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Insular epilepsy

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https://www.readbyqxmd.com/read/28520633/insular-cortex-surgery-for-the-treatment-of-refractory-epilepsy
#1
Marec von Lehe, Yaroslav Parpaley
Focal epilepsy originating from the insular cortex is rare. One reason is the small amount of cortical tissue compared with other lobes of the brain. However, the incidence of insular epilepsy might be underestimated because of diagnostic difficulties. The semiology and the surface EEG are often not meaningful or even misleading, and elaborated imaging might be necessary. The close connections of the insular cortex with other potentially epileptogenic areas, such as the temporal lobe or frontal/central cortex, is increasingly recognized as possible reason for failure of epilepsy surgery for temporal or extratemporal seizures...
May 16, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28520631/operculo-insular-epilepsy-scalp-and-intracranial-electroencephalographic-findings
#2
Ariel Levy, Thi Phuoc Yen Tran, Olivier Boucher, Alain Bouthillier, Dang Khoa Nguyen
PURPOSE: Operculo-insular seizures are heterogeneous and may resemble seizures originating from the temporal, frontal, or parietal lobe. Although surface and invasive EEG recordings are often necessary to detect operculo-insular seizures, electrophysiological features of operculo-insular epilepsies remain poorly characterized. This study describes the EEG findings of patients with operculo-insular epilepsy. METHODS: We reviewed electrophysiological data of all patients (n = 9) with operculo-insular seizures revealed by intracranial EEG and for whom operculo-insular epilepsy was confirmed by good seizure outcome after resective or radiosurgery at our center between 2005 and 2013...
May 16, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28506485/surgery-for-dysembryoplastic-neuroepithelial-tumors-and-gangliogliomas-in-eloquent-areas-functional-results-and-seizure-control
#3
B Devaux, F Chassoux, E Landré, B Turak, A Laurent, M Zanello, C Mellerio, P Varlet
INTRODUCTION: Dysembryoplastic neuroepithelial tumors and gangliogliomas are developmental glioneuronal tumors usually revealed by partial epilepsy. High epileptogenicity, childhood epilepsy onset, drug-resistance, temporal location, and seizure freedom after complete resection are common characteristics of both tumors. We report the specificity of surgical management, functional results and seizure outcome in cases of a tumor location in eloquent areas. METHODS: Among 150 patients (88 males, 3-55 years) operated on for refractory epilepsy due to a glioneuronal tumor (1990-2015), 30 (20%, dysembryoplastic neuroepithelial tumors=21; gangliogliomas=9) had a tumor located in an eloquent cortex (sensory-motor, insular or language areas)...
May 12, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28449635/seizure-control-and-memory-impairment-are-related-to-disrupted-brain-functional-integration-in-temporal-lobe-epilepsy
#4
Chang-Hyun Park, Yun Seo Choi, A-Reum Jung, Hwa-Kyoung Chung, Hyeon Jin Kim, Jeong Hyun Yoo, Hyang Woon Lee
Brain functional integration can be disrupted in patients with temporal lobe epilepsy (TLE), but the clinical relevance of this disruption is not completely understood. The authors hypothesized that disrupted functional integration over brain regions remote from, as well as adjacent to, the seizure focus could be related to clinical severity in terms of seizure control and memory impairment. Using resting-state functional MRI data acquired from 48 TLE patients and 45 healthy controls, the authors mapped functional brain networks and assessed changes in a network parameter of brain functional integration, efficiency, to examine the distribution of disrupted functional integration within and between brain regions...
April 28, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28444426/investigation-of-altered-microstructure-in-patients-with-drug-refractory-epilepsy-using-diffusion-tensor-imaging
#5
Yuwei Jiang, Lingyan Mao, Xu Yan, Mingxia Fan, Xin Wang, Jing Ding, Dongrong Xu
PURPOSE: The risk of refractory epilepsy can be more dangerous than the adverse effect caused by medical treatment. In this study, we employed voxel-wise analysis (VWA) and tract-based spatial statistics (TBSS) methods to measure microstructural changes using diffusion tensor imaging (DTI) in patients of drug refractory epilepsy (DRE) who had been epileptic for more than 10 years. METHODS: To examine the specific microstructural abnormalities in DRE patients and its difference from medically controlled epilepsy (MCE), we acquired DTI data of 7 DRE patients, 37 MCE patients, and 31 healthy controls (HCs) using a 3 T MRI scanner...
