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temporal focal intractable seizures

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https://www.readbyqxmd.com/read/29026310/laser-interstitial-thermal-therapy-for-the-treatment-of-epilepsy-evidence-to-date
#1
REVIEW
Navika D Shukla, Allen L Ho, Arjun V Pendharkar, Eric S Sussman, Casey H Halpern
Medically intractable epilepsy is associated with increased morbidity and mortality. For those with focal epilepsy and correlated electrophysiological or radiographic features, open surgical resection can achieve high rates of seizure control, but can be associated with neurologic deficits and cognitive effects. Recent innovations have allowed for more minimally invasive methods of surgical seizure control such as magnetic resonance-guided laser interstitial therapy (MRgLITT). MRgLITT achieves the goal of ablating seizure foci while preserving neuropsycho-logical function and offering real-time feedback and monitoring of tissue ablation...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29023305/insights-into-the-therapeutic-effect-of-responsive-neurostimulation-assessed-with-scalp-eeg-recording-a-case-report
#2
Maria Jose Bruzzone, Naoum Issa, Sandra Rose, Peter Warnke, Vernon L Towle, James X Tao, Shasha Wu
The responsive neurostimulation system (RNS) is the first closed-loop neurostimulator approved as an adjunctive treatment for adults with medically refractory focal epilepsy from no more than two seizure foci. In addition to its therapeutic effect, it provides chronic intracranial EEG recordings, with limited storage capacity. Long-term monitoring with scalp EEG recordings can provide additional information regarding seizure patterns, the efficacy of RNS stimulation in aborting individual seizures, and the net effect of RNS on seizure control...
October 10, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28763722/glutamate-metabolism-in-temporal-lobe-epilepsy-as-revealed-by-dynamic-proton-mrs-following-the-infusion-of-u-13-c-glucose
#3
Brenda L Bartnik-Olson, Daniel Ding, John Howe, Amul Shah, Travis Losey
Focal metabolic dysfunction commonly observed in temporal lobe epilepsy (TLE), and is associated with the development of medical intractability and neurocognitive deficits. It has not been established if this dysfunction is due to cell loss or biochemical dysfunction in metabolic pathways. To explore this question, dynamic (1)H MRS following an infusion of [U(13)- C] glucose was performed to measure glutamate (Glu) metabolism. Subjects (n=6) showed reduced Glu levels (p<0.01) in the ipsilateral mesial temporal lobe (MTL) compared with controls (n=4)...
July 23, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28732280/evaluation-of-a-novel-median-power-spectrogram-for-seizure-detection-by-non-neurophysiologists
#4
Peter Yan, Tamar Melman, Sherry Yan, Munkhzul Otgonsuren, Zachary Grinspan
PURPOSE: (1) To evaluate how well resident physicians use a novel EEG spectral analysis tool (the median power spectrogram; MPS) to detect seizures. (2) To assess the capability of the MPS to identify different seizure types. METHODS: 120 EEG records from children with intractable seizures were converted to MPS by taking the median power across leads and using multi-taper spectral estimation. Twelve blinded neurology residents were trained to interpret the spectrogram with a five-minute video tutorial and post-test...
June 15, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28633092/epilepsy-in-neurofibromatosis-type-1
#5
Anthony Pecoraro, Eric Arehart, William Gallentine, Rodney Radtke, Edward Smith, Carolyn Pizoli, Sujay Kansagra, Elie Abdelnour, Roger McLendon, Mohamad A Mikati
OBJECTIVES: To describe the characteristics of epilepsy in patients with Neurofibromatosis type 1 (NF1). METHODS: Analysis of a cohort of consecutive NF1 patients seen in our NF1 clinic during a three-year period. RESULTS: Of the 184 NF1 patients seen during that period, 26 had epilepsy and three had febrile seizures. Of the 26, 17 (65%) had localization-related epilepsy, seven of whom (41%) were drug resistant. Six (23%) had apparently primary generalized epilepsy (0/6 drug resistant), two (8%) Lennox-Gastaut syndrome, and one (4%) West syndrome (all three were drug-resistant)...
