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Lisa Vaugier, Stanislas Lagarde, Aileen McGonigal, Agnès Trébuchon, Mathieu Milh, Anne Lépine, Didier Scavarda, Romain Carron, Fabrice Bartolomei
Management of patients after initial epilepsy surgical failure is challenging. In this study, we report our experience in using the stereoelectroencephalography (SEEG) method in the reevaluation of patients after initial epilepsy surgical failure. We selected 28 patients examined through SEEG in our department for drug-resistant focal epilepsy following initial epilepsy surgical failure. For each patient, the residual seizure onset zone (rSOZ) as defined by SEEG was classified as either contiguous if the seizure onset zone (SOZ) was focal and close to the surgical cavity (same lobe) or noncontiguous in cases where the SOZ included site(s) distant from the surgical cavity...
March 8, 2018: Epilepsy & Behavior: E&B
C Cuello-Oderiz, N von Ellenrieder, R Sankhe, A Olivier, J Hall, F Dubeau, J Gotman
OBJECTIVES: There are different neurophysiological markers of the Epileptogenic Zone (EZ), but their sensitivity and specificity for the EZ is not known in Focal Cortical Dysplasia (FCD) patients. METHODS: We studied patients with FCD who underwent stereoelectroencephalography (SEEG) and surgery. We marked in the SEEG: (a) typical and atypical interictal epileptiform patterns, (b) ictal onset patterns, and (c) rates of ripples (80-250 Hz) and fast ripples (FRs) (>250 Hz)...
February 22, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Anna Witkowska-Wrobel, Kirill Aristovich, Mayo Faulkner, James Avery, David Holder
Imaging ictal and interictal activity with Electrical Impedance Tomography (EIT) using intracranial electrode mats has been demonstrated in animal models of epilepsy. In human epilepsy subjects undergoing presurgical evaluation, depth electrodes are often preferred. The purpose of this work was to evaluate the feasibility of using EIT to localise epileptogenic areas with intracranial electrodes in humans. The accuracy of localisation of the ictal onset zone was evaluated in computer simulations using 9M element FEM models derived from three subjects...
February 27, 2018: NeuroImage
Jeffrey W Britton
The practice of stereo-EEG (SEEG) is expanding. Electrical stimulation mapping remains an important part of the surgical evaluation process in SEEG, as it is in subdural electrocorticography cases. Because the technique and electrodes used in SEEG and electrocorticography are distinct, the clinician needs to be aware of the important differences between these techniques when performing electrical stimulation mapping. In this review, the advantages, disadvantages, and potential safety concerns related to electrical stimulation mapping in SEEG are discussed...
March 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Bruno Rossion, Corentin Jacques, Jacques Jonas
The neural basis of face categorization has been widely investigated with functional magnetic resonance imaging (fMRI), identifying a set of face-selective local regions in the ventral occipitotemporal cortex (VOTC). However, indirect recording of neural activity with fMRI is associated with large fluctuations of signal across regions, often underestimating face-selective responses in the anterior VOTC. While direct recording of neural activity with subdural grids of electrodes (electrocorticography, ECoG) or depth electrodes (stereotactic electroencephalography, SEEG) offers a unique opportunity to fill this gap in knowledge, these studies rather reveal widely distributed face-selective responses...
February 26, 2018: Annals of the New York Academy of Sciences
Michael D Staudt, Sarita Maturu, Jonathan P Miller
BACKGROUND: Radiofrequency thermocoagulation of epileptogenic foci via stereoelectroencephalography (SEEG) electrodes has been suggested as a treatment for medically intractable epilepsy, but reported outcomes have been suboptimal, possibly because lesions generated using conventional high-energy radiofrequency parameters are relatively small. OBJECTIVE: To describe a technique of delivering low energy across separate SEEG electrodes in order to create large confluent radiofrequency lesions...
February 16, 2018: Operative Neurosurgery (Hagerstown, Md.)
Nicholas Brandmeir, Michael Sather
PURPOSE: One of the most effective treatments for epilepsy is resection, but it remains underutilized. Efforts must be made to increase the ease, safety, and efficacy of epilepsy resection to improve utilization. Studies have shown an improved risk profile of stereoelectroencephalography (SEEG) over subdural grids (SDG) for invasive monitoring. One limitation to increased adoption of SEEG at epilepsy centers is the theoretical difficulty of planning a delayed resection once electrodes are removed...