April 25, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28434623/does-unilateral-insular-resection-disturb-personality-a-study-with-epileptic-patients
#6
Benjamin Hébert-Seropian, Olivier Boucher, Carole Sénéchal, Isabelle Rouleau, Alain Bouthillier, Franco Lepore, Dang Khoa Nguyen
The insula is now regarded as a potential site of epileptogenesis in drug-resistant epilepsy, and the advent of microsurgical techniques has allowed insular cortectomy to become a treatment of choice when the insular cortex is involved in the seizure focus. However, considering the evidence of an insular role in socio-emotional processing, it remains unknown whether these cortical resections disturb personality and social behavior as experienced in daily life. We examined such changes in a group of patients (n=19) who underwent epilepsy surgery involving partial or complete resection of the insula, and compared them to a group of patients who underwent standard temporal lobe epilepsy (TLE) surgery (n=19) as a lesion-control group...
April 20, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28419357/stereoelectroencephalography-using-magnetic-resonance-angiography-for-avascular-trajectory-planning-technical-report
#7
Krasimir Minkin, Kaloyan Gabrovski, Marin Penkov, Yuri Todorov, Rositsa Tanova, Yoana Milenova, Kiril Romansky, Petia Dimova
BACKGROUND: Stereoelectroencephalography (SEEG) requires high-quality angiographic studies because avascular trajectory planning is a prerequisite for the safety of this procedure. Some epilepsy surgery groups have begun to use computed tomography angiography and magnetic resonance T1-weighted sequence with contrast enhancement for this purpose. OBJECTIVE: To present the first series of patients with avascular trajectory planning of SEEG based on magnetic resonance angiography (MRA)...
April 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28396650/new-onset-refractory-status-epilepticus-with-claustrum-damage-definition-of-the-clinical-and-neuroimaging-features
#8
Stefano Meletti, Giada Giovannini, Giuseppe d'Orsi, Lisa Toran, Giulia Monti, Rahul Guha, Andreas Kiryttopoulos, Maria Grazia Pascarella, Tommaso Martino, Haris Alexopoulos, Martha Spilioti, Jana Slonkova
New-onset refractory status epilepticus (NORSE) is a rare but challenging condition occurring in a previously healthy patient, often with no identifiable cause. We describe the electro-clinical features and outcomes in a group of patients with NORSE who all demonstrated a typical magnetic resonance imaging (MRI) sign characterized by bilateral lesions of the claustrum. The group includes 31 patients (12 personal and 19 previously published cases; 17 females; mean age of 25 years). Fever preceded status epilepticus (SE) in 28 patients, by a mean of 6 days...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28386922/technical-descriptions-of-four-hemispherectomy-approaches-from-the-pediatric-epilepsy-surgery-meeting-at-gothenburg-2014
#9
James E Baumgartner, Jeffrey P Blount, Thomas Blauwblomme, P Sarat Chandra
Hemispherectomy is a complex multistep procedure with a steep learning curve. Several surgical approaches have been developed, but each requires considerable practice to master. Four experienced pediatric neurosurgeons, who participated in the 2014 Gothenburg Pediatric Epilepsy Surgery Meeting, provided succinct technical summaries of four hemispherectomy approaches: modified functional hemispherectomy, peri-insular hemispherotomy, parasagittal hemispherotomy, and endoscopic-assisted hemispherotomy. No clinical or outcome data are included...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28386920/insular-epilepsy-surgery
#10
Pramote Laoprasert, Jeffrey G Ojemann, Michael H Handler
Since it was originally described nearly 70 years ago, insular epilepsy has been increasingly recognized and may explain failures after apparently well-planned operations. We review the history of awareness of the phenomenon, techniques for its assessment, and its surgical management. Insular epilepsy can mimic features of frontal, parietal, or temporal seizures. It should be considered when a combination of somatosensory, visceral, and motor symptoms is observed early in a seizure. Extraoperative intracranial recordings are required to accurately diagnose insular seizures...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28325030/application-of-meg-coherence-in-lateralization-of-mtle