August 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28523469/system-for-automatic-heart-rate-calculation-in-epileptic-seizures
#6
Marcin Kołodziej, Andrzej Majkowski, Remigiusz J Rak, Bartosz Świderski, Andrzej Rysz
This article presents a comprehensive system for automatic heart rate (HR) detection. The system is robust and resistant to disturbances (noise, interferences, artifacts) occurring mainly during epileptic seizures. ECG signal filtration (IIR) and normalization due to skewness and standard deviation were used as preprocessing steps. A key element of the system is a reference QRS complex pattern calculated individually for each ECG recording. Next, a cross-correlation of the reference QRS pattern with short, normalized ECG windows is calculated and the maxima of the correlation are found (R-wave locations)...
May 18, 2017: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/28488608/epilepsy-surgery-in-children
#7
REVIEW
Sita Jayalakshmi, Sudhindra Vooturi, Swapan Gupta, Manas Panigrahi
Approximately 60% of all patients with epilepsy suffer from focal epilepsy syndromes. In approximately 15% of these patients, the seizures are not adequately controlled with anticonvulsive drugs, and such patients are potential candidates for surgical treatment and majority are children. Epilepsy surgery in children, who have been carefully chosen, can result in either seizure freedom or a marked (>90%) reduction in seizures in approximately two-third of children with intractable seizures. In the multimodality presurgical evaluation approach, sufficient concordance should be established among various independent investigations, thus identifying the location and extent of the epileptogenic zone with a high degree of confidence...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28452654/epilepsy-surgery-for-epileptic-encephalopathy-as-a-sequela-of-herpes-simplex-encephalitis-case-report
#8
Birce Dilge Taskin, Kurenai Tanji, Neil A Feldstein, Maureen McSwiggan-Hardin, Cigdem I Akman
Herpes simplex virus (HSV) encephalitis can manifest with different clinical presentations, including acute monophasic illness and biphasic chronic granulomatous HSV encephalitis. Chronic encephalitis is much less common, and very rare late relapses are associated with intractable epilepsy and progressive neurological deficits with or without evidence of HSV in the cerebrospinal fluid. The authors report on an 8-year-old girl with a history of treated HSV-1 encephalitis when she was 13 months of age and focal epilepsy when she was 2 years old...
July 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28393712/therapeutic-role-of-synaptic-vesicle-glycoprotein-2a-sv2a-in-modulating-epileptogenesis
#9
Yukihiro Ohno, Kentaro Tokudome
Dysfunction of synaptic neurotransmitter release is closely involved in the pathogenesis of various central nervous system diseases. Synaptic vesicle glycoprotein 2A (SV2A) is a membrane protein specifically expressed in synaptic vesicles and it modulates action potential-dependent neurotransmitter release in the brain. Since 1) SV2A-knockout mice exhibit severe convulsive seizures, 2) SV2A expression in the brain is reportedly altered in various epileptic disorders both in animal models (e.g., kindling and genetic models) and humans (e...
April 4, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28291425/long-term-outcomes-of-epilepsy-surgery-in-85-pediatric-patients-followed-up-for-over-10-years-a-retrospective-survey
#10
Hiroshi Hosoyama, Kazumi Matsuda, Tadahiro Mihara, Naotaka Usui, Koichi Baba, Yushi Inoue, Takayasu Tottori, Toshiaki Otsubo, Yumi Kashida, Koji Iida, Hirofumi Hirano, Ryosuke Hanaya, Kazunori Arita
OBJECTIVE The aim of this study was to investigate the treatment outcomes and social engagement of patients who had undergone pediatric epilepsy surgery more than 10 years earlier. METHODS Between 1983 and 2005, 110 patients younger than 16 years underwent epilepsy surgery at the National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders. The authors sent a questionnaire to 103 patients who had undergone follow-up for more than 10 years after surgery; 85 patients (82.5%) responded. The survey contained 4 categories: seizure outcome, use of antiepileptic drugs, social participation, and general satisfaction with the surgical treatment (resection of the epileptic focus, including 4 hemispherectomies)...
