scholarly journals Factors Associated with Short-Term Seizure Recurrence in Extratemporal Epilepsy Surgery

2021 ◽  
Vol 9 (3) ◽  
pp. 01-07
Author(s):  
Aisel Santos
Keyword(s):  
Epilepsy Surgery ◽  
Incomplete Resection ◽  
Epileptogenic Zone ◽  
Drug Resistant ◽  
Seizure Recurrence ◽  
Short Term ◽  
Factors Associated ◽  
Epileptiform Discharges ◽  
One Year

Introduction: Drug-resistant extratemporal epilepsy is the second cause of referral to epilepsy surgery. Objectives: To identify factors associated with short-term seizure recurrence following extratemporal epilepsy surgery. Materials and Methods: We performed a retrospective study of 19 consecutive patients who underwent surgery for drug-resistant extratemporal epilepsy at the National Institute of Neurology and Neurosurgery of Havana, Cuba, from September 2014 to October 2019. All patients had at least one year of postoperative follow-up. Fisher's exact test was used to search for an association between dichotomous variables. A value of p≤0.05 was considered significant. Results: After one year of follow-up, seizure freedom reached 31.6% (Engel I) and 36.8% showed significant improvement in the number of seizures (Engel II). The frontal location (p=0.046) and incomplete resection of the epileptogenic zone (p=0.017), bilateral interictal discharges on the preoperative electroencephalogram (EEG) (p=0.017), the presence of epileptiform discharges on the postsurgical EEG (p=0.001), and the occurrence of seizures after the sixth month of surgery (p=0.001), were associated with seizures recurrence. Conclusions: After one year, 31.6% of patients operated on for extratemporal epilepsy were seizure-free. The incomplete resection of the epileptogenic zone and the presence of epileptogenic discharges in the postsurgical EEG, and the presence of seizures after the sixth month of surgery were the most significant factors of seizure recurrence.

scholarly journals Reoperation after failed resective epilepsy surgery in children

2017 ◽  
Vol 20 (2) ◽  
pp. 134-140 ◽  
Author(s):  
Osama Muthaffar ◽  
Klajdi Puka ◽  
Luc Rubinger ◽  
Cristina Go ◽  
O. Carter Snead ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Pediatric Population ◽  
Seizure Outcome ◽  
Incomplete Resection ◽  
Epileptogenic Zone ◽  
Effective Treatment Option ◽  
Second Surgery ◽  
Class 1 ◽  
One Year ◽  
International League

OBJECTIVEAlthough epilepsy surgery is an effective treatment option, at least 20%–40% of patients can continue to experience uncontrolled seizures resulting from incomplete resection of the lesion, epileptogenic zone, or secondary epileptogenesis. Reoperation could eliminate or improve seizures. Authors of this study evaluated outcomes following reoperation in a pediatric population.METHODSA retrospective single-center analysis of all patients who had undergone resective epilepsy surgery in the period from 2001 to 2013 was performed. After excluding children who had repeat hemispherotomy, there were 24 children who had undergone a second surgery and 2 children who had undergone a third surgery. All patients underwent MRI and video electroencephalography (VEEG) and 21 underwent magnetoencephalography (MEG) prior to reoperation.RESULTSThe mean age at the first and second surgery was 7.66 (SD 4.11) and 10.67 (SD 4.02) years, respectively. The time between operations ranged from 0.03 to 9 years. At reoperation, 8 patients underwent extended cortical resection; 8, lobectomy; 5, lesionectomy; and 3, functional hemispherotomy. One year after reoperation, 58% of the children were completely seizure free (International League Against Epilepsy [ILAE] Class 1) and 75% had a reduction in seizures (ILAE Classes 1–4). Patients with MEG clustered dipoles were more likely to be seizure free than to have persistent seizures (71% vs 40%, p = 0.08).CONCLUSIONSReoperation in children with recurrent seizures after the first epilepsy surgery could result in favorable seizure outcomes. Those with residual lesion after the first surgery should undergo complete resection of the lesion to improve seizure outcome. In addition to MRI and VEEG, MEG should be considered as part of the reevaluation prior to reoperation.

