak, Yong D Park, Paul Rutecki, Vicenta Salanova, Raj D Sheth, Christopher Skidmore, Michael C Smith, David C Spencer, Shraddha Srinivasan, William Tatum, Paul Van Ness, David G Vossler, Robert E Wharen, Gregory A Worrell, Daniel Yoshor, Richard S Zimmerman, Tara L Skarpaas, Martha J Morrell
OBJECTIVE: Evaluate the seizure-reduction response and safety of brain-responsive stimulation in adults with medically intractable partial-onset seizures of neocortical origin. METHODS: Patients with partial seizures of neocortical origin were identified from prospective clinical trials of a brain-responsive neurostimulator (RNS System, NeuroPace). The seizure reduction over years 2-6 postimplantation was calculated by assessing the seizure frequency compared to a preimplantation baseline...
April 7, 2017: Epilepsia
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