The future of epilepsy surgery

2008 ◽  
pp. 237-242 ◽  
Keyword(s):  
Epilepsy Surgery ◽  
The Future

scholarly journals Intracranial EEG in the 21st Century

2020 ◽  
Vol 20 (4) ◽  
pp. 180-188 ◽  
Author(s):  
Barbara C. Jobst ◽  
Fabrice Bartolomei ◽  
Beate Diehl ◽  
Birgit Frauscher ◽  
Philippe Kahane ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
21St Century ◽  
High Frequency ◽  
Low Frequency ◽  
Epileptogenic Zone ◽  
Noninvasive Methods ◽  
Intracranial Eeg ◽  
Advantages And Disadvantages ◽  
Gamma Range ◽  
The Future

Intracranial electroencephalography (iEEG) has been the mainstay of identifying the seizure onset zone (SOZ), a key diagnostic procedure in addition to neuroimaging when considering epilepsy surgery. In many patients, iEEG has been the basis for resective epilepsy surgery, to date still the most successful treatment for drug-resistant epilepsy. Intracranial EEG determines the location and resectability of the SOZ. Advances in recording and implantation of iEEG provide multiple options in the 21st century. This not only includes the choice between subdural electrodes (SDE) and stereoelectroencephalography (SEEG) but also includes the implantation and recordings from microelectrodes. Before iEEG implantation, especially in magnetic resonance imaging -negative epilepsy, a clear hypothesis for seizure generation and propagation should be based on noninvasive methods. Intracranial EEG implantation should be planned by a multidisciplinary team considering epileptic networks. Recordings from SDE and SEEG have both their advantages and disadvantages. Stereo-EEG seems to have a lower rate of complications that are clinically significant, but has limitations in spatial sampling of the cortical surface. Stereo-EEG can sample deeper areas of the brain including deep sulci and hard to reach areas such as the insula.  To determine the epileptogenic zone, interictal and ictal information should be taken into consideration. Interictal spiking, low frequency slowing, as well as high frequency oscillations may inform about the epileptogenic zone. Ictally, high frequency onsets in the beta/gamma range are usually associated with the SOZ, but specialized recordings with combined macro and microelectrodes may in the future educate us about onset in higher frequency bands. Stimulation of intracranial electrodes triggering habitual seizures can assist in identifying the SOZ. Advanced computational methods such as determining the epileptogenicity index and similar measures may enhance standard clinical interpretation. Improved techniques to record and interpret iEEG may in the future lead to a greater proportion of patients being seizure free after epilepsy surgery.

Web-based eight-question tool to determine epilepsy surgery evaluation: The future is here

Neurology ◽  
2012 ◽  
Vol 79 (11) ◽  
pp. 1074-1075 ◽  
Author(s):  
J. T. Langfitt ◽  
G. W. Mathern
Keyword(s):  
Epilepsy Surgery ◽  
Web Based ◽  
The Future

Utility of neuronavigation and neuromonitoring in epilepsy surgery

2008 ◽  
Vol 25 (3) ◽  
pp. E17 ◽  
Author(s):  
Scellig S. D. Stone ◽  
James T. Rutka
Keyword(s):  
Present Article ◽  
Epilepsy Surgery ◽  
Refractory Epilepsy ◽  
Potential Utility ◽  
Technical Challenge ◽  
The Future ◽  
Therapeutic Opportunity ◽  
Medically Refractory Epilepsy

The management of medically refractory epilepsy poses both a valuable therapeutic opportunity and a formidable technical challenge to epilepsy surgeons. Recent decades have produced significant advancements in the capabilities and availability of adjunctive tools in epilepsy surgery. In particular, image-based neuronavigation and electrophysiological neuromonitoring represent versatile and informative modalities that can assist a surgeon in performing safe and effective resections. In the present article the authors discuss these 2 subjects with reference to how they can be applied and what evidence supports their use. As technologies evolve with demonstrated and potential utility, it is important for all clinicians who deal with epilepsy to understand where neuronavigation and neuromonitoring stand in the present and what avenues for improvement exist for the future.

