SLEEPY HEAD: HYPERSOMNOLENCE FOLLOWING FRONTAL LOBECTOMY; EMPIRIC SCREENING FOLLOWING FRONTAL LOBE INJURY MAY BE JUSTIFIED

CHEST Journal ◽  
2018 ◽  
Vol 154 (4) ◽  
pp. 1092A
Author(s):  
PATRICK BAGLEY ◽  
CHRISTOPHER PHAM
Keyword(s):  
Frontal Lobe ◽  
Frontal Lobectomy

scholarly journals Epilepsy Surgery in the Frontal Lobe: Terra Incognita or New Frontier?

2007 ◽  
Vol 7 (4) ◽  
pp. 98-99 ◽  
Author(s):  
John W. Miller
Keyword(s):  
Frontal Lobe ◽  
Epilepsy Surgery ◽  
Prognostic Indicators ◽  
P Value ◽  
Frontal Lobe Epilepsy ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Ratio Test ◽  
Longitudinal Outcome ◽  
Frontal Lobectomy

Surgical Outcome and Prognostic Factors of Frontal Lobe Epilepsy Surgery. Jeha LE, Najm I, Bingaman W, Dinner D, Widdess-Walsh P, Luders H. Brain 2007;130(Pt 2):574–584. Epub 2007 Jan 5. Frontal lobe epilepsy (FLE) surgery is the second most common surgery performed to treat pharmacoresistant epilepsy. Yet, little is known about long-term seizure outcome following frontal lobectomy. The aim of this study is to investigate the trends in longitudinal outcome and identify potential prognostic indicators in a cohort of FLE patients investigated using modern diagnostic techniques. We reviewed 70 patients who underwent a frontal lobectomy between 1995 and 2003 (mean follow-up 4.1 ± 3 years). Data were analysed using survival analysis and multivariate regression with Cox proportional hazard models. A favourable outcome was defined as complete seizure-freedom, allowing for auras and seizures restricted to the first post-operative week. The estimated probability of complete seizure-freedom was 55.7% [95% confidence interval (CI) = 50–62] at 1 post-operative year, 45.1% (95% CI = 39–51) at 3 years, and 30.1% (95% CI = 21–39) at 5 years. Eighty per cent of seizure recurrences occurred within the first 6 post-operative months. Late remissions and relapses occurred, but were rare. After multivariate analysis, the following variables retained their significance as independent predictors of seizure recurrence: MRI-negative malformation of cortical development as disease aetiology [risk ratio (RR) = 2.22, 95% CI = 1.40–3.47], any extrafrontal MRI abnormality (RR = 1.75, 95% CI = 1.12–2.69), generalized/non-localized ictal EEG patterns (RR = 1.83, 95% CI = 1.15–2.87), occurrence of acute post-operative seizures (RR = 2.17, 95% CI = 1.50–3.14) and incomplete surgical resection (RR = 2.56, 95% CI = 1.66–4.05) (log likelihood-ratio test P-value < 0.0001). More than half of patients in favourable prognostic categories were seizure-free at 3 years, and up to 40% were seizure-free at 5 years, compared to <15% in those with unfavourable outcome predictors. These data underscore the importance of appropriate selection of potential surgical candidates.

scholarly journals Tailoring of Cortical Excisions for Frontal Lobe Epilepsy

1991 ◽  
Vol 18 (S4) ◽  
pp. 606-610 ◽  
Author(s):  
Theodore Rasmussen
Keyword(s):  
Frontal Cortex ◽  
Frontal Lobe ◽  
Marked Reduction ◽  
Temporal Cortex ◽  
Frontal Lobe Epilepsy ◽  
Frontal Lobectomy

ABSTRACT:Follow-up data of 2 to 49 years' duration are presented on 257 patients with cortical excisions for non-tumoral frontal lobe epilepsy. Twenty-six percent have become and remained seizure free. Another 30% have had a marked reduction of seizure tendency. Thus a total of 56% have had a long term complete or marked reduction of seizure tendency after the cortical resection. The cortical resections were classified into 5 regional categories. Forty-seven percent of patients with anterior frontal resections were in the seizure free category, as were 35% of patients with excisions limited to the convexity cortex and 32% of patients with maximal or near maximal frontal lobectomy. Only 18% of patients with frontal parasaggital excisions were in the seizure free category, and 10% of the patients who had excision of frontal cortex plus limited excision of adjacent central and/or temporal cortex.

