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Seizure surgery

Sándor Beniczky, Ivana Rosenzweig, Michael Scherg, Todor Jordanov, Benjamin Lanfer, Göran Lantz, Pål Gunnar Larsson
PURPOSE: To determine the agreement between five different methods of ictal EEG source imaging, and to assess their accuracy in presurgical evaluation of patients with focal epilepsy. It was hypothesized that high agreement between methods was associated with higher localization-accuracy. METHODS: EEGs were recorded with a 64-electrode array. Thirty-eight seizures from 22 patients were analyzed using five different methods phase mapping, dipole fitting, CLARA, cortical-CLARA and minimum norm...
October 6, 2016: Seizure: the Journal of the British Epilepsy Association
Xin Wang, Jing Wang, Haikang Zhao, Nan Li, Shunnan Ge, Lei Chen, Jiaming Li, Jiangpeng Jing, Mingming Su, Zhaohui Zheng, Jinan Zhang, Guodong Gao, Xuelian Wang
BACKGROUND: Symptomatic intracranial hemorrhage (ICH) may lead to permanent neurological disability of patients and has impeded the extensive clinical application of deep brain stimulation (DBS). The present study was conducted to discuss the incidence, prevention, and treatment of symptomatic ICH after DBS surgery. METHODS: From January 2009 to December 2014, 396 patients underwent DBS with a total of 691 implanted leads. In all, 10 patients had symptomatic ICH...
October 20, 2016: British Journal of Neurosurgery
Nebras M Warsi, Oliver Lasry, Adel Farah, Christine Saint-Martin, Jose L Montes, Jeffrey Atkinson, Jean-Pierre Farmer, Roy W R Dudley
PURPOSE: Three-tesla intraoperative MRI (iMRI) is a promising tool that could help confirm complete resections and disconnections in pediatric epilepsy surgery, leading to improved outcomes. However, a large proportion of epileptogenic pathologies in children are poorly defined on imaging, which brings into question the utility of iMRI for these cases. Our aim was to compare postoperative seizure outcomes between iMRI- and non-iMRI-based epilepsy surgeries. METHODS: We performed a comparative retrospective analysis of non-iMRI- versus iMRI-based epilepsy surgeries with 2-year follow-up...
October 18, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Theresa Scholl, Angelika Mühlebner, Gerda Ricken, Victoria Gruber, Anna Fabing, Sharon Samueli, Gudrun Gröppel, Christian Dorfer, Thomas Czech, Johannes A Hainfellner, Avanita S Prabowo, Roy J Reinten, Lisette Hoogendijk, Jasper J Anink, Eleonora Aronica, Martha Feucht
Conventional antiepileptic drugs suppress the excessive firing of neurons during seizures. In drug-resistant patients, treatment failure indicates an alternative important epileptogenic trigger. Two epilepsy-associated pathologies show myelin deficiencies in seizure-related brain regions: Focal Cortical Dysplasia IIB (FCD) and cortical tubers in Tuberous Sclerosis Complex (TSC). Studies uncovering white matter-pathology mechanisms are therefore urgently needed to gain more insight into epileptogenesis, the propensity to maintain seizures, and their associated comorbidities such as cognitive defects...
October 17, 2016: Brain Pathology
Roisin Bartlam, Rajiv Mohanraj
BACKGROUND: Seizures can lead to cardiac arrhythmias by a number of mechanisms including activation/inhibition of cortical autonomic centers, increase in vagal tone through activation of brainstem reflex centers, and respiratory failure. Ictal asystole (IA) is a potential mechanism underlying sudden unexpected death in epilepsy (SUDEP). We analyzed the clinical features of 5 patients who developed IA requiring pacemaker implantation. METHODS: Patients with ictal arrhythmias were identified from the video-telemetry and ambulatory EEG database at Greater Manchester Neurosciences Centre, as well as an independent epilepsy residential care facility...
October 13, 2016: Epilepsy & Behavior: E&B
Samuel Lapalme-Remis, Gregory D Cascino
PURPOSE OF REVIEW: This article discusses structural and functional neuroimaging findings in patients with seizures and epilepsy. The indications for neuroimaging in these patients and the potential diagnostic utility of these studies are presented. RECENT FINDINGS: Patients presenting with new seizures typically require urgent imaging to rule out a critical underlying cause. MRI is the structural neuroimaging procedure of choice in individuals with epilepsy. Specific epilepsy protocols should be considered to increase the diagnostic yield of neuroimaging in patients with structural lesions associated with focal or generalized seizures...
