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Insular epilepsy

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https://www.readbyqxmd.com/read/29618099/surgical-treatment-of-extratemporal-epilepsy-results-and-prognostic-factors
#1
Daniel Delev, Bernhard Oehl, Bernhard J Steinhoff, Julia Nakagawa, Christian Scheiwe, Andreas Schulze-Bonhage, Josef Zentner
BACKGROUND: Surgery is a widely accepted option for the treatment of pharmacoresistant epilepsies of extratemporal origin. OBJECTIVE: To analyze clinical and epileptological results and to provide prognostic factors influencing seizure outcome. METHODS: This retrospective single-center study comprises a consecutive series of 383 patients, most of whom had an identifiable lesion on MRI, who underwent resective surgery for extratemporal epilepsy...
March 30, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29588979/claustrum-hyperintensities-a-potential-clue-to-autoimmune-epilepsy
#2
Claude Steriade, David F Tang-Wai, Timo Krings, Richard Wennberg
In a cohort of 34 patients with autoimmune limbic encephalitis and/or epilepsy, we identified 4 patients exhibiting claustrum fluid-attenuated inversion recovery (FLAIR) hyperintensities. All 4 patients presented with explosive onset of seizures and developed medically intractable epilepsy, and 2 exhibited a marked response to immunotherapy. Associated features included cognitive and behavioral disturbances (4/4), cerebrospinal fluid (CSF) lymphocytic pleocytosis (3/4), and a neural autoantibody (2/4). Electroencephalogram (EEG) features consisted of slow wave activity and epileptiform discharges in frontal and parasagittal regions, where ictal patterns were captured in 1 patient...
December 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29588964/application-of-rns-in-refractory-epilepsy-targeting-insula
#3
Hai Chen, Patricia Dugan, Derek J Chong, Anli Liu, Werner Doyle, Daniel Friedman
Although responsive neurostimulation (RNS) is approved for treatment of resistant focal epilepsy in adults, little is known about response to treatment of specific cortical targets. We describe the experience of RNS targeting the insular lobe. We identified patients who had RNS implantation with at least one electrode within the insula between April 2014 and October 2015. We performed a retrospective review of preoperative clinical features, imaging, electrocardiogram (EEG), intraoperative electrocorticography (ECoG), and postoperative seizure outcome...
September 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29569808/a-voxel-based-asymmetry-study-of-the-relationship-between-hemispheric-asymmetry-and-language-dominance-in-wada-tested-patients
#4
Simon S Keller, Neil Roberts, Gus Baker, Vanessa Sluming, Enis Cezayirli, Andrew Mayes, Paul Eldridge, Anthony G Marson, Udo C Wieshmann
Determining the anatomical basis of hemispheric language dominance (HLD) remains an important scientific endeavor. The Wada test remains the gold standard test for HLD and provides a unique opportunity to determine the relationship between HLD and hemispheric structural asymmetries on MRI. In this study, we applied a whole-brain voxel-based asymmetry (VBA) approach to determine the relationship between interhemispheric structural asymmetries and HLD in a large consecutive sample of Wada tested patients. Of 135 patients, 114 (84...
March 23, 2018: Human Brain Mapping
https://www.readbyqxmd.com/read/29473152/white-matter-spongiosis-with-vigabatrin-therapy-for-infantile-spasms
#5
Phillip L Pearl, Annapurna Poduri, Sanjay P Prabhu, Chellamani Harini, Richard Goldstein, Richard M Atkinson, Dawna Armstrong, Hannah Kinney
The histopathology, "white matter spongiosis," defined by electron microscopy (EM) as "intramyelinic edema," has been associated with vigabatrin therapy in various animal models, but its role or significance in clinical studies is unknown. We conducted a neuropathological examination on a 27-month-old boy with bilateral polymicrogyria and epilepsy after sudden unexpected death in epilepsy (SUDEP). The patient was initiated on vigabatrin at 4 months of age, which controlled infantile spasms, and was continued as maintenance therapy...