Catheter-directed foam sclerotherapy treatment of saphenous vein incompetence

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Asciutto ◽  
Lindblad
Keyword(s):  
Saphenous Vein ◽  
Short Term ◽  
Foam Sclerotherapy ◽  
Results Of Treatment ◽  
Ulcer Healing Rate ◽  
Complete Obliteration ◽  
Ceap Classification ◽  
One Year ◽  
The One

Background: The aim of this study is to report the short-term results of catheter-directed foam sclerotherapy (CDFS) in the treatment of axial saphenous vein incompetence. Patients and methods: Data of all patients undergoing CDFS for symptomatic primary incompetence of the great or small saphenous vein were prospectively collected. Treatment results in terms of occlusion rate and patients’ grade of satisfaction were analysed. All successfully treated patients underwent clinical and duplex follow-up examinations one year postoperatively. Results: Between September 2006 and September 2010, 357 limbs (337 patients) were treated with CDFS at our institution. Based on the CEAP classification, 64 were allocated to clinical class C3 , 128 to class C4, 102 to class C5 and 63 to class C6. Of the 188 patients who completed the one year follow up examination, 67 % had a complete and 14 % a near complete obliteration of the treated vessel. An ulcer-healing rate of 54 % was detected. 92 % of the patients were satisfied with the results of treatment. We registered six cases of thrombophlebitis and two cases of venous thromboembolism, all requiring treatment. Conclusions: The short-term results of CDFS in patients with axial vein incompetence are acceptable in terms of occlusion and complications rates.

Sustained normoglycemia in newly diagnosed type I diabetic subjects. Short-term effects and one-year follow-up

Diabetes ◽  
1984 ◽  
Vol 33 (10) ◽  
pp. 995-1001 ◽  
Author(s):  
K. Perlman ◽  
R. M. Ehrlich ◽  
R. M. Filler ◽  
A. M. Albisser
Keyword(s):  
Type I ◽  
Newly Diagnosed ◽  
Short Term ◽  
One Year ◽  
Short Term Effects

scholarly journals 357 Factors associated with changes in health-related quality of life in children with cystic fibrosis during one-year follow-up

2017 ◽  
Vol 16 ◽  
pp. S154
Author(s):  
M. Van Horck ◽  
B. Winkens ◽  
G. Wesseling ◽  
K. de Winter-de Groot ◽  
I. De Vreede ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Health Related Quality ◽  
Factors Associated ◽  
Related Quality ◽  
Health Related ◽  
One Year

scholarly journals Medically resistant pediatric insular-opercular/perisylvian epilepsy. Part 1: invasive monitoring using the parasagittal transinsular apex depth electrode

2016 ◽  
Vol 18 (5) ◽  
pp. 511-522 ◽  
Author(s):  
Alexander G. Weil ◽  
Aria Fallah ◽  
Evan C. Lewis ◽  
Sanjiv Bhatia
Keyword(s):  
Epilepsy Surgery ◽  
Electrode Placement ◽  
Epileptogenic Zone ◽  
Drug Resistant ◽  
Depth Electrodes ◽  
Depth Electrode ◽  
Age At Surgery ◽  
Feasible Alternative ◽  
The Mean ◽  
Drug Resistant Epilepsy

