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Alejandro Granados, Vejay Vakharia, Roman Rodionov, Martin Schweiger, Sjoerd B Vos, Aidan G O'Keeffe, Kuo Li, Chengyuan Wu, Anna Miserocchi, Andrew W McEvoy, Matthew J Clarkson, John S Duncan, Rachel Sparks, Sébastien Ourselin
PURPOSE: The accurate and automatic localisation of SEEG electrodes is crucial for determining the location of epileptic seizure onset. We propose an algorithm for the automatic segmentation of electrode bolts and contacts that accounts for electrode bending in relation to regional brain anatomy. METHODS: Co-registered post-implantation CT, pre-implantation MRI, and brain parcellation images are used to create regions of interest to automatically segment bolts and contacts...
May 7, 2018: International Journal of Computer Assisted Radiology and Surgery
Hussam Abou-Al-Shaar, Andrea A Brock, Bornali Kundu, Dario J Englot, John D Rolston
Intracranial electroencephalography (iEEG) can be performed using minimally invasive stereo-electroencephalography (SEEG) or by implanting subdural electrodes via a craniotomy or multiple burr holes. There is anecdotal evidence that SEEG is becoming more common in the United States, though this has yet to be quantified. To address this question, all SEEG and burr hole/craniotomy subdural iEEG procedures were extracted from the Centers for Medicare and Medicaid Services Part B data files for the years 2000-2016...
April 30, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Xiu Wang, Wenhan Hu, Kai Zhang, Xiaoqiu Shao, Yanshan Ma, Lin Sang, Zhong Zheng, Chao Zhang, Junjv Li, Jian-Guo Zhang
Purpose: Hypermotor seizures (HMS) can be triggered by different epileptogenic foci and thus common symptomatic networks generating HMS may exist among these patients. The goal of the present study was to investigate the specialized networks underlying HMS by analyzing interictal 18 FDG-PET imaging and ictal stereo-electroencephalography (SEEG) recordings. Methods: Fourteen patients with HMS were retrospectively analyzed. HMS were classified into HMS1 and HMS2 according to the speed and intensity of the motor seizure behavior...
2018: Frontiers in Neurology
C W Xu, W J Zhou, J J Bai, B Q Zhang, H X Wang, J Ruan, J Li, J L Lin, Y Q Zhang
Objective: To investigate the clinical value of stereo-electroencephalography guided radiofrequency thermos-coagulation (RFTC) in drug resistant temporal epilepsy. Methods: The clinical data of 12 patients with refractory temporal epilepsy who underwent implantation of SEEG electrodes and radiofrequency thermos-coagulation from July 2016 to November 2017 were analysed retrospectively. Results: The mean follow-up time was 6.4±4.6 months after thermos-coagulation, and 10.2±3.5 months after resection. Engel Ⅰa was observed in 9 cases, with Ⅱa, Ⅲa and Ⅳa 1 cases respectively...
April 3, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Stephan Meesters, Pauly Ossenblok, Albert Colon, Louis Wagner, Olaf Schijns, Paul Boon, Luc Florack, Andrea Fuster
OBJECTIVE: The interictal epileptic discharges (IEDs) occurring in stereotactic EEG (SEEG) recordings are in general abundant compared to ictal discharges, but difficult to interpret due to complex underlying network interactions. A framework is developed to model these network interactions. METHODS: To identify the synchronized neuronal activity underlying the IEDs, the variation in correlation over time of the SEEG signals is related to the occurrence of IEDs using the general linear model...
April 11, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Taylor J Abel, René Varela Osorio, Ricardo Amorim-Leite, Francois Mathieu, Philippe Kahane, Lorella Minotti, Dominique Hoffmann, Stephan Chabardes
OBJECTIVE Robot-assisted stereoelectroencephalography (SEEG) is gaining popularity as a technique for localization of the epileptogenic zone (EZ) in children with pharmacoresistant epilepsy. Here, the authors describe their frameless robot-assisted SEEG technique and report preliminary outcomes and relative complications in children as compared to results with the Talairach frame-based SEEG technique. METHODS The authors retrospectively analyzed the results of 19 robot-assisted SEEG electrode implantations in 17 consecutive children (age < 17 years) with pharmacoresistant epilepsy, and compared these results to 19 preceding SEEG electrode implantations in 18 children who underwent the traditional Talairach frame-based SEEG electrode implantation...
