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https://www.readbyqxmd.com/read/27923529/total-corpus-callosotomy-for-epileptic-spasms-after-acute-encephalopathy-with-biphasic-seizures-and-late-reduced-diffusion-aesd-in-a-case-with-tuberous-sclerosis-complex
#1
Tohru Okanishi, Ayataka Fujimoto, Hirotaka Motoi, Sotaro Kanai, Mitsuyo Nishimura, Tomohiro Yamazoe, Atsushi Takagi, Takamichi Yamamoto, Hideo Enoki
Corpus callosotomy is a palliative therapy for refractory epilepsy, including West syndrome, without a resectable epileptic focus. The surgical outcome of corpus callosotomy is relatively favorable in cryptogenic (non-lesional) West syndrome. Tuberous sclerosis complex (TSC) is a disorder that frequently leads to the development of refractory seizures by multiple cortical tubers. The multiple cortical tubers cause multiple or wide epileptic networks in these cases. Most of West syndrome cases in TSC with multiple tubers need additional resective surgery after corpus callosotomy...
December 3, 2016: Brain & Development
https://www.readbyqxmd.com/read/27920283/what-can-we-do-for-people-with-drug-resistant-epilepsy-the-2016-wartenberg-lecture
#2
Jerome Engel
Treatment goals for epilepsy are no seizures, no side effects, as soon as possible, but these goals are too often unmet. Approximately 1 million people in the United States continue to have seizures despite adequate treatment with antiseizure drugs, representing 40% of those with epilepsy, and 80% of the cost of epilepsy. Drug-resistant epilepsy (DRE) can be associated with developmental delay in infants and young children, and severe disability and morbidity in older children and adults, as well as a mortality rate 5-10 times that of the general population...
December 6, 2016: Neurology
https://www.readbyqxmd.com/read/27920021/venous-and-arterial-air-embolism-a-rare-phenomenon-with-fatal-consequences
#3
Jatan Shah, Nasheena Jiwa, Natasha Mamdani, David Hill
Air embolism is often an iatrogenic complication which may occur in venous or arterial circulation depending on the port of entry. We present two cases in which air embolism occurred in venous and arterial circulation after contrast medium injection (CMI) and coronary artery bypass graft (CABG) surgery, respectively. In one case, accumulation of air bubbles was observed in the pulmonary artery after CMI. This was attributed to inadvertent injection of air owing to improper connection of the injector and the catheter...
December 5, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27919270/delayed-hyperbaric-oxygen-therapy-for-air-emboli-after-open-heart-surgery-case-report-and-review-of-a-success-story
#4
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27918961/the-promise-of-subtraction-ictal-spect-co-registered-to-mri-for-improved-seizure-localization-in-pediatric-epilepsies-affecting-factors-and-relationship-to-the-surgical-outcome
#5
Catherine Stamoulis, Nishant Verma, Himanshu Kaulas, Jonathan J Halford, Frank H Duffy, Phillip L Pearl, S Ted Treves
OBJECTIVE: Ictal SPECT is promising for accurate non-invasive localization of the epileptogenic brain tissue in focal epilepsies. However, high quality ictal scans require meticulous attention to the seizure onset. In a relatively large cohort of pediatric patients, this study investigated the impact of the timing of radiotracer injection, MRI findings and seizure characteristics on ictal SPECT localizations, and the relationship between concordance of ictal SPECT, scalp EEG and resected area with seizure freedom following epilepsy surgery...
November 30, 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27918346/electrical-stimulation-for-seizure-induction-and-functional-mapping-in-stereoelectroencephalography
#6
Agnès Trébuchon, Patrick Chauvel
The challenge in epilepsy surgery is to remove the epileptogenic zone without compromising postoperative function. Electrical stimulation (ES) was developed to identify with greater anatomical and physiological precision cortical structures essential to language and motor function. Because the language network is widely distributed in the left (dominant) hemisphere, and often varies among patients, brain mapping should delineate eloquent areas at the individual level. Although ES for language is commonly performed during a presurgical investigation, the procedure remains nonstandardized among centers, and differences between grids and intracerebral depth electrodes (stereoelectroencephalography) should be taken into account when comparing results from different series...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27917700/posterior-reversible-encephalopathy-syndrome-following-elevated-mean-arterial-pressures-for-cervical-spinal-cord-injury
#7
Jeffrey H Zimering, Addisu Mesfin
BACKGROUND: Increasing the mean arterial pressure (MAP) is an accepted treatment modality to minimize the risk for irreversible neurologic damage secondary to spinal cord ischemia. Posterior reversible encephalopathy syndrome (PRES) is a rare complication occurring after transplantation surgery, in persons having an autoimmune disorder or after abrupt increases in blood pressure of various etiologies. STUDY DESIGN: Case report. METHODS: Retrospective evaluation of medical records...