October 2016: Continuum: Lifelong Learning in Neurology
Camilo Gutierrez, Ali A Asadi-Pooya, Christopher T Skidmore, Steven D Tobochnik, Carla LoPinto-Khoury, Michael R Sperling
OBJECTIVES: The objective of this study was to describe the clinical characteristics and surgical outcome in patients with gelastic seizures without hypothalamic hamartoma. METHODS: We retrospectively reviewed all the video-EEG reports over a 5-year period (2007-2011) for the occurrence of the terms "laugh" or "giggle" in the text body. All the patients with at least one documented gelastic seizure at the epilepsy monitoring unit were studied. In patients who underwent epilepsy surgery, seizure outcomes were analyzed...
October 10, 2016: Epilepsy & Behavior: E&B
Gerardo Salvato, Pina Scarpa, Stefano Francione, Roberto Mai, Laura Tassi, Elisa Scarano, Giorgio Lo Russo, Gabriella Bottini
It is largely recognized that the mesial temporal lobe and its substructure support declarative long-term memory (LTM). So far, different theories have been suggested, and the organization of declarative verbal LTM in the brain is still a matter of debate. In the current study, we retrospectively selected 151 right-handed patients with temporal lobe epilepsy with and without hippocampal sclerosis, with a homogeneous (seizure-free) clinical outcome. We analyzed verbal memory performance within a normalized scores context, by means of prose recall and word paired-associate learning tasks...
October 10, 2016: Epilepsy & Behavior: E&B
Nari Choi, Jee-Eun Yoon, Byoung-Won Park, Won-Ho Chang, Hyun-Jo Kim, Kyung Bok Lee
We report a case of aortic dissection masquerading as acute ischemic stroke followed by intravenous thrombolysis. A 59-year-old man presented with dizziness. After examination, the patient had a seizure with bilateral Babinski signs. Soon after identifying multiple acute infarctions in both hemispheres on diffusion-weighted brain magnetic resonance (MR) imaging, tissue plasminogen activator (t-PA) was administered. Both common carotid arteries were invisible on MR angiography, and subsequent chest computed tomography revealed an aortic dissection...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Amir M Arain, Nabil J Azar, Andre H Lagrange, Michael McLean, Pradumna Singh, Hasan Sonmezturk, Peter Konrad, Joseph Neimat, Bassel Abou-Khalil
RATIONALE: Hypermotor seizures are most often reported from the frontal lobe but may also have temporal, parietal, or insular origin. We noted a higher proportion of patients with temporal lobe epilepsy in our surgical cohort who had hypermotor seizures. We evaluated the anatomic localization and surgical outcome in patient with refractory hypermotor seizures who had epilepsy surgery in our center. METHODS: We identified twenty three patients with refractory hypermotor seizures from our epilepsy surgery database...
October 9, 2016: Epilepsy & Behavior: E&B
Klajdi Puka, Mary Lou Smith
OBJECTIVE: Little is known about the long-term cognitive outcomes following pediatric epilepsy surgery. Although the evidence for change within the first 2 years is not compelling, the plasticity of the immature brain may allow for improvements in the long term. This study examined memory function in a cohort of surgical and nonsurgical patients at baseline and 4-11 years after. METHOD: Participants were 88 patients (mean age 20.05, standard deviation [SD] 4.21 years) with childhood-onset intractable epilepsy; 53 had undergone resective epilepsy surgery...
October 12, 2016: Epilepsia
Eveline Teresa Hidalgo, Howard L Weiner
New developments in diagnostic methods, technical improvements in the surgical field, and a better understanding of the effects of epilepsy on the developing brain are contributing to the general observation that more children with epilepsy are being treated surgically. Malformations of cortical development are the most common cause of seizures in pediatric surgical candidates, and the best predictor of seizure freedom after surgery appears to be the complete removal of the epileptogenic lesion. To achieve this goal in challenging cases, such as magnetic resonance imaging-negative or multifocal lesions, a staged approach with pre- and/or post-resective invasive electroencephalography monitoring has increasingly been used at a number of centers...
October 11, 2016: Developmental Medicine and Child Neurology
Kailiang Wang, Tinghong Liu, Xiaobin Zhao, XiaoTong Xia, Kai Zhang, Hui Qiao, Jianguo Zhang, Fangang Meng
INTRODUCTION: Fluorine-18-fluorodeoxyglucose positron-emission tomography ((18)F-FDG-PET) is widely used to help localize the hypometabolic epileptogenic focus for presurgical evaluation of drug-refractory epilepsy patients. Two voxel-based brain mapping methods to interpret (18)F-FDG-PET, statistical parametric mapping (SPM) and three-dimensional stereotactic surface projection (3D-SSP), improve the detection rate of seizure foci. This study aimed to compare the consistency of epileptic focus detection between SPM and 3D-SSP for (18)F-FDG-PET brain mapping analysis...
