6,736 results match your criteria Outcome of Epilepsy Surgery

Electroclinical markers to differentiate between focal and generalized epilepsies.

Epileptic Disord 2021 Jun 9. Epub 2021 Jun 9.

Paediatric Neurology Division, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa, Neurosciences Institute, University of Cape Town, South Africa.

Generalized-onset seizures originate at a point within the brain and rapidly engage bilaterally distributed networks, whilst focal-onset seizures originate within networks limited to one hemisphere which may be discretely localized or more widely distributed. Challenges in data capturing have resulted in a lack of consistency across incidence and prevalence studies for estimates of generalized versus focal epilepsies in population groups, with a preponderance of unclassified cases. Infants and young children can further challenge delineation due to variable expression at different stages of brain maturation and impaired ability to express sensory seizure semiology. Read More

View Article and Full-Text PDF

Neuroimaging in pediatric temporal lobe epilepsy: Does neuroimaging accurately predict pathology and surgical outcome?

Epilepsy Res 2021 Jun 4;175:106680. Epub 2021 Jun 4.

Division of Pediatric Neurology, University of Alberta, Edmonton, Alberta, Canada; Comprehensive Epilepsy Program, University of Alberta, Edmonton, Alberta, Canada.

Temporal lobe epilepsy (TLE) in children is considered different from that in adults. As such, characterizing the structural lesions present in pediatric patients with TLE and their association with long-term seizure control is important. Here, we aimed to assess the concordance between preoperative imaging and postoperative histopathological diagnoses and their associations with seizure outcomes in pediatric patients with TLE undergoing temporal lobe surgery. Read More

View Article and Full-Text PDF

Total and partial posterior quadrant disconnection for medically refractory epilepsy: A systematic review.

Seizure 2021 May 29;91:66-71. Epub 2021 May 29.

New Jersey Brain and Spine, Montclair, New Jersey, United States. Electronic address:

Purpose: Posterior quadrant disconnection (PQD) is a surgical procedure for medically refractory epilepsy (MRE) involving diffuse regions of the temporo-parieto-occipital lobes. We sought to compare factors and efficacy according to PQD extent.

Methods: We performed a systematic review of the literature reporting the use of PQD since 2004. Read More

View Article and Full-Text PDF

Efficacy of long-term adrenocorticotropic hormone therapy for West syndrome: A retrospective multicenter case series.

Epilepsia Open 2021 Jun 28;6(2):402-412. Epub 2021 May 28.

Epilepsy and Surgery Comprehensive Epilepsy Center Seirei Hamamatsu General Hospital Hamamatsu Japan.

Objectives: Long-term adrenocorticotropic therapy (LT-ACTH), which consisted of 2-4 weeks of daily injections of adrenocorticotropic hormone (ACTH) and subsequent months of weekly injections, was tried for relapsed West syndrome (WS) or other intractable epilepsies in small case reports. Our aim was to explore the efficacy of LT-ACTH for preventing WS relapse, as well as the prevalence of its adverse events.

Methods: This is a retrospective, nationwide, multicenter case series of patients with WS who underwent LT-ACTH. Read More

View Article and Full-Text PDF

Experiences of emotional and psychosocial functioning after frontal lobe resection for epilepsy.

Epilepsy Behav 2021 Jun 1;121(Pt A):108077. Epub 2021 Jun 1.

Department of Neurology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE-413 45 Göteborg, Sweden. Electronic address:

Purpose: Frontal lobe resection (FLR) is the second most common epilepsy surgery procedure in adults. Few studies address neuropsychological consequences after FLR. The aim of this study was to explore patients' and relatives' experiences of cognitive, emotional and social cognitive functioning after frontal lobe epilepsy surgery. Read More

View Article and Full-Text PDF

Seizure outcome after epilepsy surgery in tuberous sclerosis complex: Results and analysis of predictors from a multicenter study.

J Neurol Sci 2021 May 21;427:117506. Epub 2021 May 21.

Child Neuropsychiatry Unit - Epilepsy Center, ASST SS. Paolo e Carlo, San Paolo Hospital, Milan, Italy; Department of Health Sciences, University of Milan, Italy.