December 5, 2016: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/27916450/dramatic-response-after-functional-hemispherectomy-in-a-patient-with-epileptic-encephalopathy-carrying-a-de-novo-col4a1-mutation
#8
Naomi Hino-Fukuyo, Atsuo Kikuchi, Masaki Iwasaki, Yuko Sato, Yuki Kubota, Tomoko Kobayashi, Tojo Nakayama, Kazuhiro Haginoya, Natsuko Arai-Ichinoi, Tetsuya Niihori, Ryo Sato, Tasuku Suzuki, Hiroki Kudo, Ryo Funayama, Keiko Nakayama, Yoko Aoki, Shigeo Kure
We describe the first case of a successful functional hemispherectomy in a patient with epileptic encephalopathy and a de novo collagen type IV alpha 1 (COL4A1) mutation. A 4-year-old girl was COL4A1 mutation-positive and suffered from drug-resistant epilepsy, hemiplegia, and developmental delay. Magnetic resonance imaging detected no porencephaly, and she had no cataract or renal abnormality. Following a presurgical evaluation for epilepsy, she underwent a functional hemispherectomy. She has been seizure free with no intracranial hemorrhage or other perioperative complications...
December 1, 2016: Brain & Development
https://www.readbyqxmd.com/read/27915489/drug-resistant-epilepsy-in-children-with-partial-onset-epilepsy-treated-with-carbamazepine
#9
Gewalin Aungaroon, Katherine D Holland, Paul S Horn, Shannon M Standridge, Christina Mackell Imming
: Drug-resistant epilepsy in children with partial onset epilepsy treated with carbamazepine Objective: To evaluate the outcome, including drug-resistant epilepsy in children with newly diagnosed partial onset epilepsy treated with carbamazepine (CBZ). METHODS: A retrospective medical records review and telephone questionnaire was undertaken on a total of 100 subjects. RESULTS: Long-term follow up was obtained on 79 children with a mean duration of 7...
December 4, 2016: International Journal of Neuroscience
https://www.readbyqxmd.com/read/27913320/the-concept-of-effective-inflow-application-to-interictal-localization-of-the-epileptogenic-focus-from-ieeg
#10
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/27913266/cost-utility-of-video-electroencephalography-monitoring-followed-by-surgery-in-adults-with-drug-resistant-focal-epilepsy-in-thailand
#11
Pimprapa Kitwitee, Kanjana Unnwongse, Teeradej Srikijvilaikul, Tinonkorn Yadee, Chulaporn Limwattananon
OBJECTIVES: This study assessed, whether video-electroencephalography (VEEG) monitoring followed by surgery was cost-effective in adult patients with drug-resistant focal epilepsy under Thai healthcare context, as compared to continued medical treatment without VEEG. METHODS: Total cost (in Thai Baht, THB) and effectiveness (in quality-adjusted life years, QALYs) were estimated over a lifetime horizon, using a decision tree and a Markov model. Data on short-term surgical outcomes, direct health care costs, and utilities, were collected from Thai patients in a specialized hospital...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27912169/non-harmonicity-in-high-frequency-components-of-the-intra-operative-corticogram-to-delineate-epileptogenic-tissue-during-surgery
#12
Evelien E Geertsema, Maryse A van 't Klooster, Nicole E C van Klink, Frans S S Leijten, Peter C van Rijen, Gerhard H Visser, Stiliyan N Kalitzin, Maeike Zijlmans
OBJECTIVE: We aimed to test the potential of auto-regressive model residual modulation (ARRm), an artefact-insensitive method based on non-harmonicity of the high-frequency signal, to identify epileptogenic tissue during surgery. METHODS: Intra-operative electrocorticography (ECoG) of 54 patients with refractory focal epilepsy were recorded pre- and post-resection at 2048Hz. The ARRm was calculated in one-minute epochs in which high-frequency oscillations (HFOs; fast ripples, 250-500Hz; ripples, 80-250Hz) and spikes were marked...
November 17, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27912111/can-ictal-meg-obviate-the-need-for-phase-ii-monitoring-in-people-with-drug-refractory-epilepsy-a-prospective-observational-study
#13
Bhargavi Ramanujam, Kamal Bharti, Vibhin Viswanathan, Ajay Garg, Madhavi Tripathi, Chandrashekhar Bal, P Sarat Chandra, Manjari Tripathi
PURPOSE: To determine if ictal-magnetoencephalography (ictal-MEG) source localization (SL) added information towards delineating the ictal-onset zone (IOZ), whether and how it helped final decision-making in epilepsy-surgery. METHODS: Definite focal clusters on ictal-MEG were available for 32 DRE-patients, data was analyzed (single equivalent current dipole (ECD) model), SL done. Clinical history, long-term video-EEG (VEEG) monitoring, epilepsy-protocol MRI, FDG-PET, ictal-SPECT and interictal-MEG were discussed at the multispeciality Epilepsy Surgery Case-conference (ESC)...
