SozRank: A new approach for localizing the epileptic seizure onset zone

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.

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The rate of contradictory lateralization of the epileptic seizure onset zone between ictal and interictal brain perfusion SPECT

10.1055/s-0041-1726755 ◽

2021 ◽

Author(s):

I Apostolova ◽

M Jaber ◽

J Taherpour ◽

S Stodieck ◽

S Klutmann ◽

...

Keyword(s):

Epileptic Seizure ◽

Brain Perfusion ◽

Seizure Onset ◽

Brain Perfusion Spect ◽

Seizure Onset Zone ◽

Perfusion Spect

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Assessment of the Utility of Ictal Magnetoencephalography in the Localization of the Epileptic Seizure Onset Zone

JAMA Neurology ◽

10.1001/jamaneurol.2018.1430 ◽

2018 ◽

Vol 75 (10) ◽

pp. 1264 ◽

Cited By ~ 12

Author(s):

Rafeed Alkawadri ◽

Richard C. Burgess ◽

Yosuke Kakisaka ◽

John C. Mosher ◽

Andreas V. Alexopoulos

Keyword(s):

Epileptic Seizure ◽

Seizure Onset ◽

Seizure Onset Zone

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A physiologically motivated ECoG segmentation method for epileptic seizure onset zone detection

2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society ◽

10.1109/embc.2012.6346720 ◽

2012 ◽

Author(s):

A. Graef ◽

C. Flamm ◽

S. Pirker ◽

M. Deistler ◽

C. Baumgartner

Keyword(s):

Epileptic Seizure ◽

Segmentation Method ◽

Seizure Onset ◽

Seizure Onset Zone

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Network dynamics of the brain and influence of the epileptic seizure onset zone

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1401752111 ◽

2014 ◽

Vol 111 (49) ◽

pp. E5321-E5330 ◽

Cited By ~ 149

Author(s):

Samuel P. Burns ◽

Sabato Santaniello ◽

Robert B. Yaffe ◽

Christophe C. Jouny ◽

Nathan E. Crone ◽

...

Keyword(s):

Epileptic Seizure ◽

Network Dynamics ◽

Seizure Onset ◽

Seizure Onset Zone ◽

The Brain

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Anticipation of epileptic seizure in advance and localization of seizure onset zone using power spectral density

2016 Second International Innovative Applications of Computational Intelligence on Power, Energy and Controls with their Impact on Humanity (CIPECH) ◽

10.1109/cipech.2016.7918758 ◽

2016 ◽

Cited By ~ 1

Author(s):

Aarti Sharma ◽

J.K. Rai ◽

R.P. Tewari

Keyword(s):

Spectral Density ◽

Power Spectral Density ◽

Epileptic Seizure ◽

Seizure Onset ◽

Seizure Onset Zone ◽

Power Spectral

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Phase–Amplitude Coupling and Epileptogenic Zone Localization of Frontal Epilepsy Based on Intracranial EEG

Frontiers in Neurology ◽

10.3389/fneur.2021.718683 ◽

2021 ◽

Vol 12 ◽

Author(s):

Huijuan Ma ◽

Zeyu Wang ◽

Chunsheng Li ◽

Jia Chen ◽

Yuping Wang

Keyword(s):

Epileptic Seizure ◽

Receiver Operating Curve ◽

Epileptic Focus ◽

Epileptogenic Zone ◽

Seizure Onset ◽

Intracranial Eeg ◽

Seizure Onset Zone ◽

Phase Amplitude ◽

Frontal Epilepsy

Objective: This study aimed to explore the characteristics of phase-amplitude coupling in patients with frontal epilepsy based on their electrocorticography data, in order to identify the localization of epileptic regions and further guide clinical resection surgery.Methods: We adopted the modulation index based on the Kullback-Leibler distance, phase-amplitude coupling co-modulogram, and time-varying phase-amplitude modulogram to explore the temporal-spatial patterns and characterization of PAC strength during the period from inter- seizure to post-seizure. Taking the resected area as the gold standard, the epileptogenic zone was located based on MI values of 7 different seizure periods, and the accuracy of localization was measured by the area under the receiver operating curve.Results: (1) The PAC in the inter- and pre-seizure periods was weak and paroxysmal, but strong PAC channels were confined more to the seizure-onset zone and resection region. PAC during the seizure period was intense and persistent, but gradually deviated from the seizure-onset zone. (2) The characteristics of coupling strength of the inter- and pre-seizure EEG can be used to accurately locate the epileptogenic zone, which is better than that in periods after the beginning of a seizure. (3) In an epileptic seizure, the preferred phases of coupling were usually in the rising branches at the pre- and early-seizure stages, while those in the middle- and terminal-seizure were usually in the falling branch. We thus speculate that the coupling occurred in the rising branch can promote the recruitment of abnormal discharge, while the coupling occurred in the falling branch can inhibit the abnormal discharge.Conclusion: The findings suggest that the phase-amplitude coupling during inter- and pre-seizure is a promising marker of epileptic focus location. The preferred phase of coupling changed regularly with the time of epileptic seizure, suggesting that the surge and suppression of abnormal discharges are related to different phases.

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