Adding or repositioning intracranial electrodes during presurgical assessment of neocortical epilepsy: electrographic seizure pattern and surgical outcome

2004 ◽  
Vol 100 (3) ◽  
pp. 463-471 ◽  
Author(s):  
Sang Kun LEE ◽  
Kwang-ki Kim ◽  
Hyunwoo Nam ◽  
Jong Bai Oh ◽  
Chang Ho Yun ◽  
...  

Object. The aim of this study was to investigate changes in electroencephalography (EEG) patterns obtained from added or repositioned electrodes after those initially implanted had failed to indicate the true local ictal onset zone. The authors focused on the following matters: rationale for adding or repositioning electrodes, topographic and frequency characteristics of ictal onset before and after adding or repositioning electrodes, the effect of the procedures, and the relationship between changes in intracranial EEG onset patterns and surgical outcomes. Methods. Of 183 patients with intracranial recordings, 18 experienced repositioning of existing or implanting of additional electrodes 7 or 10 days later. All patients underwent resection and were followed up for more than 1 year. In particular, the relationship between surgical outcome and distribution/frequency of intracranial seizure onset was analyzed. Results of noninvasive presurgical evaluations in patients who had undergone single and double invasive studies were also evaluated. By adding or repositioning electrodes, a new ictal onset zone was revealed in 13 patients. In another four, the second evaluation led to a change in defining the resection margin. Ictal onset in the partially sampled area, simultaneous or independent onset in two separate areas, and onset in the distal end of the electrode strip or grid were common reasons for failing to localize the ictal onset zone during the initial evaluation. Seven of 11 patients who were ultimately found to have a focal ictal onset zone on the second evaluation became seizure free after the operation. Only one of six patients with a regional ictal onset zone identified on the second evaluation became seizure free. There was no relationship between the frequency of the ictal rhythm and surgical outcome. Note, however, that surgical outcome was more favorable in patients who had undergone a single invasive study than in those who had undergone double invasive studies. The patients who needed a second evaluation had less localizing information and less concordant results on presurgical evaluations. When comparing nonlesional cases, surgical outcomes were not significantly different among patients with a single invasive study and those with double invasive studies. No additional morbidity or death occurred during the second study. Conclusions. The addition or reposition of intracranial electrodes with a short-term interval should be considered in selected patients. Spatial restriction of the ictal onset rhythm identified on repeated evaluation is the most important predictor of a good surgical outcome.

1972 ◽  
Vol 36 (5) ◽  
pp. 564-568 ◽  
Author(s):  
Kenneth Tuerk ◽  
Norman E. Chase ◽  
Irvin I. Kricheff ◽  
Joseph P. Lin ◽  
Joseph Ransohoff

✓ Twenty patients with posterior communicating artery aneurysms were treated with common carotid ligation. Postligation visualization was accomplished in 16 cases by ipsilateral brachial angiography. Two other aneurysms were visualized by contralateral brachial and contralaterial carotid angiography. The size of the aneurysm was measured before and after ligation. The relationship of postoperative reduction in size to preoperative angiographic characteristics was studied. Reduction in the size of the aneurysm occurred most often when preoperative angiography showed that the sac was long and its neck narrow, and when there was stasis of contrast material in the aneurysm.


1981 ◽  
Vol 55 (6) ◽  
pp. 935-937 ◽  
Author(s):  
Giuseppe Salar ◽  
Salvatore Mingrino ◽  
Marco Trabucchi ◽  
Angelo Bosio ◽  
Carlo Semenza

✓ The β-endorphin content in cerebrospinal fluid (CSF) was evaluated in 10 patients with idiopathic trigeminal neuralgia during medical treatment (with or without carbamazepine) and after selective thermocoagulation of the Gasserian ganglion. These values were compared with those obtained in a control group of seven patients without pain problems. No statistically significant difference was found between patients suffering from trigeminal neuralgia and those without pain. Furthermore, neither pharmacological treatment nor surgery changed CSF endorphin values. It is concluded that there is no pathogenetic relationship between trigeminal neuralgia and endorphins.