Anterior Callosotomy Added to Frontal Lobectomy in Frontal Lobe Epilepsy

1995 ◽  
pp. 191-200
Author(s):  
N. Giard ◽  
I. Rouleau ◽  
A. Bouthillier ◽  
G. Bouvier ◽  
J. M. Saint-Hilaire
Keyword(s):  
Frontal Lobe ◽  
Frontal Lobe Epilepsy ◽  
Frontal Lobectomy

scholarly journals NCO-13NEUROCOGNITIVE CHANGES ASSOCIATED WITH FRONTAL LOBECTOMY FOR RIGHT AND LEFT FRONTAL LOBE GLIOMA

2015 ◽  
Vol 17 (suppl 5) ◽  
pp. v148.4-v149
Author(s):  
Petya Demireva ◽  
Kyle Noll ◽  
Jonathan Sellin ◽  
Sujit Prabhu ◽  
Jeffrey Wefel
Keyword(s):  
Frontal Lobe ◽  
Left Frontal Lobe ◽  
Frontal Lobectomy

scholarly journals Surgical Technique and Outcome of Extensive Frontal Lobectomy for Treatment of Intracable Non-lesional Frontal Lobe Epilepsy

2020 ◽  
Vol 60 (1) ◽  
pp. 17-25
Author(s):  
Sachiko HIRATA ◽  
Michiharu MORINO ◽  
Shunsuke NAKAE ◽  
Takahiro MATSUMOTO
Keyword(s):  
Surgical Technique ◽  
Frontal Lobe ◽  
Frontal Lobe Epilepsy ◽  
Frontal Lobectomy

The Lower Quadrant Leucotomy

1952 ◽  
Vol 98 (412) ◽  
pp. 389-400 ◽  
Author(s):  
F. T. Thorpe ◽  
James Hardman
Keyword(s):  
Frontal Lobe ◽  
Human Subjects ◽  
Frontal Lobes ◽  
Lower Quadrant ◽  
Pathological Lesions ◽  
Abstract Thought ◽  
Frontal Lobe Damage ◽  
Complex Planning ◽  
Frontal Lobectomy

In recent years efforts have been made to analyse the part played by the frontal lobes in the integration of personality. The pioneer work of Bianchi (1922) based on pathological lesions in human subjects, and on experimental bilateral ablations in monkeys, dogs and foxes, still appears to be as true to-day as when originally enunciated. Sherrington (1901) also described the changes following destruction of the frontal lobes. It was noted that such animals lost the power to learn and to enjoy themselves. They had no curiosity, but became restless, hyperactive and easily distracted. Brickner (1936) studied over many years a patient with bilateral frontal lobectomy who showed a diminished ability to synthesize abstract thoughts. Goldstein (1941) found that patients with frontal lobe damage lose their power for abstract thought and this is replaced by concrete behaviour, as shown by object grouping tests and their use of words. Similarly Penfield and Hebb (1940), in a case of extensive lobectomy for an infiltrating oligodendroglioma in an intelligent housewife, described a lack of ability for complex planning, such as is necessary for preparing a meal of several courses. Jefferson (1937) was unable to find any deficiency in cases of unilateral lobectomy. Rylander (1939), on the contrary, after lobectomy for tumours was able to detect changes similar to those found by Goldstein, and in cases with frontal lobe injury he found a lack of social sense. These patients were embarrassingly outspoken, and sometimes showed excessive activity or fatigue. Hebb (1945) concluded that studies on pathological lesions of the frontal lobes were not very helpful, owing to the lack of precision of the lesions due to the uncertain extent of the pathology.