2016: Frontiers in Neurology
Monique E Brouwer, William J McMeniman
Seizures following cardiopulmonary bypass are an immediate and alarming indication that a neurologic event has occurred. A case report of a 67-year-old man undergoing aortic valve surgery who unexpectedly experiences seizures following cardiopulmonary bypass is outlined. Possible contributing factors including atheromatous disease in the aorta, low cerebral perfusion pressures, an open-chamber procedure, and the use of tranexamic acid are identified.
September 2016: Journal of Extra-corporeal Technology
Christina Eguizabal Love, Frank Webbe, Gunha Kim, Ki Hyeong Lee, Michael Westerveld, Christine M Salinas
OBJECTIVE: Children with epilepsy are vulnerable to executive dysfunction, but the relationship between executive functioning (EF) and quality of life (QOL) in children with epilepsy is not fully delineated. This exploratory study elucidated the relationship between ecological EF and QOL in pediatric intractable epilepsy. METHOD: Fifty-four consecutively referred pediatric epilepsy surgery candidates and their parents were administered IQ measures, the Behavior Rating Inventory of Executive Function (BRIEF), and the Quality of Life in Childhood Epilepsy (QOLCE) as part of a comprehensive neuropsychological evaluation...
October 8, 2016: Epilepsy & Behavior: E&B
Octavian V Lie, Pieter van Mierlo
The visual interpretation of intracranial EEG (iEEG) is the standard method used in complex epilepsy surgery cases to map the regions of seizure onset targeted for resection. Still, visual iEEG analysis is labor-intensive and biased due to interpreter dependency. Multivariate parametric functional connectivity measures using adaptive autoregressive (AR) modeling of the iEEG signals based on the Kalman filter algorithm have been used successfully to localize the electrographic seizure onsets. Due to their high computational cost, these methods have been applied to a limited number of iEEG time-series (<60)...
October 8, 2016: Brain Topography
Ranabir Pal, Ashok Munivenkatappa, Amit Agrawal, Geetha R Menon, Sagar Galwankar, P Rama Mohan, S Satish Kumar, B V Subrahmanyam
BACKGROUND: A reliable prediction of outcome for the victims of traumatic brain injury (TBI) on admission is possible from concurrent data analysis from any systematic real-time registry. OBJECTIVE: To determine the clinical relevance of the findings from our TBI registry to develop prognostic futuristic models with readily available traditional and novel predictors. MATERIALS AND METHODS: Prospectively collected data using predesigned pro forma were analyzed from the first phase of a trauma registry from a South Indian Trauma Centre, compatible with computerized management system at electronic data entry and web data entry interface on demographics, clinical, management, and discharge status...
July 2016: International Journal of Critical Illness and Injury Science
Shaun A Hussain, Gary W Mathern, Raman Sankar, Joyce Y Wu
OBJECTIVE: Fast ripples (FR, 250-500Hz) are proposed biomarkers of the epileptogenic zone on the basis of several retrospective reports linking postoperative seizure freedom to their complete resection. There are no clinical trials or prospective reports validating the use of FR as characterized by electrocorticography (ECoG), to guide the scope of epilepsy surgery, and to inform prognosis thereafter. We set out to prospectively evaluate the utility of FR resection to predict postoperative epilepsy outcomes, and examine the feasibility of "live" intraoperative FR ascertainment...
September 23, 2016: Epilepsy Research
Mindl M Messinger, Kimberly L Dinh, Erin J McDade, Brady S Moffett, Angus A Wilfong, Antonio G Cabrera
BACKGROUND: Advances in cardiac operations over the last few decades, including corrective operations in early life, have dramatically increased the survival of children with congenital heart disease. However, postoperative care has been associated with neurologic complications, with seizures being the most common manifestation. The primary objective of this study is to describe the outcomes in pediatric patients who received an antiepileptic drug (AED) post-cardiac surgery. METHOD: A retrospective cohort study was performed in all patients less than 18 years of age who received an AED in the cardiovascular intensive care unit at Texas Children's Hospital from June 2002 until June 2012...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Sarah Aminoff Kelley, Eric Heath Kossoff
Electrical status epilepticus of sleep (ESES), with the activation of profuse amounts of epileptiform discharges in sleep, may lead to intractable epilepsy and neurocognitive decline in children. Numerous varied treatments including antiseizure medications, steroids, and surgery have been investigated as possible treatment options. The ketogenic diet (KD) is an additional treatment option which may add to our treatment armamentarium for ESES. The KD may theoretically improve ESES by affecting GABA systems and reducing inflammation...
September 23, 2016: Epilepsy Research
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