2003 ◽  
Vol 98 (1) ◽  
pp. 21-31 ◽  
Author(s):  
Oliver Tucha ◽  
Christian Smely ◽  
Michael Preier ◽  
Georg Becker ◽  
Geraldine M. Paul ◽  
...  

Object. There is presently no specific information available concerning the nature and course of cognitive deficits caused by intracranial meningiomas. In this prospective study the authors examined the cognitive functioning of patients with frontal meningiomas. Methods. Fifty-four patients with frontal meningiomas were examined neuropsychologically before and after neurosurgery. The test battery consisted of standardized instruments including those assessing memory, attention, visuoconstructive abilities, and executive functions. The time period between pre-and postoperative assessment ranged from 4 to 9 months. The patients' performance was compared with the results in 54 healthy adults who were also assessed twice by using the same test battery in a period ranging from 4 to 9 months. In addition, the effect on cognition of meningioma lateralization, localization, lesion size, edema, brain compression, time course, and the occurrence of preoperative seizures was analyzed. Conclusions. Except in the case of working memory, comparisons of pre- and postoperative assessments of cognition revealed no differences in memory, visuoconstructive abilities, or executive functions, although a postoperative improvement in attentional functions was observed. The results of this study indicate that the surgical removal of frontal meningiomas does not impair patients' cognitive functioning. Furthermore, improvements in attentional functions may occur in these patients.


1997 ◽  
Vol 86 (1) ◽  
pp. 139-142 ◽  
Author(s):  
Martin M. Bednar ◽  
Cordell E. Gross ◽  
Sheila R. Russell ◽  
David Short ◽  
Patricia C. Giclas

✓ Although complement activation is associated with tissue injury during inflammatory and ischemic states, complement activation in states of acute cerebral ischemia before and after administration of tissue plasminogen activator (TPA) has not yet been examined and is the focus of this investigation. Twenty-four New Zealand White rabbits weighing 3 to 3.5 kg were used for this study. Of these, 20 were subjected to intracranial autologous clot embolization via the internal carotid artery. Three hours postembolization, rabbits received an intravenous infusion of TPA (6.3 mg/kg, 20% bolus with the remainder infused over a 2-hour interval; 12 animals) or vehicle (eight animals). All animals were observed for a total of 7 or 8 hours postembolization. These two groups were compared to a cohort undergoing sham operation with subsequent TPA infusion (four animals). Plasma samples to quantify complement component C5 hemolytic activity (C5H5O) were obtained at the following time points: 30 minutes before and after clot embolization; 1 hour before and 1 hour after the initiation of therapy with TPA or vehicle and at the completion of the protocol; 7 to 8 hours after clot embolization. The C5 activation was not detected as the result of acute cerebral ischemia. However, animals receiving TPA with or without concomitant clot embolization exhibited C5 activation as assessed by a reduction in C5 hemolytic function, both 1 hour after initiation of TPA infusion (78.7 ± 10.3% and 77.5 ± 9.9% of baseline value, respectively; mean ± standard error of the mean [SEM]) and at the end of the protocol, 2 hours after the completion of the TPA infusion (72.5 ± 8.8% and 53.3 ± 8.1%, respectively; mean ± SEM, p < 0.05, each group). This study supports the conclusion that TPA, but not acute cerebral ischemia, may activate the complement cascade in this rabbit model of thromboembolic stroke.


1994 ◽  
Vol 80 (3) ◽  
pp. 527-534 ◽  
Author(s):  
Yasuhiro Matsuda ◽  
Keiichi Kawamoto ◽  
Katsuzo Kiya ◽  
Kaoru Kurisu ◽  
Kazuhiko Sugiyama ◽  
...  