scholarly journals The early argument for prefrontal leucotomy: the collision of frontal lobe theory and psychosurgery at the 1935 International Neurological Congress in London

2017 ◽  
Vol 43 (3) ◽  
pp. E4 ◽  
Author(s):  
Lillian B. Boettcher ◽  
Sarah T. Menacho
Keyword(s):  
Mental Illness ◽  
Frontal Lobe ◽  
Special Session ◽  
Early Argument ◽  
Cortical Localization ◽  
The 19Th Century ◽  
Modern Era ◽  
The Brain ◽  
Frontal Lobectomy ◽  
Frontal Ablation

The pathophysiology of mental illness and its relationship to the frontal lobe were subjects of immense interest in the latter half of the 19th century. Numerous studies emerged during this time on cortical localization and frontal lobe theory, drawing upon various ideas from neurology and psychiatry. Reflecting the intense interest in this region of the brain, the 1935 International Neurological Congress in London hosted a special session on the frontal lobe. Among other presentations, Yale physiologists John Fulton and Carlyle Jacobsen presented a study on frontal lobectomy in primates, and neurologist Richard Brickner presented a case of frontal ablation for olfactory meningioma performed by the Johns Hopkins neurosurgeon Walter Dandy. Both occurrences are said to have influenced Portuguese neurologist Egas Moniz (1874–1955) to commence performing leucotomies on patients beginning in late 1935. Here the authors review the relevant events related to frontal lobe theory leading up to the 1935 Neurological Congress as well as the extent of this meeting’s role in the genesis of the modern era of psychosurgery.

scholarly journals Neuropsychological outcome following frontal lobectomy for pharmacoresistant epilepsy in adults

Neurology ◽  
2017 ◽  
Vol 88 (7) ◽  
pp. 692-700 ◽  
Author(s):  
Robyn M. Busch ◽  
Darlene P. Floden ◽  
Lisa Ferguson ◽  
Shamseldeen Mahmoud ◽  
Audrina Mullane ◽  
...  
Keyword(s):  
Executive Functioning ◽  
Cognitive Decline ◽  
Frontal Lobe ◽  
Processing Speed ◽  
Visual Memory ◽  
Seizure Outcome ◽  
Pharmacoresistant Epilepsy ◽  
Wide Range ◽  
Motor Outcomes ◽  
Frontal Lobectomy

Objective:This retrospective cohort study characterized cognitive and motor outcomes in a large sample of adults who underwent frontal lobe resections for treatment of pharmacoresistant epilepsy.Methods:Ninety patients who underwent unilateral frontal lobe resection for epilepsy (42 language-dominant hemisphere/48 nondominant hemisphere) between 1989 and 2014 completed comprehensive preoperative and postoperative neuropsychological evaluations that included measures of verbal and nonverbal intellectual functioning, attention/working memory, processing speed, language, executive functioning, verbal and visual memory, and motor functioning. Objective methods were used to assess meaningful change across a wide range of abilities and to identify factors associated with neuropsychological decline following frontal lobectomy. Detailed postoperative neuroimaging analysis was conducted to characterize region, extent, and volume of resection.Results:Forty-eight percent of patients did not demonstrate meaningful postoperative declines in cognition and an additional 42% demonstrated decline in 1 or 2 cognitive domains. When cognitive decline was observed, it usually occurred on measures of intelligence, visuomotor processing speed, or executive functioning. Side and site of resection were unrelated to cognitive outcome, but played a role in decline of contralateral manual dexterity following supplementary motor area resection. Higher preoperative ability, older age at surgery, absence of a malformation of cortical development on MRI, and poor seizure outcome were related to cognitive decline on some measures, but had poor sensitivity in identifying at-risk patients.Conclusions:The vast majority of patients who undergo frontal lobectomy for treatment of pharmacoresistant epilepsy demonstrate good cognitive and motor outcomes.

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