April 20, 2018: Journal of Neurosurgery. Pediatrics
Vejay N Vakharia, Rachel Sparks, Roman Rodionov, Sjoerd B Vos, Christian Dorfer, Jonathan Miller, Daniel Nilsson, Martin Tisdall, Stefan Wolfsberger, Andrew W McEvoy, Anna Miserocchi, Gavin P Winston, Aidan G O'Keeffe, Sebastien Ourselin, John S Duncan
OBJECTIVE One-third of cases of focal epilepsy are drug refractory, and surgery might provide a cure. Seizure-free outcome after surgery depends on the correct identification and resection of the epileptogenic zone. In patients with no visible abnormality on MRI, or in cases in which presurgical evaluation yields discordant data, invasive stereoelectroencephalography (SEEG) recordings might be necessary. SEEG is a procedure in which multiple electrodes are placed stereotactically in key targets within the brain to record interictal and ictal electrophysiological activity...
April 13, 2018: Journal of Neurosurgery
Timothy Hutson, Diana Pizarro, Sandipan Pati, Leon D Iasemidis
In this case study, we present evidence of resetting of brain dynamics following convulsive status epilepticus (SE) that was treated successfully with antiepileptic medications (AEDs). The measure of effective inflow (EI), a novel measure of network connectivity, was applied to the continuously recorded multichannel intracranial stereoelectroencephalographic (SEEG) signals before, during and after SE. Results from this analysis indicate trends of progressive reduction of EI over hours up to the onset of SE, mainly at sites of the epileptogenic focus with reversal of those trends upon successful treatment of SE by AEDs...
2018: Frontiers in Neurology
Marcos Quevedo-Diaz, Adrià Tauste Campo, Manel Vila-Vidal, Alessandro Principe, Miguel Ley, Rodrigo Rocamora
We report a patient presenting drug-resistant, non-dominant temporal lobe epilepsy with ictal spitting and prosopometamorphopsia, both extremely rare semiologies. Second-phase pre-surgical monitoring was performed using SEEG due to lesion-negative imaging and the rare semiology. The seizure onset zone was delimited to the right anterior hippocampus and the temporobasal cortex, with the propagation zone within the entorhinal cortex. Interestingly, direct electrical stimulation to the entorhinal cortex, which was reproduced in a number of trials, evoked spitting without leading to seizures or post-discharges...
April 5, 2018: Epileptic Disorders: International Epilepsy Journal with Videotape
Peng-Hu Wei, Yang An, Xiao-Tong Fan, Yi-He Wang, Yan-Feng Yang, Lian-Kun Ren, Yong-Zhi Shan, Guo-Guang Zhao
BACKGROUND: The use of magnetic resonance imaging (MRI)-guided ablation methods, such as laser interstitial thermal therapy and MRI-guided radiofrequency thermocoagulation (RF-TC), poses a risk of mistreatment in patients with nonepileptic hypothalamic hamartoma (HH). Using stereoelectroencephalography (SEEG)-guided RF-TC could solve this problem; however, there are no reports on the efficacy of this technique. Thus, we examined the safety and efficacy of this method. METHODS: This retrospective study was conducted in 9 consecutive patients with HH treated between August 2015 and July 2017...
March 30, 2018: World Neurosurgery
S Medina Villalon, R Paz, N Roehri, S Lagarde, F Pizzo, B Colombet, F Bartolomei, R Carron, C-G Bénar
BACKGROUND: In pharmacoresistant epilepsy, exploration with depth electrodes can be needed to precisely define the epileptogenic zone. Accurate location of these electrodes is thus essential for the interpretation of Stereotaxic EEG (SEEG) signals. As SEEG analysis increasingly relies on signal processing, it is crucial to make a link between these results and patient's anatomy. Our aims were thus to develop a suite of software tools, called "EpiTools", able to i) precisely and automatically localize the position of each SEEG contact and ii) display the results of signal analysis in each patient's anatomy...