OBJECTIVE Insular lobe epilepsy (ILE) is an under-recognized cause of extratemporal epilepsy and explains some epilepsy surgery failures in children with drug-resistant epilepsy. The diagnosis of ILE usually requires invasive investigation with insular sampling; however, the location of the insula below the opercula and the dense middle cerebral artery vasculature renders its sampling challenging. Several techniques have been described, ranging from open direct placement of orthogonal subpial depth and strip electrodes through a craniotomy to frame-based stereotactic placement of orthogonal or oblique electrodes using stereo-electroencephalography principles. The authors describe an alternative method for sampling the insula, which involves placing insular depth electrodes along the long axis of the insula through the insular apex following dissection of the sylvian fissure in conjunction with subdural electrodes over the lateral hemispheric/opercular region. The authors report the feasibility, advantages, disadvantages, and role of this approach in investigating pediatric insular-opercular refractory epilepsy. METHODS The authors performed a retrospective analysis of all children (< 18 years old) who underwent invasive intracranial studies involving the insula between 2002 and 2015. RESULTS Eleven patients were included in the study (5 boys). The mean age at surgery was 7.6 years (range 0.5–16 years). All patients had drug-resistant epilepsy as defined by the International League Against Epilepsy and underwent comprehensive noninvasive epilepsy surgery workup. Intracranial monitoring was performed in all patients using 1 parasagittal insular electrode (1 patient had 2 electrodes) in addition to subdural grids and strips tailored to the suspected epileptogenic zone. In 10 patients, extraoperative monitoring was used; in 1 patient, intraoperative electrocorticography was used alone without extraoperative monitoring. The mean number of insular contacts was 6.8 (range 4–8), and the mean number of fronto-parieto-temporal hemispheric contacts was 61.7 (range 40–92). There were no complications related to placement of these depth electrodes. All 11 patients underwent subsequent resective surgery involving the insula. CONCLUSIONS Parasagittal transinsular apex depth electrode placement is a feasible alternative to orthogonally placed open or oblique-placed stereotactic methodologies. This method is safe and best suited for suspected unilateral cases with a possible extensive insular-opercular epileptogenic zone.

scholarly journals Surgical Outcomes and EEG Prognostic Factors After Stereotactic Laser Amygdalohippocampectomy for Mesial Temporal Lobe Epilepsy

2021 ◽  
Vol 12 ◽  
Author(s):  
Shasha Wu ◽  
Naoum P. Issa ◽  
Maureen Lacy ◽  
David Satzer ◽  
Sandra L. Rose ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Surgical Outcomes ◽  
Mesial Temporal Lobe Epilepsy ◽  
Seizure Freedom ◽  
Seizure Recurrence ◽  
Factors Associated ◽  
Scalp Eeg ◽  
Mesial Temporal Lobe

Objective: To assess the seizure outcomes of stereotactic laser amygdalohippocampectomy (SLAH) in consecutive patients with mesial temporal lobe epilepsy (mTLE) in a single center and identify scalp EEG and imaging factors in the presurgical evaluation that correlate with post-surgical seizure recurrence.Methods: We retrospectively reviewed the medical and EEG records of 30 patients with drug-resistant mTLE who underwent SLAH and had at least 1 year of follow-up. Surgical outcomes were classified using the Engel scale. Univariate hazard ratios were used to evaluate the risk factors associated with seizure recurrence after SLAH.Results: The overall Engel class I outcome after SLAH was 13/30 (43%), with a mean postoperative follow-up of 48.9 ± 17.6 months. Scalp EEG findings of interictal regional slow activity (IRSA) on the side of surgery (HR = 4.05, p = 0.005) and non-lateralizing or contra-lateralizing seizure onset (HR = 4.31, p = 0.006) were negatively correlated with postsurgical seizure freedom. Scalp EEG with either one of the above features strongly predicted seizure recurrence after surgery (HR = 7.13, p &lt; 0.001) with 100% sensitivity and 71% specificity.Significance: Understanding the factors associated with good or poor surgical outcomes can help choose the best candidates for SLAH. Of the variables assessed, scalp EEG findings were the most clearly associated with seizure outcomes after SLAH.

scholarly journals The proportion of seizure onset zone contacts resected is not associated with outcome following SEEG-guided resective epilepsy surgery in children

2021 ◽  
Author(s):  
Mehdi Khan ◽  
Aswin Chari ◽  
Kiran Seunarine ◽  
Christin Eltze ◽  
Friederike Moeller ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Univariate Analysis ◽  
Seizure Outcome ◽  
Epileptogenic Zone ◽  
Imaging Data ◽  
Seizure Onset ◽  
Binary Logistic Regression Model ◽  
Primary Analysis ◽  
Seizure Onset Zone