✓ The presence of the progesterone receptor (PR) in meningioma tissue has been confirmed by previous investigations. Studies have shown that the antiprogesterone drug, mifepristone, is a potent agent that inhibits the growth of cultured meningioma cells and reduces the size of meningiomas in experimental animal models and humans. However, these studies have not fully examined the relationship between the antitumor effects of an antiprogesterone agent and the expression of the PR. The present study examined the antitumor effects of mifepristone and a new potent antiprogesterone agent, onapristone; a correlation between the antitumor effects of these antiprogesterones and the presence of PR's in meningiomas in vitro and in vivo was also investigated. Meningioma tissue surgically removed from 13 patients was used in this study. In the in vitro arm of the study, mifepristone and onapristone exhibited cytostatic and cytocidal effects against cultured meningioma cells, regardless of the presence or absence of PR's; however, three PR-negative meningiomas showed no response to any dose of mifepristone and/or onapristone. In the in vivo arm, meningioma cells, embedded in a collagen gel, were implanted into the renal capsules of nude mice. Antiprogesterone treatment resulted in a marked reduction of the tumor volume regardless of the presence or absence of PR's. No histological changes in the meningioma cells suggestive of necrosis or apoptosis were detected in any of the mice treated with antiprogesterones. These findings suggest that mifepristone and onapristone have an antitumor effect against meningioma cells via the PR's and/or another receptor, such as the glucocorticoid receptor.


2005 ◽  
Vol 102 ◽  
pp. 234-240 ◽  
Author(s):  
Chihiro Ohye ◽  
Tohru Shibazaki ◽  
Sumito Sato

Object.The authors studied the effects of gamma knife thalamotomy (GKT) on Parkinson disease-related tremor and essential tremor before and after reloading of radioactive cobalt.Methods.Based on experience in stereotactic thalamotomy aided by depth microrecording, the target was located at the lateral border of the thalamic ventralis intermedius nucleus (VIM). For more precise targeting, the percentage representation of the thalamic VIM in relation to the entire thalamic length is useful. The location of the target was determined on magnetic resonance (MR) imaging and computerized tomography scanning. A maximum dose of 130 Gy was delivered to the target by using a single isocenter with the 4-mm collimator. In more recent cases, a systematic follow-up examination was performed at 3, 6, 12, 18, and 24 months after GKT.Since 1993, the authors have treated 70 patients with PD. Throughout the series the same dosimetric technique has been used. The course after GKT was compared between the 25 cases with PD treated before reloading and the 35 cases treated after reloading. In the majority (80–85%) treated after reloading, tremor and rigidity were reduced around 6 months after GKT. In the cases treated before reloading this effect took approximately 1 year. The thalamic reaction on MR imaging showed the same two lesion types in both series: a restricted and a diffuse. After reloading the restricted lesion was more frequent and the lesion volume was smaller.Conclusions.The shorter delay in clinical improvement and smaller lesion size may be related to an increased radiation dose.


1973 ◽  
Vol 38 (2) ◽  
pp. 167-171 ◽  
Author(s):  
Darwin J. Ferry ◽  
Ronald Gooding ◽  
Jim C. Standefer ◽  
G. Michael Wiese

✓ Cerebrospinal fluid (CSF) changes induced by Pantopaque myelography were determined by comparing samples of CSF from 47 patients with disc symptoms, obtained before and after myelography. Cell count, total protein, colloidal gold curve, and CSF protein electrophoretic patterns were compared. An immediate and persistent modest lymphocytosis was found. Total protein and CSF gamma globulin were elevated 3 weeks after myelography and throughout the remainder of the 80-day study period. This CSF profile characterizes a chronic inflammatory reaction induced by Pantopaque.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Anwar Sadat Shimul ◽  
Matthew Barber ◽  
Mohammad Ishmam Abedin

Purpose This paper aims to examine the role of religiosity on consumers’ forgiveness when celebrities get involved in transgression. The celebrity’s reaction and its impact on consumers’ forgiveness is tested as well. In addition, consumers’ attitudes towards the brand and celebrity as well as purchase intention for the endorsed brand are examined both before and after the transgression. Design/methodology/approach Data (n = 356) were collected through a self-administered online survey and analysed though structural equation modelling in AMOS 26. Findings The results show that consumers’ attitude towards celebrity, brand and purchase intention gets weaker once the celebrity gets into transgression. Consumers tend to forgive more if the celebrity apologises (vs denies) for the wrongdoing. The hypothesised relationship between attitude towards celebrity and purchase intention did not sustain after the transgression. In addition, consumers’ intrinsic religiosity strengthens the relationship between attitude towards the celebrity and purchase intention. Practical implications The findings of this research present valuable implications for brands practitioners. Brands should formulate actionable contingency plans to mitigate the negative ramifications of celebrity transgressions. Specifically, intrinsic religiosity and celebrity apologies should assist consumers in forgiving the transgression and negate the implications that could have arisen if the celebrity instead denied the transgressions. Originality/value This research extends the previous research by examining religiosity and forgiveness within the context of celebrity transgressions. To the best of the authors’ knowledge, this is one of the first few research studies to consider the role religiosity plays in consumers’ intention to forgive celebrity transgressions.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ja Young (Jacey) Choe ◽  
Jinkyung Jenny Kim ◽  
Jinsoo Hwang