October 31, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27908322/-traumatic-bilateral-posterior-shoulder-dislocation-after-a-seizure
#14
Mazaher Azizpour, Peter Anton Suder, Rebekka Fonnesbæk
We report a rare case in which a 52-year-old man was found lying on the floor of a sauna. He was confused and complained of pain in both shoulders. He had previously had surgery of a benign meningioma. The initial X-ray examination of both shoulders showed bilateral posterior shoulder dislocation, but no fractures were detected. An attempt to reposition the shoulder dislocation was performed but with no success. Intraoperative examination on the next day detected bilateral fractures with partially destroyed joint head...
November 28, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27907826/extent-of-mossy-fiber-sprouting-in-patients-with-mesiotemporal-lobe-epilepsy-correlates-with-neuronal-cell-loss-and-granule-cell-dispersion
#15
Barbara Schmeiser, Josef Zentner, Marco Prinz, Armin Brandt, Thomas M Freiman
OBJECTIVE: The most frequent finding in temporal lobe epilepsy is hippocampal sclerosis, characterized by selective cell loss of hippocampal subregions CA1 and CA4 as well as mossy fiber sprouting (MFS) towards the supragranular region and granule cell dispersion. Although selective cell loss is well described, its impact on mossy fiber sprouting and granule cell dispersion remains unclear. MATERIALS AND METHODS: In a single center series, we examined 319 human hippocampal specimens, collected in a 15-years period...
November 22, 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27906933/anterior-cingulotomy-for-the-treatment-of-chronic-intractable-pain-a-systematic-review
#16
Justin Sharim, Nader Pouratian
BACKGROUND: Anterior cingulotomy for chronic pain aims to modulate patients' attention or emotional reaction to pain rather than to modulate pain intensity. OBJECTIVES: To evaluate the clinical efficacy, both short- and long-term, of anterior cingulotomy in the treatment of chronic pain. STUDY DESIGN: Systematic review. SETTING: This systematic review assessed studies reporting anterior cingulotomy for the treatment of chronic pain...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27905093/magnetic-resonance-imaging-guided-laser-interstitial-thermal-therapy-for-treatment-of-drug-resistant-epilepsy
#17
Joon Y Kang, Michael R Sperling
Surgery is the most effective treatment for drug-resistant epilepsy. Long-term studies demonstrate that about 60% to 80% of patients become seizure-free after anterior temporal lobectomy and a majority of patients (about 95%) report significant seizure reduction after surgery. In the last few years, there has been significant advances in minimally invasive surgical techniques to treat drug-resistant epilepsy. These minimally invasive procedures have significant advantages over open surgery in that they produce less immediate discomfort and disability, while allowing for greater preservation of functional tissue...
November 30, 2016: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/27903764/epilepsy-and-music-practical-notes
#18
REVIEW
M Maguire
Music processing occurs via a complex network of activity far beyond the auditory cortices. This network may become sensitised to music or may be recruited as part of a temporal lobe seizure, manifesting as either musicogenic epilepsy or ictal musical phenomena. The idea that sound waves may directly affect brain waves has led researchers to explore music as therapy for epilepsy. There is limited and low quality evidence of an antiepileptic effect with the Mozart Sonata K.448. We do not have a pathophysiological explanation for the apparent dichotomous effect of music on seizures...
November 30, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27898361/movement-symptoms-in-european-moyamoya-angiopathy-first-systematic-questionnaire-study
#19
Markus Kraemer, Leonidas Trakolis, Jens Platzen, Jan Claudius Schwitalla, Anna Bersano, Philipp Albrecht, Marc Schlamann, Peter Berlit
OBJECTIVE: Movement disorders are a rare manifestation of Moyamoya angiopathy (MMA). Data on prevalence and clinical presentation are warranted. Possible involuntary movements include focal motor seizures, tremor, limb-shaking transient ischemic attacks, choreiform and spastic or dystonic movement disorders. PATIENTS AND METHODS: We developed a questionnaire to systematically assess movement disorders in MMA. Patients' history of involuntary movements and their clinical presentation were assessed systematically by interview...
November 23, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27897304/-the-role-of-diffusion-tensor-imaging-in-the-pre-surgical-study-of-temporal-lobe-epilepsy
#20
M A Garcia-Pallero, C V Torres, R Manzanares-Soler, E Camara, R G Sola
INTRODUCTION: Diffusion tensor imaging (DTI) is a non-invasive technique that can be used to assess the integrity of the white matter in the brain. AIMS: To investigate the usefulness of DTI in patients with temporal lobe epilepsy (TLE) and to observe its relationship with lateralisation of the epileptogenic focus in these patients. PATIENTS AND METHODS: We analysed 11 patients diagnosed with TLE in accordance with the pre-surgical protocol of our epilepsy unit, and who were seizure-free two years after performing a temporal lobectomy plus amygdalohippocampectomy (Spencer technique)...
December 16, 2016: Revista de Neurologia
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