AbstractPurposeChildren undergoing stereoelectroencephalography (SEEG)-guided epilepsy surgery represent a complex cohort. We aimed to determine whether the proportion of putative seizure onset zone (SOZ) contacts resected associates with seizure outcome in a cohort of children undergoing SEEG-guided resective epilepsy surgery.MethodsPatients who underwent SEEG-guided resective surgery over a six-year period were included. The proportion of SOZ contacts resected was determined by co-registration of pre- and post-operative imaging. Seizure outcomes were classified as seizure free (SF, Engel class I) or not seizure-free (NSF, Engel class II-IV) at last clinical follow-up.ResultsOf 94 patients undergoing SEEG, 29 underwent subsequent focal resection of whom 22 had sufficient imaging data to be included in the primary analysis (median age at surgery of 10 years, range 5-18). Fifteen (68.2%) were SF and 7 (31.8%) NSF at median follow-up of 19.5 months (range 12-46). On univariate analysis, histopathology, was the only significant factor associated with SF (p<0.05). The percentage of defined SOZ contacts resected ranged from 25-100% and was not associated with SF (p=0.89). In a binary logistic regression model, it was highly likely that histology was the only independent predictor of outcome, although the interpretation was limited by pseudo-complete separation of the data.ConclusionHistopathology is a significant predictor of surgical outcomes in children undergoing SEEG-guided resective epilepsy surgery. The percentage of SOZ contacts resected was not associated with SF. Factors such as spatial organisation of the epileptogenic zone, neurophysiological biomarkers and the prospective identification of pathological tissue may therefore play an important role.

scholarly journals Effect of short-term heart rate variability biofeedback on long-term abstinence in alcohol dependent patients – a one-year follow-up

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Ana Isabel Penzlin ◽  
Kristian Barlinn ◽  
Ben Min-Woo Illigens ◽  
Kerstin Weidner ◽  
Martin Siepmann ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Short Term ◽  
Heart Rate Variability Biofeedback ◽  
One Year ◽  
Alcohol Dependent

scholarly journals No association between the intake of marine n-3 PUFA during the second trimester of pregnancy and factors associated with cardiometabolic risk in the 20-year-old offspring

2013 ◽  
Vol 110 (11) ◽  
pp. 2037-2046 ◽  
Author(s):  
Dorte Rytter ◽  
Bodil H. Bech ◽  
Thorhallur Halldorsson ◽  
Jeppe H. Christensen ◽  
Erik B. Schmidt ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Cardiometabolic Risk ◽  
Venous Blood ◽  
Second Trimester ◽  
Short Term ◽  
Pufa Intake ◽  
Factors Associated ◽  
Regression Modelling ◽  
Offspring Adiposity

The intake of marine n-3 PUFA has been shown to decrease the risk of CVD in a number of studies. Since the development of CVD is often a lifelong process, marine n-3 PUFA intake early in life may also affect the development of later CVD. The aim of the present study was to investigate the association between maternal intake of marine n-3 PUFA during the second trimester of pregnancy and factors associated with cardiometabolic risk in the 20-year-old offspring. The study was based on the follow-up of the offspring of a Danish pregnancy cohort who participated in a study conducted from 1988 to 1989. A total of 965 pregnant women were originally included in the cohort and detailed information about the intake of marine n-3 PUFA during the second trimester was collected. In 2008–9, the offspring were invited to participate in a clinical examination including anthropometric, blood pressure (BP) and short-term heart rate variability measurements. Also, a fasting venous blood sample was drawn from them. Multiple linear regression modelling, using the lowest quintile of marine n-3 PUFA intake as the reference, was used to estimate the association with all outcomes. A total of 443 offspring participated in the clinical examination. No association between the intake of marine n-3 PUFA during the second trimester of pregnancy and offspring adiposity, glucose metabolism, BP or lipid profile was found. In conclusion, no association between the intake of marine n-3 PUFA during the second trimester of pregnancy and the factors associated with cardiometabolic risk in the 20-year-old offspring could be detected.

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