March 29, 2018: Journal of Neuroscience Methods
Chuanzuo Yang, Guoming Luan, Qian Wang, Zhao Liu, Feng Zhai, Qingyun Wang
Patients with focal drug-resistant epilepsy are potential candidates for surgery. Stereo-electroencephalograph (SEEG) is often considered as the "gold standard" to identify the epileptogenic zone (EZ) that accounts for the onset and propagation of epileptiform discharges. However, visual analysis of SEEG still prevails in clinical practice. In addition, epilepsy is increasingly understood to be the result of network disorder, but the specific organization of the epileptic network is still unclear...
2018: Frontiers in Neurology
Lucia Rita Quitadamo, Roberto Mai, Francesca Gozzo, Veronica Pelliccia, Francesco Cardinale, Stefano Seri
Pathological High-Frequency Oscillations (HFOs) have been recently proposed as potential biomarker of the seizure onset zone (SOZ) and have shown superior accuracy to interictal epileptiform discharges in delineating its anatomical boundaries. Characterization of HFOs is still in its infancy and this is reflected in the heterogeneity of analysis and reporting methods across studies and in clinical practice. The clinical approach to HFOs identification and quantification usually still relies on visual inspection of EEG data...
January 15, 2018: International Journal of Neural Systems
Pratik Y Chhatbar, Steven A Kautz, Istvan Takacs, Nathan C Rowland, Gonzalo J Revuelta, Mark S George, Marom Bikson, Wuwei Feng
BACKGROUND: Transcranial direct current stimulation (tDCS) is a promising brain modulation technique for several disease conditions. With this technique, some portion of the current penetrates through the scalp to the cortex and modulates cortical excitability, but a recent human cadaver study questions the amount. This insufficient intracerebral penetration of currents may partially explain the inconsistent and mixed results in tDCS studies to date. Experimental validation of a transcranial alternating current stimulation-generated electric field (EF) in vivo has been performed on the cortical (using electrocorticography, ECoG, electrodes), subcortical (using stereo electroencephalography, SEEG, electrodes) and deeper thalamic/subthalamic levels (using DBS electrodes)...
March 13, 2018: Brain Stimulation
Nan Zhang, Bingqing Zhang, Gary B Rajah, Xiaokun Geng, Rasanjeet Singh, Yanfeng Yang, Xiupeng Yan, Zhe Li, Wenjing Zhou, Yuchuan Ding, Wei Sun
Objective The aim of the study was to evaluate the parameters for localizing the seizure onset zone in refractory epilepsy patients using cortico-cortical evoked potentials (CCEP). Methods Fifteen patients (nine females) with medically refractory partial epilepsy underwent stereo electro encephalography (SEEG) in Tsinghua University Yu-Quan Hospital from 2015 to 2016. Clinical semiology and, scalp electroencephalography (EEG) findings were analyzed during phase I preoperative evaluation. During phase II evaluation, localization of seizure onset zone (SOZ) was analyzed using SEEG by experienced epileptologists...
March 24, 2018: Neurological Research
Louis Ross, Ahsan M Naduvil, Juan C Bulacio, Imad M Najm, Jorge A Gonzalez-Martinez
BACKGROUND: Laser ablation surgery has had encouraging results in the treatment of multiple intracranial diseases including primary and metastatic brain tumors, radiation necrosis, and epilepsy. The use of the stereoelectroencephalography (SEEG) method in combination with laser thermocoagulation therapy with the goal of modulating epileptic networks in patients with neocortical nonlesional phamacoresistant epilepsy has not been previously described. OBJECTIVE: To describe the novel methodological and conceptual aspects related to SEEG-guided laser ablations in patients with magnetic resonance imaging (MRI)-negative pharmacoresistant neocortical focal epilepsy...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
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...
April 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)...
June 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...
June 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
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