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Brain Commun 2022 6;4(3):fcac115. Epub 2022 May 6.

Department of Neurology, Bioelectronics Neurophysiology and Engineering Laboratory, Mayo Clinic, Rochester, MN, USA.

Early implantable epilepsy therapy devices provided open-loop electrical stimulation without brain sensing, computing, or an interface for synchronized behavioural inputs from patients. Recent epilepsy stimulation devices provide brain sensing but have not yet developed analytics for accurately tracking and quantifying behaviour and seizures. Here we describe a distributed brain co-processor providing an intuitive bi-directional interface between patient, implanted neural stimulation and sensing device, and local and distributed computing resources. Read More

Altern Ther Health Med 2022 Jun 24. Epub 2022 Jun 24.

Context: Parietal lobe epilepsy (PLE) accounts for approximately 5% of all focal epilepsies worldwide,1 and few PLE patients have undergone epilepsy surgery in the past. With the introduction of functional neuroimaging methods, such as interictal fluorodeoxyglucose-positron emission tomography (FDG-PET), stereotactic electroencephalograms (SEEGs), and high-resolution magnetic resonance imaging (MRI), more patients with intractable neocortical epilepsy have been considered for surgical treatment.

Objective: The study intended to characterize the clinical features, aura, and presurgical evaluations of patients with PLE, by investigating their demographic and clinical characteristics, and to evaluate the prognostic value of the four diagnostic modalities-MRI, FDG-PET, scalp EEG, and SEEG-in terms of the localization of epileptogenic area. Read More

Epilepsia 2022 Jun 25. Epub 2022 Jun 25.

Texas Institute for Restorative Neurotechnologies, The University of Texas Health Science Center at Houston, Houston, TX, USA.

Seizure clusters are seizures that occur in rapid succession during periods of heightened seizure risk and are associated with substantial morbidity and sudden unexpected death in epilepsy. The objective of this feasibility study is to evaluate the performance of a novel seizure cluster forecasting algorithm. Chronic ambulatory electrocorticography recorded over an average of 38 months in 10 subjects with drug-resistant epilepsies was analyzed pseudoprospectively by dividing data into training (first 85%) and validation periods. Read More

Acta Clin Croat 2021 Dec;60(4):627-631

1Department of Neurosurgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; 2Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 3Department of Anatomy, University of Applied Health Sciences, Zagreb, Croatia; 4Josip Juraj Strossmayer University of Osijek, School of Dental Medicine and Health, Osijek, Croatia; 5University of Applied Health Sciences, Zagreb, Croatia.

Dysembryoplastic neuroepithelial tumors (DNETs) are benign neoplasms classified in the category of glioneuronal tumors. The estimated incidence of DNETs is 0.03 100,000 person year with the age peak in a range between 10 and 14 years, and decreasing dramatically with increasing age. Read More

J Neuroimaging 2022 Jun 21. Epub 2022 Jun 21.

Localization Laboratory, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background And Purpose: The success of epilepsy surgery in children with tuberous sclerosis complex (TSC) hinges on identification of the epileptogenic zone (EZ). We studied structural MRI markers of epileptogenic lesions in young children with TSC.

Methods: We included 26 children with TSC who underwent epilepsy surgery before the age of 3 years at five sites, with 12 months or more follow-up. Read More

Front Neurosci 2022 2;16:861480. Epub 2022 Jun 2.

Klinik für Neurochirurgie, UniversitätsSpital Zürich, Universität Zürich, Zurich, Switzerland.

Interictal high-frequency oscillations (HFO) detected in electroencephalography recordings have been proposed as biomarkers of epileptogenesis, seizure propensity, disease severity, and treatment response. Automatic HFO detectors typically analyze the data offline using complex time-consuming algorithms, which limits their clinical application. Neuromorphic circuits offer the possibility of building compact and low-power processing systems that can analyze data on-line and in real time. Read More

Clin Neurol Neurosurg 2022 Jun 11;219:107336. Epub 2022 Jun 11.

Stanford University Department of Neurology and Neurological Sciences, Palo Alto, CA 94304, USA.

Objective: Electrical source localization (ESI) can help to identify the seizure onset zone or propagation zone, but it is unclear how dipole localization techniques influence surgical planning.

