scholarly journals Optimization of surgical intervention outside the epileptogenic zone in the Virtual Epileptic Patient (VEP)

2019 ◽  
Vol 15 (6) ◽  
pp. e1007051 ◽  
Author(s):  
Sora An ◽  
Fabrice Bartolomei ◽  
Maxime Guye ◽  
Viktor Jirsa
Keyword(s):  
Surgical Intervention ◽  
Epileptic Patient ◽  
Epileptogenic Zone

scholarly journals On The Use of Machine Learning Algorithms to Classify Focal Cortical Dysplasia on MRI

2021 ◽  
Author(s):  
João Guilherme Pereira ◽  
Matheus de Freitas Oliveira Baffa ◽  
Fabrício Henrique Simozo ◽  
Luiz Otavio Murta Junior ◽  
Joaquim Cezar Felipe
Keyword(s):  
Deep Neural Network ◽  
Surgical Intervention ◽  
Refractory Epilepsy ◽  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Machine Learning Algorithms ◽  
Textural Features ◽  
Epileptogenic Zone ◽  
Neural Network Classifier ◽  
Multiple Classifiers

Refractory epilepsy is a condition characterized by epileptic seizure occurrence which cannot be controlled with antiepileptic drugs. This condition is associated with an excessive neuronal discharge produced by a group of neurons in a certain epileptogenic zone. Focal Cortical Dysplasia (FCD), usually found in these zones, was detected as one of the main causes of refractory epilepsy. In these cases, surgical intervention is necessary to minimize or eliminate the seizure occurrences. However, surgical treatment is only indicated in cases where there is complete certainty of the FCD. In order to assist neurosurgeons to detect precisely these regions, this paper aims to develop a classification method to detect FCD on MRI based on morphological and textural features from a voxel-level perspective. Multiple classifiers were tested throughout the extracted features, the best results achieved an accuracy of 91.76% using a Deep Neural Network classifier and 96.15% with J48 Decision Tree. The set of evaluating metrics showed that the results are promising.

Difficult-to-Localize Epilepsy After Stereoelectroencephalography: Technique, Safety, and Efficacy of Placing Additional Electrodes During the Same Admission

2020 ◽  
Vol 20 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Alexander C Whiting ◽  
Juan Bulacio ◽  
Benjamin B Whiting ◽  
Lara Jehi ◽  
William Bingaman
Keyword(s):  
Surgical Intervention ◽  
Infectious Complications ◽  
Antimicrobial Treatment ◽  
Surgical Patients ◽  
Epileptogenic Zone ◽  
Invasive Monitoring ◽  
Wound Breakdown ◽  
Safe Technique ◽  
Patients With Epilepsy

Abstract BACKGROUND Stereoelectroencephalography (SEEG) is used to identify the epileptogenic zone (EZ) in patients with epilepsy for potential surgical intervention. Occasionally, the EZ is difficult to localize even after an SEEG implantation. OBJECTIVE To demonstrate a safe technique for placing additional electrodes in ongoing SEEG evaluations. Describe efficacy, complications, and surgical outcomes. METHODS An operative technique which involves maintaining previously placed electrodes and sterilely placing new electrodes was developed and implemented. All patients who underwent placement of additional SEEG electrodes during the same admission were retrospectively reviewed. RESULTS A total of 14 patients met criteria and had undergone SEEG evaluation with 198 electrodes implanted. A total 93% of patients (13/14) had nonlesional epilepsy. After unsuccessful localization of the EZ after a mean of 9.6 d of monitoring, each patient underwent additional placement of electrodes (5.5 average electrodes per patient) to augment the original implantation. At no point did any patients develop new hemorrhage, infection, wound breakdown, or require any kind of additional antimicrobial treatment. A total 64% (9/14) of patients were able to undergo surgery aimed at removing the EZ guided by the additional SEEG electrodes. A total 44% (4/9) of surgical patients had Engel class I outcomes at an average follow-up time of 11 mo. CONCLUSION Placing additional SEEG electrodes, while maintaining the previously placed electrodes, appears to be safe, effective, and had no infectious complications. When confronted with difficult-to-localize epilepsy even after invasive monitoring, it appears to be safe and potentially clinically effective to place additional electrodes during the same admission

scholarly journals A Build Up of Seizure Prediction and Detection Software: A Review Article

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hadriche A ◽  
◽  
Jmail N ◽  
Keyword(s):  
Surgical Intervention ◽  
Neurological Diseases ◽  
Gamma Oscillations ◽  
Epileptogenic Zone ◽  
Cortical Tissue ◽  
Neurological Illness ◽  
Epilepsy Diagnosis ◽  
Detection Software ◽  
Space Time Evolution ◽  
Control Seizure

Introduction: Neurological diseases are much often due to our stressed daily life, and epilepsy is considered as a second cause of hospitalization in neurological illness. It is about 30% of epileptic cases where medicine would not stop or control seizure; hence, a surgical intervention is required to delineate abnormal hyperexcitable cortical tissue. Defining these epileptogenic zones is a challenge that require physiological and anatomical acquisition. Discussion: Clinicians, researcher and engineer researcher are multiplying advanced techniques in order to exploit these acquisitions for a better diagnosis. Several software are used to enhance epilepsy diagnosis. Here we proposed a software that rely on space-time evolution of inter- ictal gamma oscillations. Conclusion: Our proposed software would predict a build up of seizure during monitoring of stereo-electroencephalographic SEEG recording. It allows also detection of seizure during analysis and diagnosis of SEEG. This software would assist neurologist in recognition of seizure and in defining epileptogenic zone EZ.

scholarly journals A build up of seizure prediction and detection Software: A review