April 2018: Epilepsia
https://www.readbyqxmd.com/read/29467710/structural-covariance-network-of-cortical-gyrification-in-benign-childhood-epilepsy-with-centrotemporal-spikes
#6
Lin Jiang, Tijiang Zhang, Fajin Lv, Shiguang Li, Heng Liu, Zhiwei Zhang, Tianyou Luo
Benign childhood epilepsy with centrotemporal spikes (BECTS) is associated with cognitive and language problems. According to recent studies, disruptions in brain structure and function in children with BECTS are beyond a Rolandic focus, suggesting atypical cortical development. However, previous studies utilizing surface-based metrics (e.g., cortical gyrification) and their structural covariance networks at high resolution in children with BECTS are limited. Twenty-six children with BECTS (15 males/11 females; 10...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29465623/the-distinct-roles-of-insular-subareas-in-recognition-memory-a-stereo-electroencephalography-study
#7
Chengtian Zhao, Yuping Wang
Previous studies have reported that the insular cortex is involved in recognition memory, but it remains unclear which subarea of the insular cortex serves this function. To address this question, we examined 14 drug-resistant focal epilepsy patients implanted with stereotactic electrodes in the insular cortex. All participants performed a delayed match-to-sample task. Event-related potentials and spectrograms from each insular subarea were analyzed when the participants were exposed to identical (match condition) and different (mismatch condition) stimuli...
April 11, 2018: Neuroreport
https://www.readbyqxmd.com/read/29383717/topographic-principles-of-cortical-fluid-attenuated-inversion-recovery-signal-in-temporal-lobe-epilepsy
#8
Sophie Adler, Seok-Jun Hong, Min Liu, Torsten Baldeweg, J Helen Cross, Andrea Bernasconi, Boris C Bernhardt, Neda Bernasconi
OBJECTIVE: In drug-resistant temporal lobe epilepsy (TLE), relative to the large number of whole-brain morphological studies, neocortical T2 changes have not been systematically investigated. The aim of this study was to assess the anatomical principles that govern the distribution of neocortical T2-weighted fluid-attenuated inversion recovery (FLAIR) signal intensity and uncover its topographic principles. METHODS: Using a surface-based sampling scheme, we mapped neocortical FLAIR intensity of 61 TLE patients relative to 38 healthy controls imaged at 3 T...
March 2018: Epilepsia
https://www.readbyqxmd.com/read/29342237/the-roles-of-subdivisions-of-human-insula-in-emotion-perception-and-auditory-processing
#9
Yang Zhang, Wenjing Zhou, Siyu Wang, Qin Zhou, Haixiang Wang, Bingqing Zhang, Juan Huang, Bo Hong, Xiaoqin Wang
Previous studies have shown insular activations involving sensory, motor, and affective processing. However, the functional roles of subdivisions within the human insula are still not well understood. In the present study, we used intracranial electroencephalography and electrical cortical stimulation to investigate the causal roles of subdivisions of the insula in auditory emotion perception in epilepsy patients implanted with depth electrodes in this brain region. The posterior and the anterior subdivisions of the human insula, identified based on structural and functional analyses, showed distinct response properties to auditory emotional stimuli...
January 12, 2018: Cerebral Cortex
https://www.readbyqxmd.com/read/29288902/diagnostic-evaluation-and-surgical-management-of-pediatric-insular-epilepsy-utilizing-magnetoencephalography-and-invasive-eeg-monitoring
#10
Raheel Ahmed, Hiroshi Otsubo, Carter Snead, Elizabeth Donner, Elysa Widjaja, Ayako Ochi, James M Drake, James T Rutka
INTRODUCTION: The diagnosis and surgical management of pediatric patients with insular epilepsy is challenging due to variable and indistinct seizure semiology arising within the insular cortex. In addition, surgical approaches are associated with potential morbidity given the regional neurosurgical and vascular anatomy. Our institutional experience in evaluation and surgical management of insular epilepsy patients is presented. Diagnostic evaluation, surgical treatment and seizures outcomes are highlighted...
