scholarly journals Feasibility of imaging epileptic seizure onset with EIT and depth electrodes

NeuroImage ◽  
2018 ◽  
Vol 173 ◽  
pp. 311-321 ◽  
Author(s):  
Anna Witkowska-Wrobel ◽  
Kirill Aristovich ◽  
Mayo Faulkner ◽  
James Avery ◽  
David Holder
Keyword(s):  
Epileptic Seizure ◽  
Seizure Onset ◽  
Depth Electrodes

scholarly journals The fence post depth electrode technique to control both brain tumors and epileptic seizures in patients with brain tumor-related epilepsy

2019 ◽  
Vol 10 ◽  
pp. 187 ◽  
Author(s):  
Yosuke Masuda ◽  
Ayataka Fujimoto ◽  
Mitsuyo Nishimura ◽  
Keishiro Sato ◽  
Hideo Enoki ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Epileptic Seizure ◽  
Epileptic Seizures ◽  
Seizure Onset ◽  
Tumor Removal ◽  
Depth Electrodes ◽  
Fence Post ◽  
Group 2 ◽  
The Brain ◽  
Group 1

Background: To control brain tumor-related epilepsy (BTRE), both epileptological and neuro-oncological approaches are required. We hypothesized that using depth electrodes (DEs) as fence post catheters, we could detect the area of epileptic seizure onset and achieve both brain tumor removal and epileptic seizure control. Methods: Between August 2009 and April 2018, we performed brain tumor removal for 27 patients with BTRE. Patients who underwent lesionectomy without DEs were classified into Group 1 (13 patients) and patients who underwent the fence post DE technique were classified into Group 2 (14 patients). Results: The patients were 15 women and 12 men (mean age, 28.1 years; median age 21 years; range, 5–68 years). The brain tumor was resected to a greater extent in Group 2 than Group 1 (P < 0.001). Shallower contacts showed more epileptogenicity than deeper contacts (P < 0.001). Group 2 showed better epilepsy surgical outcomes than Group 1 (P = 0.041). Conclusion: Using DEs as fence post catheters, we detected the area of epileptic seizure onset and controlled epileptic seizures. Simultaneously, we removed the brain tumor to a greater extent with fence post DEs than without.

scholarly journals Functional and Anatomic Correlates of Two Frequently Observed Temporal Lobe Seizure-Onset Patterns

2000 ◽  
Vol 7 (1-2) ◽  
pp. 49-63 ◽  
Author(s):  
Ana Luisa Velascol ◽  
Charles L. Wilson ◽  
Thomas L. Babb ◽  
Jerome Engel Jr
Keyword(s):  
Temporal Lobe ◽  
Low Voltage ◽  
Low Frequency ◽  
Neuronal Loss ◽  
High Amplitude ◽  
Seizure Onset ◽  
Depth Electrodes ◽  
Cell Counts ◽  
Number Of Patients ◽  
Temporal Lobe Seizure

Intracranial depth electrode EEG records of 478 seizures, recorded in 68 patients undergoing diagnostic monitoring with depth electrodes, were evaluated to investigate the correlates of electrographic onset patterns in patients with temporal lobe seizures. The seizure onsets in 78% of these patients were identified as either hypersynchronous onsets, beginning with low-frequency, high-amplitude spikes, or low-voltage fast (LVF) onsets, increasing in amplitude as the seizure progressed. The number of patients (35) having hypersynchronous seizure onsets was nearly twice that of patients (18) having LVF onsets. Three major differences were seen among patients with the two seizure-onset patterns. When compared with patients having LVF onsets, patients with hypersynchronous seizure onsets had a significantly greater probability of having (1) focal rather than regional seizure onsets (p<0.01), (2) seizures spreading more slowly to the contralateral mesial temporal lobe (p<0.003), and (3) cell counts in resected hippocampal tissue showing greater neuronal loss (p<0.001). The results provide evidence that the most frequent electrographic abnormality associated with mesial temporal seizures is local hypersynchrony, a condition associated with major neuronal-loss in the hippocampus. The results also indicate that LVF seizure onsets more frequently represent widely distributed discharges, which interact with and spread more rapidly to surrounding neocortical areas.

350 Stereoelectroencephalography for Refractory Localization-related Epilepsy: Initial Experience in 50 Patients

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 279-280
Author(s):  
Brett E Youngerman ◽  
Justin Oh ◽  
Yagna Pathak ◽  
Garrett P Banks ◽  
Sameer A Sheth ◽  
...  
Keyword(s):  
Seizure Freedom ◽  
Initial Experience ◽  
Seizure Onset ◽  
Depth Electrodes ◽  
Seizure Onset Zone ◽  
Previously Treated ◽  
Eloquent Cortex ◽  
Intracranial Recording ◽  
Epileptogenic Foci

Abstract INTRODUCTION Patients with pharmacotherapy-resistant localization-related epilepsy (LRE) may be candidates for surgical intervention if the seizure onset zone can be well localized. Long used in Europe, intracranial recording with stereoelectroencephalography (sEEG) is emerging as an alternative to subdural strip and grid techniques in North American centers. METHODS We reviewed our initial experience in a consecutive cohort of patients who underwent sEEG for extraoperative monitoring of LRE between May 2014 and September 2016. RESULTS >Fifty patients (37 adult, 13 pediatric) were implanted with 536 depth electrodes (mean 10.7 per patient, 7.9 per implanted hemisphere). Among 18 patients with suspected lesional epilepsy (including 3 with bilateral and 4 with multiple unilateral lesions), sEEG identified lesional foci in 16 (89%) cases (15 unifocal, 1 bitemporal). Two patients required further localization with subdural grids. Of 20 patients with nonlesional epilepsy, sEEG localized foci in 16 (80%) cases (13 unifocal, 2 bitemporal, 1 multifocal). Two patients had foci near eloquent cortex requiring grid placement for further mapping and two could not be focally localized. Finally, of 12 patients who had previous resections or ablations, sEEG localized foci in 11 (92%) cases (10 peri-cavity, 1 multifocal) and 1 was not focally localized. Complications were minor and rare. In 536 electrodes, there were no (0.0%) infections or symptomatic hemorrhages and 3 (0.6%) small, asymptomatic hemorrhages. One electrode was deflected into the subdural space during placement and 1 patient required replacement of 2 electrodes that were broken during seizures in the monitoring unit. CONCLUSION Robot-assisted sEEG is a safe and useful method for localizing epileptogenic foci in patients with lesional, nonlesional, and previously treated LRE. The success of seizure onset localization and safety compare favorably with invasive subdural monitoring. Longer clinical follow up will be required to determine whether sEEG monitoring improves long-term seizure freedom in these challenging epilepsy patients.