#11
Mohammad R Nazem-Zadeh, Susan M Bowyer, John E Moran, Esmaeil Davoodi-Bojd, Andrew Zillgitt, Hassan Bagher-Ebadian, Fariborz Mahmoudi, Kost V Elisevich, Hamid Soltanian-Zadeh
Magnetoencephalography (MEG) is a noninvasive imaging method for localization of focal epileptiform activity in patients with epilepsy. This study investigates the cerebral functional abnormalities quantified by MEG coherence laterality in mesial temporal lobe epilepsy (mTLE). Resting state MEG data was analyzed using MEG coherence source imaging (MEG-CSI) method to determine the coherence in 54 anatomical sites in 12 adult mTLE patients and 12 age- and gender-matched controls. MEG coherence laterality, after Bonferroni adjustment, showed significant differences for right versus left mTLE in insular cortex and both lateral orbitofrontal and superior temporal gyri (p<;0...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28325026/application-of-dti-connectivity-in-lateralization-of-mtle
#12
Mohammad R Nazem-Zadeh, Susan M Bowyer, John E Moran, Esmaeil Davoodi-Bojd, Andrew Zillgitt, Hassan Bagher-Ebadian, Fariborz Mahmoudi, Kost V Elisevich, Hamid Soltanian-Zadeh
Diffusion tensor imaging (DTI) is a noninvasive imaging method for measuring the diffusion properties of the underlying white matter tracts through which epileptiform activity is propagated. This study investigates the structural abnormalities quantified by DTI in mesial temporal lobe epilepsy (mTLE). Fiber tracts passing through 54 anatomical sites in 12 adult mTLE patients and 12 age- and gender-matched controls were identified using DTI tractography. DTI nodal degree (ND) and laterality index were then calculated...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28319879/how-can-we-explain-the-frontal-presentation-of-insular-lobe-epilepsy-the-impact-of-non-linear-analysis-of-insular-seizures
#13
Koichi Hagiwara, Julien Jung, Romain Bouet, Chifaou Abdallah, Marc Guénot, Luis Garcia-Larrea, François Mauguière, Sylvain Rheims, Jean Isnard
OBJECTIVE: For a decade it has been known that the insular lobe epilepsy can mimic frontal lobe epilepsy. We aimed to clarify the pattern of functional coupling occurring during the frontal presentation. METHODS: We analyzed five insular lobe epilepsy patients. Frontal semiology was predominant for three of them, whereas insular semiology was predominant for the two others. We applied the non-linear regression analysis to stereoelectroencephalography-recorded seizures...
May 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28318128/proton-mr-spectroscopy-in-patients-with-nonlesional-insular-cortex-epilepsy-confirmed-by-invasive-eeg-recordings
#14
Yasmine Aitouche, Steve A Gibbs, Guillaume Gilbert, Olivier Boucher, Alain Bouthillier, Dang Khoa Nguyen
BACKGROUND AND PURPOSE: Recent studies suggest that a nonnegligible proportion of drug-resistant epilepsy surgery candidates have an epileptogenic zone that involves the insula. We aimed to examine the value of proton magnetic resonance spectroscopy ((1) H-MRS) in identifying patients with insular cortex epilepsy. METHODS: Patients with possible nonlesional drug-refractory insular epilepsy underwent a voxel-based (1) H-MRS study prior to an intracranial electroencephalographic (EEG) study...
March 20, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28281494/role-of-magnetoencephalography-and-stereo-electroencephalography-in-the-presurgical-evaluation-in-patients-with-drug-resistant-epilepsy
#15
REVIEW
V Jayabal, Ashok Pillai, S Sinha, N Mariyappa, P Satishchandra, S Gopinath, Kurupath Radhakrishnan
In selected patients with drug-resistant focal epilepsies (DRFE), who otherwise are likely to be excluded from epilepsy surgery (ES) because of the absence of a magnetic resonance imaging (MRI)-demonstrable lesion or discordant anatomo-electro-clinical (AEC) data, magnetoencephalography (MEG) may help to generate an AEC hypothesis and stereo-electroencephalography (SEEG) may help to verify the hypothesis and proceed with ES. The sensitivity of MEG is much better in localizing the spiking zone in relation to lateral temporal and extratemporal cortical regions compared to the mesial temporal structures...