February 20, 2018: British Journal of Neurosurgery
Dario J Englot
Epilepsy surgery has seen numerous technological advances in both diagnostic and therapeutic procedures in recent years. This has increased the number of patients who may be candidates for intervention and potential improvement in quality of life. However, the expansion of the field also necessitates a broader understanding of how to incorporate both traditional and emerging technologies into the care provided at comprehensive epilepsy centers. This review summarizes both old and new surgical procedures in epilepsy using an example algorithm...
February 1, 2018: Epilepsy & Behavior: E&B
Brett E Youngerman, Justin Y Oh, Deepti Anbarasan, Santoshi Billakota, Camilla H Casadei, Emily K Corrigan, Garret P Banks, Alison M Pack, Hyunmi Choi, Carl W Bazil, Shraddha Srinivasan, Lisa M Bateman, Catherine A Schevon, Neil A Feldstein, Sameer A Sheth, Guy M McKhann
OBJECTIVE: Selective laser amygdalohippocampotomy (SLAH) using magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is emerging as a treatment option for drug-resistant mesial temporal lobe epilepsy (MTLE). SLAH is less invasive than open resection, but there are limited series reporting its safety and efficacy, particularly in patients without clear evidence of mesial temporal sclerosis (MTS). METHODS: We report seizure outcomes and complications in our first 30 patients who underwent SLAH for drug-resistant MTLE between January 2013 and December 2016...
February 2, 2018: Epilepsia
Jerome Aupy, Ika Noviawaty, Balu Krishnan, Piradee Suwankpakdee, Juan Bulacio, Jorge Gonzalez-Martinez, Imad Najm, Patrick Chauvel
OBJECTIVE: Oroalimentary automatisms (OAAs) resembling normal alimentary behavior are stereotyped complex movements that may occur during epileptic seizures. They are considered common clinical signs in temporal lobe seizures, but their anatomofunctional mechanisms are not established. We took the opportunity of presurgical intracerebral recordings to study the relations between the occurrence of OAAs and temporal/spatial features of ictal activities. METHODS: We retrospectively reviewed patients with medically intractable medial temporal lobe epilepsy who underwent stereoelectroencephalography (SEEG) at Cleveland Clinic between 2009 and 2016...
February 2, 2018: Epilepsia
Viateur Tuyisenge, Lena Trebaul, Manik Bhattacharjee, Blandine Chanteloup-Forêt, Carole Saubat-Guigui, Ioana Mîndruţă, Sylvain Rheims, Louis Maillard, Philippe Kahane, Delphine Taussig, Olivier David
OBJECTIVE: Intracranial electroencephalographic (iEEG) recordings contain "bad channels", which show non-neuronal signals. Here, we developed a new method that automatically detects iEEG bad channels using machine learning of seven signal features. METHODS: The features quantified signals' variance, spatial-temporal correlation and nonlinear properties. Because the number of bad channels is usually much lower than the number of good channels, we implemented an ensemble bagging classifier known to be optimal in terms of stability and predictive accuracy for datasets with imbalanced class distributions...
December 24, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Lorella Minotti, Alexandra Montavont, Julia Scholly, Louise Tyvaert, Delphine Taussig
Epilepsy surgery is now an accepted treatment to achieve seizure control in carefully selected patients, both children and adults, suffering from drug-resistant focal epilepsy. Although surgical strategies can often be defined on the basis of non-invasive diagnostic procedures, and despite the recent advances in this field, an increasing number of more complex cases requires invasive EEG (iEEG) to provide precise information on the localization of the epileptogenic zone (EZ), its relationships with eloquent cortex (EC), and the feasibility of a tailored surgical resection...
February 2018: Neurophysiologie Clinique, Clinical Neurophysiology
Hélène Catenoix, Pierre Bourdillon, Marc Guénot, Jean Isnard
SEEG-guided radiofrequency thermocoagulation (SEEG-guided RFTC), a combination of Stereo-electroencephalography (SEEG) and radiofrequency thermocoagulation (RFTC), has been performed since 2001 in drug resistant epilepsy. The interest of this procedure is to aim at total or partial destruction of the epileptogenic zone, as tailored in each individual patient by the SEEG exploration. These multiple SEEG-guided RFTC lesions of epileptic foci are produced by using a radiofrequency generator connected to the electrode contacts...
