Novel non‐invasive modalities for presurgical evaluation in focal epilepsy

Introduction: about 20% to 30% of patients with epilepsy are diagnosed with drug-resistant epilepsy and one third of these are candidates for epilepsy surgery. Surgical resection of the epileptogenic tissue is a well-established method for treating patients with intractable focal epilepsy. Determining language laterality and locality is an important part of a comprehensive epilepsy program before surgery. Functional Magnetic Resonance Imaging (fMRI) has been increasingly employed as a non-invasive alternative method for the Wada test and cortical stimulation. Sensitive and accurate language tasks are essential for any reliable fMRI mapping. Methods: The present study reviews the methods of presurgical fMRI language mapping and their dedicated fMRI tasks, specifically for patients with epilepsy. Results: Different language tasks including verbal fluency are used in fMRI to determine language laterality and locality in different languages such as Persian. there are some considerations including the language materials and technical protocols for task design that all presurgical teams should take into consideration. Conclusion: Accurate presurgical language mapping is very important to preserve patients language after surgery. This review was the first part of a project for designing standard tasks in Persian to help precise presurgical evaluation and in Iranian PWFIE.

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Presurgical evaluation and postoperative seizure-outcome in children and adolescents with intracranial tumors and drug resistant focal epilepsy

Neuropediatrics ◽

10.1055/s-0031-1274074 ◽

2011 ◽

Vol 42 (S 01) ◽

Author(s):

T Hartlieb ◽

T Pieper ◽

S Kessler-Uberti ◽

HC Eitel ◽

T Getzinger ◽

...

Keyword(s):

Children And Adolescents ◽

Focal Epilepsy ◽

Seizure Outcome ◽

Drug Resistant ◽

Intracranial Tumors ◽

Presurgical Evaluation ◽

Postoperative Seizure

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Arterial Spin Labeling is a Useful MRI Method for Presurgical Evaluation in MRI-Negative Focal Epilepsy

Brain Topography ◽

10.1007/s10548-021-00833-5 ◽

2021 ◽

Author(s):

Martin Kojan ◽

Martin Gajdoš ◽

Pavel Říha ◽

Irena Doležalová ◽

Zdeněk Řehák ◽

...

Keyword(s):

Arterial Spin Labeling ◽

Focal Epilepsy ◽

Spin Labeling ◽

Presurgical Evaluation

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Multimodal approach in the pre-surgical evaluation of focal epilepsy surgery candidates: how far are we from a non-invasive ESI-based “sourcectomy”?

Epileptic Disorders ◽

10.1684/epd.2021.1309 ◽

2021 ◽

Vol 23 (4) ◽

pp. 661-666

Author(s):

Giulia Nobile ◽

Alessandro Consales ◽

Domenico Tortora ◽

Mattia Pacetti ◽

Francesca Gianno ◽

...

Keyword(s):

Epilepsy Surgery ◽

Focal Epilepsy ◽

Multimodal Approach ◽

Non Invasive ◽

Surgical Evaluation

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Stereoelectroencephalography-Guided Radiofrequency Thermocoagulation (SEEG-Guided RF-TC) in Patients with Drug-Resistant Focal Epilepsy

Translational Neuroscience and Clinics ◽

10.18679/cn11-6030_r.2017.006 ◽

2017 ◽

Vol 3 (1) ◽

pp. 40-47

Author(s):

Chengwei Xu ◽

Wenjing Zhou

Keyword(s):

Radio Frequency ◽

Surgical Resection ◽

Seizure Frequency ◽

Palliative Treatment ◽

Focal Epilepsy ◽

Epileptogenic Zone ◽

Drug Resistant ◽

Functional Area ◽

Presurgical Evaluation ◽

Epileptic Patients

For some patients with drug-resistant focal epilepsy, we usually select conventional surgical resection, which has brought better outcomes. However, others are not eligible for a conventional open surgical resection of the epileptogenic zone because of the proximity of a functional area or the implication of a larger epileptogenic network. Initially, stereoelectroencephalography (SEEG) exploration was a method of electroencephalography recording that was used in the presurgical evaluation of epileptic patients with complex epilepsy. Later, intracerebral electrodes used for SEEG were applied to produce radio frequency thermocoagulation (RF-TC) in epileptic patients. SEEG-guided RF-TC has produced some promising results, especially in the last dacade. Now, it has become popular as a palliative treatment to reduce seizure frequency in patients with drug-resistant focal epilepsy. This article presents a review of SEEG-guided RF-TC.

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Value of stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation in treating drug-resistant focal epilepsy

Brain Science Advances ◽

10.26599/bsa.2019.9050015 ◽

2019 ◽

Vol 5 (3) ◽

pp. 189-202

Author(s):

Jianjun Bai ◽

Wenjing Zhou ◽

Haixiang Wang ◽

Bingqing Zhang ◽

Jiuluan Lin ◽

...

Keyword(s):

Refractory Epilepsy ◽

Focal Epilepsy ◽

Intractable Epilepsy ◽

Epileptogenic Zone ◽

Presurgical Evaluation ◽

The Past ◽

Limited Efficacy ◽

Radiofrequency Thermocoagulation ◽

Temporary Treatment ◽

Promising Treatment

Stereoelectroencephalography (SEEG) has been widely used in the presurgical evaluation of patients with medically intractable epilepsy. In the past, SEEG was commonly used as a method for mapping and localizing the epileptogenic zone (EZ). Since 2004, several studies have been conducted to examine the effectiveness of SEEG-guided radiofrequency thermocoagulation (RF-TC) in treating refractory epilepsy. However, the seizure-free and responder rates varied greatly across studies. We aimed to analyze the outcome of 56 patients who were treated with SEEG-guided RF-TC to evaluate the effectiveness of this treatment. SEEG-guided RF-TC can be considered as a treatment for refractory epilepsy. However, due to its limited efficacy, SEEG-guided RF-TC might be regarded as a temporary treatment performed under SEEG rather than a promising treatment for refractory epilepsy.

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