Methods: Patients who received a high density (HD)-EEG from 7/2014-7/2019 at Stanford were included if they met the following inclusion criteria: (1) adequate epileptiform discharges were recorded for source localization analysis, (2) underwent surgical treatment, which was at least 6 months before the survey. Interictal ESI was performed with the LORETA method on age matched MRIs. Read More

Eur Radiol 2022 Jun 17. Epub 2022 Jun 17.

Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.

Objectives: To integrate the glucose metabolism measured using [F]FDG PET/CT and anatomical features measured using MRI to forecast the post-surgical seizure outcomes of intractable temporal lobe epilepsy.

Methods: This retrospective study enrolled 63 patients with drug-resistant temporal lobe epilepsy. Z-transform of the patients' PET images based on comparison with a database of healthy controls, cortical thickness, and quantitative anisotropy (QA) of the diffusion spectrum imaging concordant/non-concordant with cortical resection was adopted to quantify their predictive values for the post-surgical seizure outcomes. Read More

J Neurol 2022 Jun 15. Epub 2022 Jun 15.

Epilepsy-Center Berlin-Brandenburg, Institute for Diagnostics of Epilepsy, Berlin, Germany.

Background: Epilepsy surgery cases are becoming more complex and increasingly require invasive video-EEG monitoring (VEM) with intracranial subdural or intracerebral electrodes, exposing patients to substantial risks. We assessed the utility and safety of using foramen ovale (FO) and epidural peg electrodes (FOP) as a next step diagnostic approach following scalp VEM.

Methods: We analyzed clinical, electrophysiological, and imaging characteristics of 180 consecutive patients that underwent FOP VEM between 1996 and 2021. Read More

Brain 2022 Jun 15. Epub 2022 Jun 15.

Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.

Successful outcomes in epilepsy surgery rely on the accurate localization of the seizure onset zone (SOZ). Localizing the SOZ is often a costly and time-consuming process wherein a patient undergoes intracranial EEG (iEEG) monitoring, and a team of clinicians wait for seizures to occur. Clinicians then analyze the iEEG before each seizure onset to identify the SOZ, and localization accuracy increases when more seizures are captured. Read More

Neurochirurgie 2022 Jun 11. Epub 2022 Jun 11.

Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto-SP, Brazil. Electronic address:

Background: Mesial temporal lobe epilepsy (MTLE) is a symptomatic epilepsy syndrome clinically characterized by high prevalence, pharmacoresistance, good surgical prognosis and hippocampal sclerosis (HS); however, no singular criteria can be considered sufficient for the MTLE-HS diagnosis. MicroRNAs (miRNAs) are small non-coding molecules that act as important gene-expression regulators at post-transcriptional level. Evidences on the involvement of miRNAs in epilepsy pathogenesis as well as their potential to be employed as biomarkers claim for investigations on miRNAs' applicability as epilepsy diagnosis and prognosis biomarkers. Read More

Epilepsia 2022 Jun 14. Epub 2022 Jun 14.

Neuroethics Canada, Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Objective: Novel and minimally invasive neurotechnologies offer the potential to reduce the burden of epilepsy while avoiding the risks of conventional resective surgery. Few neurotechnologies have been tested in randomized controlled trials with pediatric populations, leaving clinicians to face decisions about whether to recommend these treatments with insufficient evidence about relevant risks and benefits. This study specifically explores the preferences of clinicians to treat pediatric drug resistant epilepsy (DRE) with novel neurotechnologies. Read More

Ann Clin Transl Neurol 2022 Jun 14. Epub 2022 Jun 14.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.

Objective: Fear aura has traditionally been considered relevant to epileptic discharges from mesial temporal areas, and few studies have investigated its effect on surgical outcome in drug-resistant epilepsy. We aim to assess the localizing and lateralizing value as well as prognostic significance of fear aura in patients with focal epilepsy.

Methods: The occurrence of fear aura in relation to epileptogenic origin and its association with postoperative outcome were analyzed in 146 consecutive patients undergoing resective surgery for intractable epilepsy. Read More

Cureus 2022 May 10;14(5):e24894. Epub 2022 May 10.

Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, JPN.

Background Brain tumor patients tend to develop postoperative epileptic seizures, which can lead to an unfavorable outcome. Although the incidence of postoperative epileptic seizures and adverse events are improved with the advent of levetiracetam (LEV), postoperative epilepsy occurs at a frequency of 4.6% or higher. Read More

Neurosurg Rev 2022 Jun 9. Epub 2022 Jun 9.

Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.

The objective is to provide a treatment algorithm for pediatric patients with intracranial cavernous malformations (CMs) based on our experience. Patients < 18 years of age who were treated either surgically or conservatively at the authors' institution between 1982 and 2019 were retrospectively evaluated. A total of 61 pediatric patients were treated at the authors' institution: 39 with lobar CMs; 18 with deep CMs, including 12 in the brainstem and 6 in the basal ganglia; and 4 with CMs in the cerebellar hemispheres. Read More

Neurologia (Engl Ed) 2022 Jun 25;37(5):334-345. Epub 2021 May 25.

Programa de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Madrid, Spain.

Objective: Stereoelectroencephalography (SEEG) is a technique for preoperative evaluation of patients with difficult-to-localise refractory focal epilepsy (DLRFE), enabling the study of deep cortical structures. The procedure, which is increasingly used in international epilepsy centres, has not been fully developed in Spain. We describe our experience with SEEG in the preoperative evaluation of DLRFE. Read More

Childs Nerv Syst 2022 Jun 6. Epub 2022 Jun 6.

Division of Pediatric Hematology and Oncology, Department of Pediatrics, Ege University School of Medicine, 35030, Bornova, Izmir, Turkey.

Background: Dysembryoplastic neuroepithelial tumors (DNETs) are rare, low-grade tumors of the central nervous system (CNS) of childhood. It is an important cause of intractable epilepsy, and it is surgically curable. We aimed to review our institutional experience with DNET in children. Read More

Epilepsia Open 2022 Jun 4. Epub 2022 Jun 4.

Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Interictal 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) is used in the workup for epilepsy surgery when MRI and EEG video monitoring are not conclusive. Timing of FDG-PET is crucial to avoid the metabolically dynamic (post)ictal state that complicates interpretation, but the exact time window is unclear. We performed a systematic review to provide an evidence-based recommendation for the minimal time interval between last seizure and FDG-PET acquisition. Read More

Epilepsy Res 2022 May 28;184:106954. Epub 2022 May 28.

Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, TX, USA; Department of Neurology, McGovern Medical School at UT Health Houston, Houston, TX, USA; Texas Institute for Restorative Neurotechnologies, The University of Texas Health Science Center at Houston, Houston, TX, USA; Memorial Hermann Hospital, Texas Medical Center, Houston, TX, USA. Electronic address:

Background: Deep brain stimulation (DBS) of the centromedian nucleus (CM) is an effective therapeutic option for select patients with generalized epilepsy. However, several studies suggest that success varies with active contact location within the CM and the exact target remains undefined.

Objective: To quantify the association between active contact location and outcomes across all published series of CM DBS. Read More

Epilepsia 2022 Jun 6. Epub 2022 Jun 6.

Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.

Objective: There is substantial variability in reported seizure outcome following pediatric epilepsy surgery, and lack of individualized predictive tools that could evaluate the probability of seizure freedom postsurgery. The aim of this study was to develop and validate a supervised machine learning (ML) model for predicting seizure freedom after pediatric epilepsy surgery.

Methods: This is a multicenter retrospective study of children who underwent epilepsy surgery at five pediatric epilepsy centers in North America. Read More

Philos Trans A Math Phys Eng Sci 2022 Jul 6;380(2228):20210010. Epub 2022 Jun 6.

Bioinformatics, Intelligent Systems and Educational Technology (BISITE) Research Group, Salamanca, Spain.

In this research, a vagus nerve stimulator has been developed and miniaturized for use in epilepsy research. The board contains all the components necessary for its operation during the standard duration of the experiments, being possible to control it once implanted and even being able to reuse it. The VNS system has been designed for rodents since the VNS devices available for human are not only too large for laboratory animals, but also too expensive. Read More

Neuroimage Clin 2022 May 28;35:103063. Epub 2022 May 28.

Division of Pediatric Neurosurgery, Barrow Neurological Institute at Phoenix Children's Hospital, 1919 E. Thomas Rd, Phoenix, AZ 85016, USA.