May 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28168619/pure-endoscopic-management-of-epileptogenic-hypothalamic-hamartomas
#11
S Chibbaro, H Cebula, J Scholly, J Todeschi, I Ollivier, A Timofeev, M Ganau, P Di Emidio, M P Valenti, A M Staack, T Bast, B J Steinhoff, E Hirsch, P Kehrli, F Proust
Hypothalamic hamartomas (HH) are rare congenital malformations located in the region of the tuber cinereum and third ventricle. Their usual clinical presentation is characterized by gelastic/dacrystic seizures which often become pharmaco-resistant and progress to secondary focal/generalized intractable epilepsy causing mostly in children cognitive and behavioral problems (particularly in cases of progressive epileptic encephalopathy) and precocious puberty. Whereas gelastic seizures can be surgically controlled either by resection of the lesion or disconnection (tissue-destructive) procedures, aimed at functionally prevent the spreading of the epileptic burst; generalized seizures tend to respond better to HH excision rather than isolated neocortical resections, which generally fail to control them...
February 7, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28045733/pet-mri-coregistration-in-intractable-epilepsy-and-gray-matter-heterotopia
#12
Nikhil Seniaray, Anuj Jain
A 25-year-old woman with intractable seizures underwent FDG PET/MRI for seizure focus localization. MRI demonstrated bilateral carpetlike nodular subependymal gray matter and asymmetrical focal dilatation in the right temporal horn. PET/MRI showed increased FDG within subependymal gray matter with significant hypometabolism in right anterior temporal lobe. EEG and ictal semiology confirmed the right temporal seizure origin. This case highlights the importance of identification of gray matter heterotopia on FDG PET/MRI...
March 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27988965/ictal-asystole-a-systematic-review
#13
REVIEW
Dalma Tényi, Csilla Gyimesi, Péter Kupó, Réka Horváth, Beáta Bóné, Péter Barsi, Norbert Kovács, Tamás Simor, Zsuzsa Siegler, László Környei, András Fogarasi, József Janszky
OBJECTIVE: To comprehensively analyze ictal asystole (IA) on a large number of subjects. METHODS: We performed a systematic review of case report studies of patients diagnosed with IA (1983-2016). Each included case was characterized with respect to patient history, IA seizure characteristics, diagnostic workup, and therapy. In addition, comparative analyses were also carried out: two alignments were developed based on the delay between epilepsy onset and IA onset ("new-onset" if <1 year, "late-onset" if ≥1 year) and asystole duration (asystole was "very prolonged" if lasted >30 s)...
March 2017: Epilepsia
https://www.readbyqxmd.com/read/27939253/hippocampal-sclerosis-and-associated-focal-cortical-dysplasia-related-epilepsy-in-neurofibromatosis-type-i
#14
REVIEW
Jordan Gales, Richard A Prayson
Neurofibromatosis type I (NF1) is a relatively common disorder associated with a range of neurologic sequelae. Refractory epilepsy occurs in 4-13% of NF1 patients. Hippocampal sclerosis and focal cortical dysplasia, both well-defined epilepsy-related entities, have been described in a subset of cases. To our knowledge, there has been only one other series describing coexistent focal cortical dysplasia and hippocampal sclerosis in the setting of NF1. We report two such patients who presented with intractable seizures requiring epilepsy surgery...
March 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27883965/frequency-independent-characteristics-of-high-frequency-oscillations-in-epileptic-and-non-epileptic-regions
#15
COMPARATIVE STUDY
Martin Pail, Pavel Řehulka, Jan Cimbálník, Irena Doležalová, Jan Chrastina, Milan Brázdil
OBJECTIVE: The purpose of the presented study is to determine whether there are frequency-independent high-frequency oscillation (HFO) parameters which may differ in epileptic and non-epileptic regions. METHODS: We studied 31 consecutive patients with medically intractable focal (temporal and extratemporal) epilepsies who were examined by either intracerebral or subdural electrodes. Automated detection was used to detect HFO. The characteristics (rate, amplitude, and duration) of HFO were statistically compared within three groups: the seizure onset zone (SOZ), the irritative zone (IZ), and areas outside the IZ and SOZ (nonSOZ/nonIZ)...