Purpose The purpose of this study was to explore if five subdimensions of perceived risk (financial, time, privacy, performance and psychological risks) negatively affects image. In addition, this study aims to investigate if image has a positive effect on intentions to use. Lastly, the purpose of this study was to examine the moderating effect of Coronavirus disease-2019 (COVID-19), before and after the outbreak, in the relationship between perceived risk and image. Design/methodology/approach Data were collected from 331 people before the COVID-19 outbreak and 343 people after the COVID-19 outbreak. To test hypotheses, this study used structural equation modeling. Findings Time, performance and psychological risks negatively affected image before the outbreak of COVID-19. Meanwhile, performance risks and psychological risks had a negative influence on image only after the outbreak of COVID-19. In addition, there was demonstrated to be a positive relationship between image and intentions to use, both before and after the COVID-19 outbreak. Finally, the outbreak of COVID-19 positively moderates the relationship between performance risk and image. Practical implications The current study provides the following practical implications. First, industry practitioners need to develop a performance guarantee system which enhances the quality assurance of drone food delivery services (DFDS). Second, live streaming or creative activities would help to visualize DFDS in a way that stresses the stable operation of these services. Originality/value The importance of contactless services has been emphasized ever since the beginning of the COVID-19 outbreak. However, there has been very little research on the future of contactless services after COVID-19. This study investigated the perceived risk from DFDS as a form of contactless service which has not been conducted before. The findings of this study will improve the understanding of the changes that have occurred in consumers’ perception of risk from DFDS during the COVID-19 pandemic.


2004 ◽  
Vol 100 (4) ◽  
pp. 606-610 ◽  
Author(s):  
Taro Nimura ◽  
Tadashi Ando ◽  
Keiichiro Yamaguchi ◽  
Takeshi Nakajima ◽  
Reizo Shirane ◽  
...  

Object. Levodopa-induced dyskinesia (LID) in patients with Parkinson disease (PD) mimics acute dystonic reactions induced by antipsychotic agents, possibly mediated by σ-receptors; however, there are few reports in which the relationship between σ-receptors and LID in advanced PD is investigated. The binding potential of cerebellar σ-receptors before and after a pallidal surgery for dyskinesia in patients with advanced PD is assessed. Methods. Six patients with advanced PD (male/female ratio 3:3, age 56.7 ± 9.8 years) underwent stereotactic pallidal surgery (two posteroventral pallidotomy procedures and four deep brain stimulation of the globus pallidus internus, including one bilateral case). Clinical features of patients with PD were assessed using Hoehn and Yahr (H & Y) stages, the Unified Parkinson's Disease Rating Scale (UPDRS), and the Schwab and England Activities of Daily Life Scale (S & E). The LID was evaluated by LID severity score. The binding potential of cerebellar σ-receptors was determined before and after the surgery by 11C-nemonapride positron emission tomoraphy, a specific radioligand for σ-receptors in the cerebellum. All clinical scores, especially the LID severity score, were dramatically improved after the surgery (p < 0.05). Preoperatively, contralateral cerebellar binding potential was significantly elevated (p < 0.01), and it was reduced after the surgery, but it was still higher than that of healthy volunteers (p < 0.05). The ipsilateral cerebellar binding potential remained unchanged after the surgery. The level of binding potential did not correlate with H & Y stage, UPDRS, or S & E score, but a strong positive correlation was seen between the binding potential and the preoperative LID severity score when the patients were receiving medication (r = 0.893, p < 0.05). Conclusions. Cerebellar σ-receptors may potentially involve the genesis of LID in advanced PD.


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