Epilepsy surgery is recommended in selected patients with Tuberous Sclerosis Complex (TSC). However, reports on predictive factors of seizure outcome are variable. Here we report on seizure and cognitive outcome of 35 TSC patients who received surgery for refractory epilepsy in 7 Italian centers over a period of 22 years (1997-2019). Read More

View Article and Full-Text PDF

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

Front Neurol 2021 17;12:654668. Epub 2021 May 17.

Department of Neurology, The University of Chicago, Chicago, IL, United States.

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. 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. Read More

View Article and Full-Text PDF

Choice and Trade-offs: Parent Decision Making for Neurotechnologies for Pediatric Drug-Resistant Epilepsy.

J Child Neurol 2021 Jun 2:8830738211015010. Epub 2021 Jun 2.

8166University of British Columbia, Division of Neurology, Department of Medicine, Vancouver, British Columbia, Canada.

This qualitative study investigated factors that guide caregiver decision making and ethical trade-offs for advanced neurotechnologies used to treat children with drug-resistant epilepsy. Caregivers with affected children were recruited to semi-structured focus groups or interviews at one of 4 major epilepsy centers in Eastern and Western Canada and the USA (n = 22). Discussions were transcribed and qualitative analytic methods applied to examine values and priorities (eg, risks, benefits, adherence, invasiveness, reversibility) of caregivers pertaining to novel technologies to treat drug-resistant epilepsy. Read More

View Article and Full-Text PDF

Subtraction ictal SPECT co-registered to MRI (SISCOM) patterns in children with temporal lobe epilepsy.

Epilepsy Behav 2021 May 29;121(Pt A):108074. Epub 2021 May 29.

Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Objective: We evaluated SISCOM patterns and their relationship with surgical outcome in children with temporal lobe epilepsy (TLE) who had undergone a temporal lobe surgery.

Methods: This was an observational study evaluating SISCOM patterns in 40 children with TLE. We classified SISCOM patterns into 4 categories; (i) unilateral anteromesial and/or anterolateral temporal pattern; (ii) unilateral anteromesial and/or anterolateral temporal plus posterior extension pattern; (iii) bilateral anteromesial and/or anterolateral temporal pattern; and (iv) atypical pattern. Read More

View Article and Full-Text PDF

In vivo hippocampal cornu ammonis 1-3 glutamatergic abnormalities are associated with temporal lobe epilepsy surgery outcomes.

Epilepsia 2021 May 31. Epub 2021 May 31.

Department of Neurology and Neurosurgery, Montréal Neurological Institute, McGill University, Montréal, Québec, Canada.

Objective: Previous positron emission tomography (PET) studies using [ C]ABP688 show reduced metabotropic glutamate receptor type 5 (mGluR5) allosteric binding site availability in the epileptogenic hippocampus of mesial temporal lobe epilepsy (MTLE) patients. However, the link between mGluR5 abnormalities and postsurgical outcomes remains unclear. Here, we test whether reduced PET [ C]ABP688 binding in cornu ammonis (CA) sectors more vulnerable to glutamatergic excitotoxicity relates to surgical outcomes. Read More

View Article and Full-Text PDF

Five-Year Follow-Up and Successful Kidney Transplantation in a Girl with a Severe Phenotype of Pierson Syndrome.

Nephron 2021 May 31:1-6. Epub 2021 May 31.

Department of Pediatric Nephrology, Medical University of Lublin, Lublin, Poland.

Pierson syndrome (PIERSS) is a rare autosomal recessive disorder characterized by the combination of congenital nephrotic syndrome (CNS) and extrarenal symptoms including ocular malformations and neurodevelopmental deficits. PIERSS is caused by biallelic pathogenic variants in the LAMB2 gene leading to the defects of β2-laminin, the protein mainly expressed in the glomerular basement membrane, ocular structures, and neuromuscular junctions. Severe complications of PIERSS lead to the fatal outcome in early childhood in majority of the cases. Read More

View Article and Full-Text PDF

Magnetic source imaging in presurgical evaluation of paediatric focal drug-resistant epilepsy and its predictive value of surgical outcome in lesional cases: A single-centre experience from South India.

Seizure 2021 May 24;91:22-28. Epub 2021 May 24.

MEG research Centre, NIMHANS, Hosur Road, Bangalore, India; Department of Neurology, NIMHANS, Hosur Road, Bangalore, India. Electronic address:

Objective: This study aims to evaluate the utility of magnetoencephalography in presurgical planning and in predicting post-surgical seizure outcome.