January 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27637803/activation-of-lilrb2-signal-pathway-in-temporal-lobe-epilepsy-patients-and-in-a-pilocarpine-induced-epilepsy-model
#16
Jiong Yue, Wei Li, Chao Liang, Bing Chen, Xin Chen, Lukang Wang, Zhenle Zang, Sixun Yu, Shiyong Liu, Song Li, Hui Yang
Temporal lobe epilepsy (TLE) is a frequent form of focal intractable epilepsy in adults, but the specific mechanism underlying the epileptogenesis of TLE is still unknown. Human leukocyte immunoglobulin-like receptor B2 (LILRB2) (the murine homolog gene called paired immunoglobulin-like receptor B, or PirB), participates in the process of synaptic plasticity and neurite growth in the central nervous system (CNS), suggesting a potential role of LILRB2 in epilepsy. However, the expression pattern of LILRB2 and the downstream molecular signal in intractable TLE remains poorly understood...
November 2016: Experimental Neurology
https://www.readbyqxmd.com/read/27628031/the-temporal-instability-of-resting-state-network-connectivity-in-intractable-epilepsy
#17
Lucy F Robinson, Xiaosong He, Paul Barnett, Gaёlle E Doucet, Michael R Sperling, Ashwini Sharan, Joseph I Tracy
OBJECTIVE: Focal epilepsies, such as temporal lobe epilepsy (TLE), are known to disrupt network activity in areas outside the epileptogenic zone [Tracy et al., 2015]. We devised a measure of temporal instability of resting state functional connectivity (FC), capturing temporal variations of BOLD correlations between brain regions that is less confounded than the "sliding window" approach common in the literature. METHODS: We investigated healthy controls and unilateral TLE patients (right and left seizure focus groups), utilizing group ICA to identify the default mode network (DMN), a network associated with episodic memory, a key cognitive deficit in TLE...
January 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/27566969/outcomes-of-resective-surgery-in-children-and-adolescents-with-focal-lesional-epilepsy-the-experience-of-a-tertiary-epilepsy-center
#18
Tugba Hirfanoglu, Ayse Serdaroglu, Gokhan Kurt, Atilla Erdem, Irem Capraz, Erhan Bilir, Ozge Vural, Murat Ucar, Ali Yusuf Oner, Baran Onal, Ozgur Akdemir, Ozlem Atay, Ebru Arhan, Kursad Aydin
OBJECTIVE: This study aimed to investigate the efficacy of resective surgery in children with focal lesional epilepsy by evaluating the predictive value of pre- and postsurgical factors in terms of seizure freedom. METHODS: This study included 61 children aged between 2 and 18years who were admitted to the pediatric video-EEG unit for presurgical workup. Each patient was evaluated with a detailed history, video-EEG, neuroimaging, and postsurgical outcomes according to Engel classification to predict postsurgical seizure freedom...
October 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27500381/long-term-outcome-characteristics-in-mesial-temporal-lobe-epilepsy-with-and-without-associated-cortical-dysplasia
#19
B Schmeiser, T Hammen, B J Steinhoff, J Zentner, A Schulze-Bonhage
OBJECT: The intention of our study was to identify predictive characteristics for long-term seizure control and running down phenomenon after surgical treatment of pharmacoresistant mesiotemporal lobe epilepsy (mTLE) with and without associated cortical dysplasia. MATERIALS AND METHODS: Our study comprises a consecutive series of 458 patients who underwent surgical treatment for intractable mTLE at the Epilepsy Center Freiburg. Data evaluated included semiology, duration and frequency of seizures, results of presurgical diagnostics including video-EEG monitoring, MRI, PET and SPECT as well as postoperative seizure outcome...
October 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27472665/medically-resistant-pediatric-insular-opercular-perisylvian-epilepsy-part-2-outcome-following-resective-surgery
#20
Alexander G Weil, Ngoc Minh D Le, Prasanna Jayakar, Trevor Resnick, Ian Miller, Aria Fallah, Michael Duchowny, Sanjiv Bhatia
OBJECTIVE Seizure onset in the insular cortex as a cause of refractory epilepsy is underrepresented in the pediatric population, possibly due to difficulties localizing seizure onset in deep anatomical structures and limited surgical access to the insula, a complex anatomical structure with a rich overlying vascular network. Insular seizure semiology may mimic frontal, temporal, or parietal lobe semiology, resulting in false localization, incomplete resection, and poor outcome. METHODS The authors retrospectively reviewed the records of all pediatric patients who underwent insular cortical resections for intractable epilepsy at Miami Children's Hospital from 2009 to 2015...
November 2016: Journal of Neurosurgery. Pediatrics
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