scholarly journals Diagnostic evaluation of drug-resistant insular epilepsy

2019 ◽  
Vol 10 (4) ◽  
pp. 83-93 ◽  
Author(s):  
R. G. Khachatryan ◽  
G. S. Ibatova ◽  
T. M. Alekseeva ◽  
W. A. Khachatryan
Keyword(s):  
Surgical Treatment ◽  
Temporal Lobe ◽  
Insular Cortex ◽  
Drug Resistant ◽  
Epileptogenic Focus ◽  
Anatomical Features ◽  
Temporal Epilepsy ◽  
Drug Resistant Epilepsy ◽  
Possible Cause ◽  
Selection Of

About 30% of patients with temporal epilepsy are resistant to antiepileptic drugs; in such cases, surgical treatment is considered to be the best option. Existence of an extra-temporal epileptogenic focus in the insula is a possible cause of seizures after temporal lobe surgery in about 20% of patients. Because of its localization, the anatomical features of the insular lobe, as well as the entire concept of insular epilepsy have not been well documented. Yet, it has been established that the seizures developing from the insular cortex can mimic the paroxysms arising from the temporal lobe. When the insula is involved in the epileptic process, resection of the insular cortex improves the outcome of surgical treatment. Rational and well-based selection of candidates for surgical treatment is of paramount importance for patients with drug-resistant epilepsy. The article presents a review of the up-to-date literature on this matter.

Understanding the association of neurocysticercosis and mesial temporal lobe epilepsy and its impact on the surgical treatment of patients with drug-resistant epilepsy

2017 ◽  
Vol 76 ◽  
pp. 168-177 ◽  
Author(s):  
Marino Muxfeldt Bianchin ◽  
Tonicarlo Rodrigues Velasco ◽  
Lauro Wichert-Ana ◽  
Antonio Carlos dos Santos ◽  
Américo Ceiki Sakamoto
Keyword(s):  
Surgical Treatment ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Drug Resistant ◽  
Mesial Temporal Lobe ◽  
Drug Resistant Epilepsy

scholarly journals B.03 Safety and effectiveness of insular resections for drug-resistant epilepsy

2017 ◽  
Vol 44 (S2) ◽  
pp. S11-S11
Author(s):  
S Vuddagiri ◽  
L Bello-Espinosa ◽  
S Singh ◽  
S Wiebe ◽  
Y Agha-khani ◽  
...  
Keyword(s):  
Insular Cortex ◽  
Seizure Outcome ◽  
Epileptogenic Zone ◽  
Drug Resistant ◽  
Total Resection ◽  
Temporal Epilepsy ◽  
Surgical Evaluation ◽  
Drug Resistant Epilepsy ◽  
Age Range

Background: Insular cortex involvement as a part of epileptogenic zone is often suspected in the context of operculo-insular semiology and can be confirmed by routine interrogation of the insula with stereo-electroencephalography (SEEG). However the safety and efficacy of insular resections remains unclear. Methods: We reviewed all the patients who underwent insular resection for drug-resistant epilepsy, from 2002 – 2016, in the Calgary Epilepsy Program. Details of the comprehensive pre-surgical evaluation, surgery performed, complications and seizure outcome at the latest follow-up were collected. Results: Fifteen patients (8 males, 7 females) with age range 3 – 41 years were identified. MRI was normal in 9 patients. The decision to resect the Insula was made based on clinical semiology and structural and functional imaging in 6 patients and on SEEG findings in 9 patients. Insular resection was total in 11 and partial in 4 patients. Four (26%) patients had transient hemiparesis and 1 patient had permanent mild upper extremity weakness following total resection. After a mean follow-up period of 45.6 months (range 2 – 150 months), 40% of the patients are seizure free. Conclusions: Insular cortex resections for drug resistant epilepsy can be performed safely and may contribute to additional effectiveness in seizure outcomes in patients with challenging extra-temporal epilepsy.

Surgical treatment of bilateral temporal lobe pharmacoresistant epilepsy

2020 ◽  
pp. 60-82
Author(s):  
Igor Sergeevich Trifonov ◽  
Mikhail Vladimirovich Sinkin ◽  
Elena Vladimirovna Grigoryeva ◽  
Rashid Abdurakhmanovich Navruzov
Keyword(s):  
Surgical Treatment ◽  
Temporal Lobe ◽  
Clinical Picture ◽  
Clinical Manifestations ◽  
Epileptogenic Zone ◽  
Pharmacoresistant Epilepsy ◽  
Modern Methods ◽  
Selection For ◽  
Selection Of Patients ◽  
Selection Of

Surgical treatment of bilateral temporal lobe pharmacoresistant epilepsy is associated with some difficulties: particularly, the lack of stereotypical clinical picture in the same patient and controversial data on modern methods of diagnostics — all these statements make identifying epileptogenic zone more difficult and lack of clear criteria for the selection of patients for surgical treatment. In this review, issues of aetiology, pathogenesis, clinical manifestations and criteria for the selection for surgical treatment suggested by different authors are presented.