2017: Neurology India
https://www.readbyqxmd.com/read/28227859/application-of-meg-coherence-in-lateralization-of-mtle
#16
Mohammad R Nazem-Zadeh, Susan M Bowyer, John E Moran, Esmaeil Davoodi-Bojd, Andrew Zillgitt, Hassan Bagher-Ebadian, Fariborz Mahmoudi, Kost V Elisevich, Hamid Soltanian-Zadeh, Mohammad R Nazem-Zadeh, Susan M Bowyer, John E Moran, Esmaeil Davoodi-Bojd, Andrew Zillgitt, Hassan Bagher-Ebadian, Fariborz Mahmoudi, Kost V Elisevich, Hamid Soltanian-Zadeh, Susan M Bowyer, Hassan Bagher-Ebadian, Esmaeil Davoodi-Bojd, Andrew Zillgitt, Fariborz Mahmoudi, John E Moran, Hamid Soltanian-Zadeh, Kost V Elisevich, Mohammad R Nazem-Zadeh
Magnetoencephalography (MEG) is a noninvasive imaging method for localization of focal epileptiform activity in patients with epilepsy. This study investigates the cerebral functional abnormalities quantified by MEG coherence laterality in mesial temporal lobe epilepsy (mTLE). Resting state MEG data was analyzed using MEG coherence source imaging (MEG-CSI) method to determine the coherence in 54 anatomical sites in 12 adult mTLE patients and 12 age- and gender-matched controls. MEG coherence laterality, after Bonferroni adjustment, showed significant differences for right versus left mTLE in insular cortex and both lateral orbitofrontal and superior temporal gyri (p<;0...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227761/application-of-dti-connectivity-in-lateralization-of-mtle
#17
Mohammad R Nazem-Zadeh, Susan M Bowyer, John E Moran, Esmaeil Davoodi-Bojd, Andrew Zillgitt, Hassan Bagher-Ebadian, Fariborz Mahmoudi, Kost V Elisevich, Hamid Soltanian-Zadeh, Mohammad R Nazem-Zadeh, Susan M Bowyer, John E Moran, Esmaeil Davoodi-Bojd, Andrew Zillgitt, Hassan Bagher-Ebadian, Fariborz Mahmoudi, Kost V Elisevich, Hamid Soltanian-Zadeh, Susan M Bowyer, Hassan Bagher-Ebadian, Esmaeil Davoodi-Bojd, Andrew Zillgitt, Fariborz Mahmoudi, John E Moran, Hamid Soltanian-Zadeh, Kost V Elisevich, Mohammad R Nazem-Zadeh
Diffusion tensor imaging (DTI) is a noninvasive imaging method for measuring the diffusion properties of the underlying white matter tracts through which epileptiform activity is propagated. This study investigates the structural abnormalities quantified by DTI in mesial temporal lobe epilepsy (mTLE). Fiber tracts passing through 54 anatomical sites in 12 adult mTLE patients and 12 age- and gender-matched controls were identified using DTI tractography. DTI nodal degree (ND) and laterality index were then calculated...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28202427/the-insula-lobe-and-sudden-unexpected-death-in-epilepsy-a-hypothesis
#18
Jia Li, Qianwen Ming, Weihong Lin
Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in patients with refractory epilepsy, particularly those with chronic epilepsy. The physiopathological mechanisms underlying SUDEP have not been elucidated. Autonomic dysregulation of cardiac or respiratory function is thought to underlie SUDEP. Here, we present a summary of available evidence on the involvement of the insular lobe in the regulation of cardiorespiratory function. Ictal discharge that originates in the cortex can, primarily or secondarily, involve the insula lobe through epileptogenic signal networks, leading to cardiorespiratory dysfunction, central apnoea, arrhythmias, and sudden death in patients with epilepsy...
March 1, 2017: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/28188304/-18-f-fdg-pet-patterns-of-surgical-success-and-failure-in-mesial-temporal-lobe-epilepsy
#19
Francine Chassoux, Eric Artiges, Franck Semah, Agathe Laurent, Elisabeth Landré, Baris Turak, Philippe Gervais, Badia-Ourkia Helal, Bertrand Devaux
OBJECTIVE: To search for [(18)F]-fluorodeoxyglucose (FDG)-PET patterns predictive of long-term prognosis in surgery for drug-resistant mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS). METHODS: We analyzed metabolic data with [(18)F]-FDG-PET in 97 patients with MTLE (53 female participants; age range 15-56 years) with unilateral HS (50 left) and compared the metabolic patterns, electroclinical features, and structural atrophy on MRI in patients with the best outcome after anteromesial temporal resection (Engel class IA, completely seizure-free) to those with a non-IA outcome, including suboptimal outcome and failure...
March 14, 2017: Neurology
https://www.readbyqxmd.com/read/28175482/203%C3%A2-insular-depth-electrode-in-pediatric-treatment-refractory-epilepsy
#20
Luke Tomycz, Ali Haider, Maura Hamilton, David B Clarke, Mark R Lee
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
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