The Future of Pediatric Epilepsy Surgery: Signposts and Science

1995 ◽  
Vol 6 (3) ◽  
pp. 589-598 ◽  
Author(s):  
Joseph R. Madsen ◽  
P. David Adelson ◽  
Michael M. Haglund
Keyword(s):  
Epilepsy Surgery ◽  
Pediatric Epilepsy ◽  
Pediatric Epilepsy Surgery ◽  
The Future

International determination of the total motion of the pole

1961 ◽  
Vol 13 ◽  
pp. 29-41
Author(s):  
Wm. Markowitz
Keyword(s):  
Secular Motion ◽  
The Future

A symposium on the future of the International Latitude Service (I. L. S.) is to be held in Helsinki in July 1960. My report for the symposium consists of two parts. Part I, denoded (Mk I) was published [1] earlier in 1960 under the title “Latitude and Longitude, and the Secular Motion of the Pole”. Part II is the present paper, denoded (Mk II).

Status of the Lick Proper Motion Program

1978 ◽  
Vol 48 ◽  
pp. 387-388
Author(s):  
A. R. Klemola
Keyword(s):  
Proper Motion ◽  
The Future

Second-epoch photographs have now been obtained for nearly 850 of the 1246 fields of the proper motion program with centers at declination -20° and northwards. For the sky at 0° and northward only 130 fields remain to be taken in the next year or two. The 270 southern fields with centers at -5° to -20° remain for the future.

Some Structural Features of Metaphase Chromosomes of Mice and Men

1967 ◽  
Vol 25 ◽  
pp. 190-191
Author(s):  
Godfrey C. Hoskins ◽  
Betty B. Hoskins
Keyword(s):  
Electron Microscopy ◽  
Electron Micrographs ◽  
Structural Features ◽  
Metaphase Chromosomes ◽  
The Future ◽  
Of Mice And Men ◽  
Mouse Cells ◽  
Human And Mouse

Metaphase chromosomes from human and mouse cells in vitro are isolated by micrurgy, fixed, and placed on grids for electron microscopy. Interpretations of electron micrographs by current methods indicate the following structural features.Chromosomal spindle fibrils about 200Å thick form fascicles about 600Å thick, wrapped by dense spiraling fibrils (DSF) less than 100Å thick as they near the kinomere. Such a fascicle joins the future daughter kinomere of each metaphase chromatid with those of adjacent non-homologous chromatids to either side. Thus, four fascicles (SF, 1-4) attach to each metaphase kinomere (K). It is thought that fascicles extend from the kinomere poleward, fray out to let chromosomal fibrils act as traction fibrils against polar fibrils, then regroup to join the adjacent kinomere.

Freeze-fracture cytochemistry: A goal set by Russell Steere in 1957

1993 ◽  
Vol 51 ◽  
pp. 60-61
Author(s):  
Nicholas J Severs
Keyword(s):  
Chemical Nature ◽  
Biological Systems ◽  
Freeze Fracture ◽  
Structural Components ◽  
Major Goal ◽  
Membrane Biology ◽  
Routine Application ◽  
The Future ◽  
Freeze Etching

In his pioneering demonstration of the potential of freeze-etching in biological systems, Russell Steere assessed the future promise and limitations of the technique with remarkable foresight. Item 2 in his list of inherent difficulties as they then stood stated “The chemical nature of the objects seen in the replica cannot be determined”. This defined a major goal for practitioners of freeze-fracture which, for more than a decade, seemed unattainable. It was not until the introduction of the label-fracture-etch technique in the early 1970s that the mould was broken, and not until the following decade that the full scope of modern freeze-fracture cytochemistry took shape. The culmination of these developments in the 1990s now equips the researcher with a set of effective techniques for routine application in cell and membrane biology.Freeze-fracture cytochemical techniques are all designed to provide information on the chemical nature of structural components revealed by freeze-fracture, but differ in how this is achieved, in precisely what type of information is obtained, and in which types of specimen can be studied.

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