Methods: This study included a cohort of 231 children (1-18 years) with focal drug-resistant epilepsy who underwent MEG as a part of their presurgical workup. Characteristics of MEG observations were described in all children. Read More

View Article and Full-Text PDF

Subclinical seizures detected on intracranial EEG: Patient characteristics and impact on surgical outcome in a single pediatric epilepsy surgery center.

Epilepsy Behav 2021 May 28;121(Pt A):108040. Epub 2021 May 28.

Division of Epilepsy and Neurophysiology, Boston Children's Hospital, Boston, MA, United States.

Objective: Subclinical seizures (SCS) are often captured during intracranial EEG monitoring of pediatric patients with refractory focal epilepsy. However, their clinical significance remains uncertain. We aimed to characterize features associated with SCS and whether their presence impacts epilepsy outcomes post-surgically. Read More

View Article and Full-Text PDF

Clinical characteristics of low-grade tumor-related epilepsy and its predictors for surgical outcome.

Ann Clin Transl Neurol 2021 May 31. Epub 2021 May 31.

Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Objectives: Low-grade tumors are the most common neoplasms inducing focal epilepsy; however, the short- and medium-term efficacy of surgery in epilepsy patients with low-grade tumors remains underappreciated. This study aims to summarize the clinical characteristics of epilepsy patients with low-grade tumors and to identify factors associated with postsurgical seizure-free outcomes.

Methods: We retrospectively reviewed consecutive patients with low-grade tumors who underwent subsequent epilepsy surgery in our epilepsy center, between 2012 and 2018 with a minimum follow-up of 1 year. Read More

View Article and Full-Text PDF

Deep Brain Stimulation in KMT2B-Related Dystonia: Case Report and Review of the Literature With Special Emphasis on Dysarthria and Speech.

Front Neurol 2021 14;12:662910. Epub 2021 May 14.

Departmemt of Pediatric Neurology, Neuro-Rehabilitation and Epileptology, Schön Klinik Vogtareuth, Vogtareuth, Germany.

KMT2B-related dystonia is a progressive childhood-onset movement disorder, evolving from lower-limb focal dystonia into generalized dystonia. With increasing age, children frequently show prominent laryngeal or facial dystonia manifesting in dysarthria. Bilateral deep brain stimulation of the globus pallidus internus (GPi-DBS) is reported to be an efficient therapeutic option. Read More

View Article and Full-Text PDF

Source imaging of seizure onset predicts surgical outcome in pediatric epilepsy.

Clin Neurophysiol 2021 Apr 28;132(7):1622-1635. Epub 2021 Apr 28.

Laboratory of Children's Brain Dynamics, Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Jane and John Justin Neurosciences Center, Cook Children's Health Care System, Fort Worth, TX, USA; School of Medicine, Texas Christian University and University of North Texas Health Science Center, Fort Worth, TX, USA; Department of Bioengineering, University of Texas at Arlington, Arlington, TX, USA. Electronic address:

Objective: To assess whether ictal electric source imaging (ESI) on low-density scalp EEG can approximate the seizure onset zone (SOZ) location and predict surgical outcome in children with refractory epilepsy undergoing surgery.

Methods: We examined 35 children with refractory epilepsy. We dichotomized surgical outcome into seizure- and non-seizure-free. Read More

View Article and Full-Text PDF

Nomograms to Predict Verbal Memory Decline After Temporal Lobe Resection in Adults With Epilepsy.

Neurology 2021 May 19. Epub 2021 May 19.

Epilepsy Center and.

Objective: To develop and externally validate models to predict the probability of postoperative verbal memory decline in adults following temporal lobe resection (TLR) for epilepsy using easily-accessible preoperative clinical predictors.

Methods: Multivariable models were developed to predict delayed verbal memory outcome on three commonly used measures: Rey Auditory Verbal Learning Test (RAVLT) and Logical Memory (LM) and Verbal Paired Associates (VPA) subtests from Wechsler Memory Scale-Third Edition. Using Harrell's step-down procedure for variable selection, models were developed in 359 adults who underwent TLR at Cleveland Clinic and validated in 290 adults at one of five epilepsy surgery centers in the United States or Canada. Read More

View Article and Full-Text PDF

The feasibility of vagal nerve stimulation revision surgery and surgical techniques: a retrospective review.