February 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29258969/a-case-of-anti-nmda-receptor-encephalitis-revealed-by-insular-epilepsy
#11
Charlotte De Maeseneire, Riem El Tahry, Susana Ferrao Santos
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder of the central nervous system that typically manifests predominantly as a psychiatric disorder. However, other manifestations such as epileptic seizures, abnormal movements, and memory or language complications are not unusual. Here, we report the case of a young man who presented with a new-onset epilepsy, with ictal semiology suggestive of insular involvement; this hypothesis was supported by a PET-CT study. Anti-NMDAR antibodies were found in the CSF, confirming the diagnosis of anti-NMDAR encephalitis...
December 1, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/29244100/invasive-insular-sampling-in-pediatric-epilepsy-a-single-institution-experience
#12
Luke D Tomycz, Andrew T Hale, Ali S Haider, Dave F Clarke, Mark R Lee
BACKGROUND: It has been increasingly recognized that the insular cortex plays an important role in frontotemporal-parietal epilepsy in children. The insula, however, cannot be properly interrogated with conventional subdural grids, and its anatomy makes it difficult to implicate the insula with semiology or noninvasive modalities. Frame-based, stereotactic placement of insular depth electrodes for direct extraoperative monitoring is a relatively low-risk maneuver that allows for conclusive interrogation of this region, and, in select cases, can easily be replaced with a laser applicator for minimally invasive treatment via thermoablation...
December 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29181526/cortical-structures-associated-with-human-blood-pressure-control
#13
Nuria Lacuey, Johnson P Hampson, Wanchat Theeranaew, Bilal Zonjy, Ajay Vithala, Norma J Hupp, Kenneth A Loparo, Jonathan P Miller, Samden D Lhatoo
Importance: A better understanding of the role of cortical structures in blood pressure control may help us understand cardiovascular collapse that may lead to sudden unexpected death in epilepsy (SUDEP). Objective: To identify cortical control sites for human blood pressure regulation. Design, Setting, and Participants: Patients with intractable epilepsy undergoing intracranial electrode implantation as a prelude to epilepsy surgery in the Epilepsy Monitoring Unit at University Hospitals Cleveland Medical Center were potential candidates for this study...
February 1, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29163352/parahippocampal-involvement-in-mesial-temporal-lobe-epilepsy-with-hippocampal-sclerosis-a-proof-of-concept-from-memory-guided-saccades
#14
Silvia Colnaghi, Giorgio Beltrami, Guy Poloni, Anna Pichiecchio, Stefano Bastianello, Carlo Andrea Galimberti, Maurizio Versino
Objective: Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) may involve extrahippocampal areas of structural damage and dysfunction. The accuracy of medium-term spatial memory can be tested by memory-guided saccades (MGS) to evaluate a functional impairment of the parahippocampal cortex (PHC), while voxel-based morphometry (VBM) analysis can be used to detect a structural damage of the latter region. Methods: MGS with 3- and 30-s memorization delays were compared between 7 patients affected by right MTLE-HS (r-MTLE-HS), 6 patients affected by left MTLE-HS, and 13 healthy controls...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29117337/seeg-is-a-safe-procedure-for-a-comprehensive-anatomic-exploration-of-the-insula-a-retrospective-study-of-108-procedures-representing-254-transopercular-insular-electrodes
#15
Anne Laure Salado, Laurent Koessler, Gabriel De Mijolla, Emmanuelle Schmitt, Jean-Pierre Vignal, Thierry Civit, Louise Tyvaert, Jacques Jonas, Louis Georges Maillard, Sophie Colnat-Coulbois
BACKGROUND: The exploration of the insula in pre-surgical evaluation of epilepsy is considered to be associated with a high vascular risk resulting in an incomplete exploration of the insular cortex. OBJECTIVE: To report a retrospective observational study of insular exploration using stereoelectroencephalography (sEEG) with transopercular and parasagittal oblique intracerebral electrodes from January 2008 to January 2016. The first purpose of this study was to evaluate the surgical risks of insular cortex sEEG exploration...