scholarly journals Influence analysis for high-dimensional time series with an application to epileptic seizure onset zone detection

2013 ◽  
Vol 214 (1) ◽  
pp. 80-90 ◽  
Author(s):  
Christoph Flamm ◽  
Andreas Graef ◽  
Susanne Pirker ◽  
Christoph Baumgartner ◽  
Manfred Deistler
Keyword(s):  
Time Series ◽  
Epileptic Seizure ◽  
High Dimensional ◽  
Seizure Onset ◽  
Influence Analysis ◽  
Seizure Onset Zone

scholarly journals Epileptic seizure propagation from the second somatic sensory area to the fronto-medial region, by insular redistribution. A case report and a connectome description

2015 ◽  
Vol 23 (1) ◽  
pp. 61-67
Author(s):  
Attila Balogh ◽  
Péter Halász ◽  
Dániel Fabó ◽  
Lóránd Erőss
Keyword(s):  
Case Report ◽  
Epilepsy Surgery ◽  
Epileptic Seizure ◽  
Motor Area ◽  
Seizure Onset ◽  
3T Mri ◽  
Sensory Area ◽  
Seizure Onset Zone ◽  
Video Eeg

SUMMARY Introduction. The seizure propagation phenomenon by inducing remote symptoms brings several difficulties in finding the seizure onset and delineating the epileptic network which should be taken into consideration in epilepsy surgery. By demonstrating a difficult (MRI negative) epilepsy surgery case explored with invasive presurgical evaluation we highlight the importance to recognise the secondary sensory area and to explore the the parieto-opercular-insular-medial frontal network in certain cases. A further conclusion is the consideration of the redistributory role of the insula as a special structure in the cerebral connectome, having a role in epileptic network organisation. Aims. To support the role of the insula in the organisation of an opercular – medial frontal epileptic network and to confirm Penfield’s the “second somatic sensory leg area” by way of a case report. We try to give an up to date exploration of our patient’s remote epileptic seizures by way of a connectome. Methods. The epileptic disorder was studied with intensive video EEG monitoring and two times 3T MRI. Interictal FDG (fluorodeoxyglucose) PET was also undertaken. Beside the scalp EEG and computerized frequency analysis, the evaluation was performed by invasive EEG with 2 grids and 2 strips and an insular deep electrode in addition. Electrical cortical stimulation and cortical mapping were also undertaken. Results. The video-EEG study revealed the complex seizure semiology. The left sided global somatosesensory aura in the leg, followed supplementary motor area manifestations represented a remote seizure. The seizure onset zone and the symptomatogenic zone were localised by the invasive electrophysiology. With the insular deep electrode we succeeded to explore the propagation of ictal activity to the insula and later to frontal medial surface. The PET, the negative 3T MRI results and the postprocessing morphometry confirmed the lesional origin and localised the epileptogenic area to the second somato-sensory field where a dysgenesis was located. Conclusions. By preoperative invasive video-EEG evaluation, the second somato-sensory leg area was delineated as the seizure onset zone. The resection of this area by IIb type cortical dysgenesis, resulted in a complete relief of the seizures. The invasive video-EEG revealed the peculiar role of the insula in the propagation of the epileptic seizure from the second sensory leg area to the ipsilateral fronto-medial supplemetary motor area. Our results, confirm, that the insula has a relay or node function on the parietal opercular-fronto-medial epileptic network. The connectome of the insula is a further additive of the scale-free features of the remote epileptic networks.

Fast, Accurate Localization of Epileptic Seizure Onset Zones Based on Detection of High-Frequency Oscillations Using Improved Wavelet Transform and Matching Pursuit Methods

2017 ◽  
Vol 29 (1) ◽  
pp. 194-219 ◽  
Author(s):  
Min Wu ◽  
Ting Wan ◽  
Xiongbo Wan ◽  
Yuxiao Du ◽  
Jinhua She
Keyword(s):  
Wavelet Transform ◽  
Epileptic Seizure ◽  
High Frequency ◽  
Matching Pursuit ◽  
Frequency Resolution ◽  
Adaptive Genetic Algorithm ◽  
Seizure Onset ◽  
High Frequency Oscillations ◽  
Mp Method ◽  
Seizure Onset Zones

This letter describes the improvement of two methods of detecting high-frequency oscillations (HFOs) and their use to localize epileptic seizure onset zones (SOZs). The wavelet transform (WT) method was improved by combining the complex Morlet WT with Shannon entropy to enhance the temporal-frequency resolution during HFO detection. And the matching pursuit (MP) method was improved by combining it with an adaptive genetic algorithm to improve the speed and accuracy of the calculations for HFO detection. The HFOs detected by these two methods were used to localize SOZs in five patients. A comparison shows that the improved WT method provides high specificity and quick localization and that the improved MP method provides high sensitivity.

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