Acta Otolaryngol 2021 May 18:1-5. Epub 2021 May 18.

Otolaryngology Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

Background: With the large number of VNS implants performed worldwide, the need for removal or replacement of the device in selected cases is emerging, this removal or replacement of VNS can be challenging.

Aims/objective: To describe the feasibility and safety of revising vagal nerve stimulation surgery in terms of the indications, surgical techniques, and outcomes.

Materials And Methods: A retrospective study, a series of eight cases with VNS implants that needed revision surgery have been reviewed, four devices were completely removed and four were only revised. Read More

View Article and Full-Text PDF

Functional hemispherectomy: can preoperative imaging predict outcome?

J Neurosurg Pediatr 2020 Jun 21;25(6). Epub 2020 Feb 21.

Division of Pediatric Neurosurgery, Department of Neurosurgery, Brain Institute, Miami Children's Hospital, Miami, Florida.

Objective: Although hemispherectomy is an effective treatment for children with intractable hemispheric epilepsy syndromes, as many as 40% of patients eventually develop seizure recurrence. The causes of seizure recurrence in these patients are incompletely understood. The authors sought to evaluate the efficacy of hemispherectomy at their center and determine whether contralateral MRI abnormalities can predict seizure recurrence. Read More

View Article and Full-Text PDF

Tumor-associated epilepsy in patients with brain metastases: necrosis-to-tumor ratio forecasts postoperative seizure freedom.

Neurosurg Rev 2021 May 14. Epub 2021 May 14.

Department of Neurosurgery, Center of Integrated Oncology (CIO) Bonn, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.

Surgical resection is highly effective in the treatment of tumor-related epilepsy (TRE) in patients with brain metastases (BM). Nevertheless, some patients suffer from postoperative persistent epilepsy which negatively impacts health-related quality of life. Therefore, early identification of patients with potentially unfavorable seizure outcome after BM resection is important. Read More

View Article and Full-Text PDF

Temporal lobe epilepsy with amygdala enlargement: A systematic review.

Acta Neurol Scand 2021 May 13. Epub 2021 May 13.

Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Temporal lobe epilepsy (TLE) with enlargement of the amygdala (AE) is a distinct clinical entity with contrasting clinical features from TLE with hippocampal sclerosis (HS). The objectives of this systematic analysis were to study the clinical characteristics and treatment outcome of people with TLE with AE. Pubmed, Embase, Cochrane, Web of Science, Scopus, and Medline were searched using the keywords amygdala enlargement, temporal lobe epilepsy, epilepsy, and seizure in November 2020. Read More

View Article and Full-Text PDF

Connectivity within regions characterizes epilepsy duration and treatment outcome.

Hum Brain Mapp 2021 May 11. Epub 2021 May 11.

School of Computing, Newcastle University, Newcastle upon Tyne, UK.

Finding clear connectome biomarkers for temporal lobe epilepsy (TLE) patients, in particular at early disease stages, remains a challenge. Currently, the whole-brain structural connectomes are analyzed based on coarse parcellations (up to 1,000 nodes). However, such global parcellation-based connectomes may be unsuitable for detecting more localized changes in patients. Read More

View Article and Full-Text PDF

Surgical Treatment of Unruptured Brain AVMs: Short- and Long-Term Results.

Acta Neurochir Suppl 2021 ;132:87-90

National Medical Research Center "Burdenko Neurosurgical Institute", Moscow, Russia.

Unruptured brain AVMs (bAVMs) remain a controversial subject for practicing neurosurgeons, especially in the light of ARUBA and other observational studies. This retrospective study aims to analyze our experience with unruptured bAVMs to see whether it is beneficial in the long-term and how it corresponds to large literature trials. The study comprised 160 adult patients with unruptured bAVMs surgically treated in Burdenko NMC (Moscow) in 2009-2017. Read More

View Article and Full-Text PDF
January 2021

Automated ictal EEG source imaging: A retrospective, blinded clinical validation study.

Clin Neurophysiol 2021 Apr 27. Epub 2021 Apr 27.