January 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29115470/dimethylation-of-histone-3-lysine-9-is-sensitive-to-the-epileptic-activity-and-affects-the-transcriptional-regulation-of-the-potassium-channel-kcnj10-gene-in-epileptic-rats
#16
Shao-Ping Zhang, Man Zhang, Hong Tao, Yan Luo, Tao He, Chun-Hui Wang, Xiao-Cheng Li, Ling Chen, Lin-Na Zhang, Tao Sun, Qi-Kuan Hu
Potassium channels can be affected by epileptic seizures and serve a crucial role in the pathophysiology of epilepsy. Dimethylation of histone 3 lysine 9 (H3K9me2) and its enzyme euchromatic histone‑lysine N‑methyltransferase 2 (G9a) are the major epigenetic modulators and are associated with gene silencing. Insight into whether H3K9me2 and G9a can respond to epileptic seizures and regulate expression of genes encoding potassium channels is the main purpose of the present study. A total of 16 subtypes of potassium channel genes in pilocarpine‑modelled epileptic rats were screened by reverse transcription‑quantitative polymerase chain reaction, and it was determined that the expression ATP‑sensitive inward rectifier potassium channel 10 (Kcnj10) increased in hippocampus and insular cortex, while the expression of most of the other subtypes decreased...
January 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29060406/the-role-of-nonmotor-brain-regions-during-human-motor-control
#17
Jacob J Johnson, Macauley S Breault, Pierre Sacre, Matthew S D Kerr, Mathew Johnson, Juan Bulacio, Jorge Gonzalez-Martinez, Sridevi V Sarma, John T Gale
Neural prostheses have generally relied on signals from cortical motor regions to control reaching movements of a robotic arm. However, little work has been done in exploring the involvement of nonmotor cortical and associative regions during motor tasks. In this study, we identify regions which may encode direction during planning and movement of a center-out motor task. Local field potentials were collected using stereoelectroencephalography (SEEG) from nine epilepsy patients implanted with multiple depth electrodes for clinical purposes...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29028955/gamma-band-oscillations-preferential-for-nociception-can-be-recorded-in-the-human-insula
#18
Giulia Liberati, Anne Klöcker, Maxime Algoet, Dounia Mulders, Marta Maia Safronova, Susana Ferrao Santos, José-Géraldo Ribeiro Vaz, Christian Raftopoulos, André Mouraux
Transient nociceptive stimuli elicit robust phase-locked local field potentials (LFPs) in the human insula. However, these responses are not preferential for nociception, as they are also elicited by transient non-nociceptive vibrotactile, auditory, and visual stimuli. Here, we investigated whether another feature of insular activity, namely gamma-band oscillations (GBOs), is preferentially observed in response to nociceptive stimuli. Although nociception-evoked GBOs have never been explored in the insula, previous scalp electroencephalography and magnetoencephalography studies suggest that nociceptive stimuli elicit GBOs in other areas such as the primary somatosensory and prefrontal cortices, and that this activity could be closely related to pain perception...
September 25, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/29027866/magnetic-resonance-imaging-guided-laser-interstitial-thermal-therapy-as-treatment-for-intractable-insular-epilepsy-in-children
#19
M Scott Perry, David J Donahue, Saleem I Malik, Cynthia G Keator, Angel Hernandez, Rohit K Reddy, Freedom F Perkins, Mark R Lee, Dave F Clarke
OBJECTIVE Seizure onset within the insula is increasingly recognized as a cause of intractable epilepsy. Surgery within the insula is difficult, with considerable risks, given the rich vascular supply and location near critical cortex. MRI-guided laser interstitial thermal therapy (LiTT) provides an attractive treatment option for insular epilepsy, allowing direct ablation of abnormal tissue while sparing nearby normal cortex. Herein, the authors describe their experience using this technique in a large cohort of children undergoing treatment of intractable localization-related epilepsy of insular onset...
December 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28926747/ictal-source-imaging-and-electroclinical-correlation-in-self-limited-epilepsy-with-centrotemporal-spikes
#20
Jørgen Alving, Martin Fabricius, Ivana Rosenzweig, Sándor Beniczky
PURPOSE: To elucidate the localization of ictal EEG activity, and correlate it to semiological features in self-limited epilepsy with centrotemporal spikes (formerly called "benign epilepsy with centrotemporal spikes"). METHODS: We have performed ictal electric source imaging, and we analysed electroclinical correlations in three patients with self-limited epilepsy with centrotemporal spikes. RESULTS: The source of the evolving rhythmic ictal activity (9...
November 2017: Seizure: the Journal of the British Epilepsy Association
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