Surgical treatment of drug-resistant epilepsy following hippocampal sclerosis

2021 ◽  
Vol 85 (5) ◽  
pp. 31
Author(s):  
D.I. Pitskhelauri ◽  
E.S. Kudieva ◽  
A.G. Melikyan ◽  
P.A. Vlasov ◽  
M.I. Kamenetskaya ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hippocampal Sclerosis ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy

Selection of children with drug resistant epilepsy who are candidates for epilepsy surgery: pre and post-operative evaluation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Osama Salah Mohamed El Sharkawy ◽  
Zeinab Anwar El kabbany ◽  
Neveen Tawakol Younis ◽  
Khaled Aboulfotouh Ahmad ◽  
Ahmed Darwish Mahmoud ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Preoperative Evaluation ◽  
Drug Resistant ◽  
Surgery Outcome ◽  
Class 1 ◽  
Operative Evaluation ◽  
Drug Resistant Epilepsy ◽  
Stage 1 ◽  
International League ◽  
Selection Of

Abstract Objective To select patients with drug resistant epilepsy following up in Pediatrics Neurology Outpatient Clinic of Children's Hospital, Ain Shams University who are candidates for epilepsy surgery and to detect outcome of epilepsy surgery in such children as regards seizures control. Methods This prospective study was conducted over a period of 36 months and comprises of 3 stages. Stage 1 includes selection of candidates for epilepsy surgery and preoperative evaluation. Evaluation included clinical assessment, video EEG, MRI epilepsy protocol. Stage 2 include surgery phase where decision of surgery was made by a multidisciplinary team. Stage 3 includes post-operative evaluation as regards Seizures frequency, Seizures Severity using Chalfont score, Engel Epilepsy Surgery Outcome Scale and the International League Against Epilepsy (ILAE) outcome classification. Data was tabulated and analyzed with SSPS package for windows. Results 17 patients underwent epilepsy surgery. Results revealed significant decrease in seizures frequency and severity at 6 and 12 months after surgery. As regards Engel Epilepsy Surgery Outcome Scale 11 (64.7%) patients were class I at 12 months. As regards the ILAE outcome classification 10 (58.8%) patients are class 1 at 12 months. Conclusions epilepsy surgery can be a hope for patients with drug resistant epilepsy who are well selected and evaluated preoperatively. New studies on larger number and for longer duration are recommended.

scholarly journals Decision-making impairments following insular and medial temporal lobe resection for drug-resistant epilepsy

2016 ◽  
pp. nsw152 ◽  
Author(s):  
Zorina Von Siebenthal ◽  
Olivier Boucher ◽  
Isabelle Rouleau ◽  
Maryse Lassonde ◽  
Franco Lepore ◽  
...  
Keyword(s):  
Decision Making ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Drug Resistant ◽  
Temporal Lobe Resection ◽  
Drug Resistant Epilepsy

Safety and Usefulness of Insular Depth Electrodes Implanted Via an Oblique Approach in Patients with Epilepsy

2008 ◽  
Vol 62 (suppl_5) ◽  
pp. ONS471-ONS480 ◽  
Author(s):  
Afif Afif ◽  
Stephan Chabardes ◽  
Lorella Minotti ◽  
Philippe Kahane ◽  
Dominique Hoffmann
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Insular Cortex ◽  
Temporal Epilepsy ◽  
Depth Electrodes ◽  
Small Series ◽  
Group 3 ◽  
Group 2 ◽  
Oblique Approach ◽  
Group 1

Abstract Objective: This study investigates the feasibility, safety, and usefulness of depth electrodes stereotactically implanted within the insular cortex. Methods: Thirty patients with suspected insular involvement during epileptic seizure underwent presurgical stereotactic electroencephalographic recordings using 10 to 16 depth electrodes per patient. Among these, one or two electrodes were implanted via an oblique approach to widely sample the insular cortex. Results: Thirty-five insular electrodes were implanted in the 30 patients without morbidity. A total of 226 recording contacts (mean, 7.5 contacts/patient) explored the insular cortex. Stereotactic electroencephalographic recordings of seizures allowed the differentiation into groups: Group 1, 10 patients with no insular involvement; Group 2, 15 patients with secondary insular involvement; and Group 3, five patients with an initial insular involvement. In temporal epilepsy (n = 17), the insula was never involved at the seizure onset but was frequently involved during the seizures (11 out of 17). In fron-totemporal or frontal epilepsy, the insula was involved at the onset of seizure in five out of 13 patients. All patients in Groups 1 and 2 underwent surgery, with a seizure-free outcome in 76.2% of patients. In Group 3, only two of the five patients underwent surgery, with a poor outcome. In temporal lobe epilepsy, surgical outcome tended to be better in Group 1 compared with Group 2 in this small series: results were good in 83.3% (Engel I) versus 72.7%. Conclusion: Insula can be safely explored with oblique electrodes. In temporal lobe epilepsy, insular involvement does not significantly modify the short-term postoperative outcome. Future larger studies are necessary to clarify the long-term prognostic value of insular spread.

scholarly journals Erratum to: Markers of Neuroinflammation and Apoptosis in the Temporal Lobe of Patients with Drug-Resistant Epilepsy

2021 ◽  
Vol 57 (6) ◽  
pp. 1533-1533
Author(s):  
A. V. Litovchenko ◽  
Yu. M. Zabrodskaya ◽  
D. A. Sitovskaya ◽  
L. K. Khuzhakhmetova ◽  
V. G. Nezdorovina ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Drug Resistant ◽  
Drug Resistant Epilepsy
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