Department of Clinical Neurophysiology, Danish Epilepsy Centre, Visby Allé 5, 4293 Dianalund, Denmark; Department of Clinical Neurophysiology, Aarhus University Hospital, Palle Juul-Jensens Blvd., 8200 Aarhus, Denmark. Electronic address:

Objective: EEG source imaging (ESI) is a validated tool in the multimodal workup of patients with drug resistant focal epilepsy. However, it requires special expertise and it is underutilized. To circumvent this, automated analysis pipelines have been developed and validated for the interictal discharges. Read More

View Article and Full-Text PDF

A meta-analysis on potential modifiers of LITT efficacy for mesial temporal lobe epilepsy: Seizure-freedom seems to fade with time.

Clin Neurol Neurosurg 2021 Apr 20;205:106644. Epub 2021 Apr 20.

Departments of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece.

Background: The efficacy of laser interstitial thermal therapy (LITT) in mesial temporal lobe epilepsy (MTLE) has not been clearly established yet.

Objective: We conducted a meta-analysis to estimate the efficacy of LITT for TLE (Q1). We also examined the effect of the patient's age (Q2), the total ablation volume (TAV) (Q3), the strength of the MRI unit (Q4), the type of the utilized stereotactic platform (Q5), and the follow up period (Q6) on the patient's outcome. Read More

View Article and Full-Text PDF

Altered ripple density inside seizure onset zone in patients with focal cortical dysplasia-associated epilepsy.

Brain Behav 2021 May 7:e02169. Epub 2021 May 7.

Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.

Purpose: To evaluate the clinical and stereoelectroencephalography (SEEG) features and postsurgical outcome in a uniform series of patients who underwent epilepsy surgery and had pathologically confirmation of focal cortical dysplasia (FCD).

Methods: We studied consecutive patients with drug-refractory epilepsy who underwent SEEG recording. The high-frequency oscillations (HFOs) features of SEEG, clinical characteristics, and surgical outcome were evaluated. Read More

View Article and Full-Text PDF

Objective interictal electrophysiology biomarkers optimize prediction of epilepsy surgery outcome.

Brain Commun 2021 14;3(2):fcab042. Epub 2021 Mar 14.

Department of Paediatrics, Children's Hospital of Michigan, Detroit Medical Centre, Wayne State University, Detroit, MI 48201, USA.

Researchers have looked for rapidly- and objectively-measurable electrophysiology biomarkers that accurately localize the epileptogenic zone. Promising candidates include interictal high-frequency oscillation and phase-amplitude coupling. Investigators have independently created the toolboxes that compute the high-frequency oscillation rate and the severity of phase-amplitude coupling. Read More

View Article and Full-Text PDF

Interictal spike networks predict surgical outcome in patients with drug-resistant focal epilepsy.

Ann Clin Transl Neurol 2021 Jun 5;8(6):1212-1223. Epub 2021 May 5.

Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada.

Objective: To determine if properties of epileptic networks could be delineated using interictal spike propagation seen on stereo-electroencephalography (SEEG) and if these properties could predict surgical outcome in patients with drug-resistant epilepsy.

Methods: We studied the SEEG of 45 consecutive drug-resistant epilepsy patients who underwent subsequent epilepsy surgery: 18 patients with good post-surgical outcome (Engel I) and 27 with poor outcome (Engel II-IV). Epileptic networks were derived from interictal spike propagation; these networks described the generation and propagation of interictal epileptic activity. Read More

View Article and Full-Text PDF

Surgical treatment of children with drug-resistant epilepsy involving the Rolandic area.

Epileptic Disord 2021 Apr;23(2):376-384

Pediatric Epilepsy Center, Peking University First Hospital, No. 1 Xi'an Men Street, Xicheng District, Beijing 100034, China, Department of Pediatrics, Peking University First Hospital, No. 1 Xi'an Men Street, Xicheng District, Beijing 100034, China.

We retrospectively analysed the clinical features and prognostic factors of surgery in children with drug-resistant epilepsy involving the Rolandic area, and the relationship between the stable compound muscle action potentials (CMAPs) of intraoperative neurophysiological monitoring (IONM) and good motor function outcomes postoperatively. A study was conducted on the clinical data of 91 patients with epilepsy who underwent epilepsy surgery involving the Rolandic area and IONM from November 2015 to February 2019. In total, 91 patients were included in this study. Read More

View Article and Full-Text PDF