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Abir Hadriche ◽  
◽  
Nawel Jmail ◽  
Keyword(s):  
Surgical Intervention ◽  
Neurological Diseases ◽  
Gamma Oscillations ◽  
Epileptogenic Zone ◽  
Seizure Prediction ◽  
Cortical Tissue ◽  
Neurological Illness ◽  
Epilepsy Diagnosis ◽  
Detection Software ◽  
Control Seizure

Introduction: Neurological diseases are much often due to our stressed daily life, and epilepsy is considered as a second cause of hospitalization in neurological illness. It is about 30% of epileptic cases where medicine would not stop or control seizure; hence, a surgical intervention is required to delineate abnormal hyperexcitable cortical tissue. Defining these epileptogenic zones is a challenge that require physiological and anatomical acquisition. Discussion: Clinicians, researcher and engineer researcher are multiplying advanced techniques in order to exploit these acquisitions for a better diagnosis. Several software are used to enhance epilepsy diagnosis. Here we proposed a software that rely on spacetime evolution of inter- ictal gamma oscillations. Conclusion: Our proposed software would predict a build up of seizure during monitoring of stereo-electroencephalographic SEEG recording. It allows also detection of seizure during analysis and diagnosis of SEEG. This software would assist neurologist in recognition of seizure and in defining epileptogenic zone EZ. Keywords: Pharmaco-ressistant epilepsy; SEEG; Seizure build up; Prediction; Detection.

Thrombolysis in Arterial Occlusion

1999 ◽  
Vol 82 (S 01) ◽  
pp. 109-111 ◽  
Author(s):  
Raymond Verhaeghe
Keyword(s):  
Clinical Practice ◽  
Thrombolytic Therapy ◽  
Hemorrhagic Stroke ◽  
Surgical Intervention ◽  
Bypass Graft ◽  
Surgical Techniques ◽  
Arterial Occlusion ◽  
Second Step ◽  
Severe Bleeding ◽  
Initial Management

SummaryIntra-arterial thrombolytic therapy has replaced systemic intravenous infusion of thrombolytic agents as a treatment modality for arterial occlusion in the limbs. Several catheter-guided techniques and various infusion methods and schemes have been developed. At present there is no scientific proof of definite superiority of any agent in terms of efficacy or safety but clinical practice favours the use of urokinase or alteplase. Studies which compared thrombolysis to surgical intervention suggest that thrombolytic therapy is an appropriate initial management in patients with acute occlusion of a native leg artery or a bypass graft. Underlying causative lesions are treated in a second step by endovascular or open surgical techniques. Severe bleeding is the most feared complication: the risk of hemorrhagic stroke is 1-2%.

Surgical treatment of alveolar echinococcosis: a single centre experience and systematic review of the literature

2019 ◽  
Vol 98 (4) ◽  
pp. 167-173
Keyword(s):  
Case Report ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Lymphatic System ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Safety Margin ◽  
Surgical Removal ◽  
Single Centre Experience ◽  
Therapeutic Procedures

Introduction: Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis. AE is primarily localised in the liver. Echinococcus multilocularis imitates tumour-like behaviour. It can metastasise through blood or lymphatic system to distant organs. Echinococcosis often remains asymptomatic due to its long incubation period and indistinct symptoms. Clinical symptoms are determined by the parasite’s location. Diagnosis of echinococcosis is based on medical history, clinical symptoms, laboratory tests, serology results, imaging methods and final histology findings. Surgical removal of the cyst with a safety margin, followed by chemotherapy is the therapeutic method of choice. Case report: We present a case report of alveolar echinococcosis in a thirty-year-old female patient in whom we surgically removed multiple liver foci of alveolar echinococcosis. The disease recurred after two years and required another surgical intervention. Conclusions: Alveolar echinococcosis is a disease with a high potential for a complete cure provided that it is diagnosed early and that the recommended therapeutic procedures are strictly adhered to.

Outcomes of endoscopic surgical intervention for acromegaly - the Wessex experience

2018 ◽  
Author(s):  
Louise Curtis ◽  
N Mathad ◽  
Aabir Chakraborty ◽  
Sarah Brewster ◽  
Kate Millar ◽  
...  
Keyword(s):  
Surgical Intervention

Acute Aortic Intramural Hematoma Presenting with Painless Recurrent Syncope

2012 ◽  
Vol 15 (5) ◽  
pp. 286
Author(s):  
Jan Droste ◽  
Heidar Zafarani Zadeh ◽  
Mohammed Arif ◽  
Ian Craig ◽  
A K Thakur
Keyword(s):  
Aortic Wall ◽  
Surgical Intervention ◽  
Intramural Hematoma ◽  
Pericardial Tamponade ◽  
Transthoracic Echocardiogram ◽  
Type A Aortic Dissection ◽  
Severe Hypotension ◽  
Patient’S History ◽  
Aortic Intramural Hematoma ◽  
Venous Pulse

<p>A patient presented with recurrent syncope due to transient severe hypotension. The patient's history, physical examination, and initial baseline investigation did not suggest a cardiovascular cause. After fluid resuscitation, a raised jugular venous pulse was noted. Bedside transthoracic echocardiogram showed a pericardial effusion and a proximally dilated aorta. Computed tomography of the thorax confirmed these findings and also demonstrated an intramural hematoma of the proximal aortic wall.</p><p>The patient was transferred to a cardiothoracic center, where he was at first treated medically. He then developed sudden cardiogenic shock due to pericardial tamponade and was successfully operated on.</p><p>It is important to recognize an acute intramural hematoma of the proximal aortic wall as a cardiothoracic emergency. This condition can present atypically, but nevertheless warrants urgent surgical intervention, equal to type A aortic dissection. Echocardiography can help in making the diagnosis.</p>

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