January 9, 2018: Epilepsy Research
Andrea Spyrantis, Adriano Cattani, Adam Strzelczyk, Felix Rosenow, Volker Seifert, Thomas M Freiman
OBJECTIVE: Recent studies with robot-guided stereotaxy use computed tomography (CT) scans for referencing. We will provide evidence that using preoperative MRI datasets referenced with a laser scan of the patient's face is sufficient for sEEG implantation. METHODS: In total, 40 sEEG electrodes were implanted in five patients by the robotic surgical assistant (ROSA). The postoperative CT scan for identifying electrode positions was fused with the preoperative MRI-based planning data...
January 8, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Patrick Chauvel, Sylvain Rheims, Aileen McGonigal, Philippe Kahane
No abstract text is available yet for this article.
December 27, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
Fabrice Bartolomei, Anca Nica, Maria Paola Valenti-Hirsch, Claude Adam, Marie Denuelle
The interpretation of SEEG recordings is a crucial step. It must be carried out by an epileptologist/neurophysiologist with sufficient training and qualification in this field. The objectives of the interpretation are to define the brain topography of interictal activities (irritative zone) and the epileptogenic zone, defined as the site of primary organization of ictal discharges. Several patterns of seizure onset are possible, the most typical including fast discharges. The interpretation of the SEEG is based on the recording of spontaneous activity but also on the results of intracerebral electrical stimulation...
December 27, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
Jean Isnard, Delphine Taussig, Fabrice Bartolomei, Pierre Bourdillon, Hélène Catenoix, Francine Chassoux, Mathilde Chipaux, Stéphane Clémenceau, Sophie Colnat-Coulbois, Marie Denuelle, Stéphane Derrey, Bertrand Devaux, Georg Dorfmüller, Vianney Gilard, Marc Guenot, Anne-Sophie Job-Chapron, Elisabeth Landré, Axel Lebas, Louis Maillard, Aileen McGonigal, Lorella Minotti, Alexandra Montavont, Vincent Navarro, Anca Nica, Nicolas Reyns, Julia Scholly, Jean-Christophe Sol, William Szurhaj, Agnès Trebuchon, Louise Tyvaert, Maria Paola Valenti-Hirsch, Luc Valton, Jean-Pierre Vignal, Paul Sauleau
Stereoelectroencephalography (SEEG) was designed and developed in the 1960s in France by J. Talairach and J. Bancaud. It is an invasive method of exploration for drug-resistant focal epilepsies, offering the advantage of a tridimensional and temporally precise study of the epileptic discharge. It allows anatomo-electrical correlations and tailored surgeries. Whereas this method has been used for decades by experts in a limited number of European centers, the last ten years have seen increasing worldwide spread of its use...
December 22, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
Marc Guénot, Axel Lebas, Bertrand Devaux, Sophie Colnat-Coulbois, Georg Dorfmuller, Aileen McGonigal, Nicolas Reyns, Vianney Gilard, Stéphane Derrey, Jean-Christophe Sol, Stéphane Clémenceau
In SEEG, as for any surgical procedure, the benefit/risk ratio is a key-point. This implies rigorous clinical practice in terms of indication, information delivered to the patient, and surgical technique. Numerous technical options may be used to achieve this goal. All are valuable, as long as they are executed with rigor and consistency. Intracranial bleeding represents the main risk of the procedure (1-4% of cases). The procedure also carries a risk of infection (0.8%), death (total of 6 reported cases in all the literature, <0...
December 19, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
Pierre Bourdillon, Bertrand Devaux, Anne-Sophie Job-Chapron, Jean Isnard
We propose expert recommendations on the use of SEEG-guided radiofrequency thermocoagulation (RF-TC) based on an exhaustive literature review. This technique consists in performing a RF-TC lesion using a SEEG depth electrode at the end of the recording. It is indicated when conventional surgical resection of the ictal onset zone is not possible. SEEG guided RF-TC can also be considered as a diagnostic tool since an improvement, even limited, has a high positive predictive value concerning the good outcome after surgery...
December 19, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
Nicolas Roehri, Francesca Pizzo, Stanislas Lagarde, Isabelle Lambert, Anca Nica, Aileen McGonigal, Bernard Giusiano, Fabrice Bartolomei, Christian-George Bénar
OBJECTIVE: High-frequency oscillations (HFOs) in intracerebral EEG (stereoelectroencephalography, SEEG) are considered as better biomarkers of epileptogenic tissues than spikes. How this can be applied at the patient level remains poorly understood. We investigated how well the HFOs and the spikes can predict epileptogenic regions with a large spatial sampling at the patient level. METHODS: We analyzed non-REM sleep SEEG recordings sampled at 2,048Hz of thirty patients...
December 15, 2017: Annals of Neurology
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