The goal of this study was to determine resting state fMRI (rs-fMRI) effective connectivity (RSEC) capacity, agnostic of epileptogenic events, in distinguishing seizure onset zones (SOZ) from propagation zones (pZ). Consecutive patients (2.1-18. Read More

Epilepsia 2022 Jun 2. Epub 2022 Jun 2.

Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Objective: Existing data suggest that epilepsy presenting in the first few years of life carries a worse prognosis than later onset. However, studies are few and methods differ, making interpretations of data uncertain. This study analyzes outcome at age 7 and potential prognostic factors in a well-characterized population-based cohort with epilepsy onset during the first 2 years of life. Read More

Front Neurol 2022 16;13:890857. Epub 2022 May 16.

Neurosurgery Unit, S. Maria della Misericordia University Hospital, Udine, Italy.

Background: Regarding brain tumor-related epilepsy (BTRE), there is an increasing number of evidence about a relationship between epileptogenesis and oncogenesis. A recent study suggests a role of post-surgery seizure outcome on the survival of patients with low-grade glioma (LGG), underlying the need for a targeted and aggressive epilepsy treatment.

Objective: This study aims at investigating the possible correlation between pre- and post-surgical seizure control and tumor progression in patients who underwent surgery for LGG. Read More

Epilepsy Behav 2022 Jul 28;132:108708. Epub 2022 May 28.

Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal; Centro de Referência de Epilepsia Refratária, Hospital de Santa Maria, (CHULN), Lisboa, Portugal; EpiCARE Network, European Reference Network for Rare and Complex Epilepsies, Portugal.

Introduction: About one-third of patients with epilepsy have a refractory form which is associated with important economic and psychosocial burden. Most of these patients also suffer from comorbidities. One of the most frequent is cognitive impairment. Read More

Epilepsia Open 2022 May 28. Epub 2022 May 28.

Department of Neurosurgery, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Objective: The impact of the coronavirus disease 2019 (COVID-19) pandemic on epilepsy care across Japan was investigated by conducting a multicenter retrospective cohort study.

Methods: This study included monthly data on the frequency of (1) visits by outpatients with epilepsy, (2) outpatient electroencephalography (EEG) studies, (3) telemedicine for epilepsy, (4) admissions for epilepsy, (5) EEG monitoring, and (6) epilepsy surgery in epilepsy centers and clinics across Japan between January 2019 and December 2020. We defined the primary outcome as epilepsy-center-specific monthly data divided by the 12-month average in 2019 for each facility. Read More

Laryngorhinootologie 2022 May 23;101(S 01):S114-S143. Epub 2022 May 23.

Klinik für HNO-Heilkunde, Kopf- und Halschirurgie, KRH Klinikum Nordstadt, Hannover.

Numerous studies confirm that the vagus nerve stimulation (VNS) is an efficient, indirect neuromodulatory therapy with electrically induced current for epilepsy that cannot be treated by epilepsy surgery and is therapy-refractory and for drug therapy-refractory depression. VNS is an established, evidence-based and in the long-term cost-effective therapy in an interdisciplinary overall concept.Long-term data on the safety and tolerance of the method are available despite the heterogeneity of the patient populations. Read More

Front Pediatr 2022 6;10:892445. Epub 2022 May 6.

Neuroradiology, Department of Neurological Sciences, University of Padova, Padova, Italy.

Background: Moyamoya is a rare progressive cerebral arteriopathy, occurring as an isolated phenomenon (moyamoya disease, MMD) or associated with other conditions (moyamoya syndrome, MMS), responsible for 6-10% of all childhood strokes and transient ischemic attacks (TIAs).

Methods: We conducted a retrospective multicenter study on pediatric-onset MMD/MMS in Italy in order to characterize disease presentation, course, management, neuroradiology, and outcome in a European country.

Results: A total of 65 patients (34/65 women) with MMD (27/65) or MMS (38/65) were included. Read More

Epilepsia 2022 May 20. Epub 2022 May 20.

Department of Neurology, Taipei Veterans General Hospital, Neurological Institute, Taipei, Taiwan.

Objective: Cerebral cavernous malformations (CCMs) present variably, and epileptic seizures are the most common symptom. The factors contributing to cavernoma-related epilepsy (CRE) and drug resistance remain inconclusive. The outcomes of CRE after different treatment modalities have not yet been fully addressed. Read More

Epilepsy Res 2022 Jul 11;183:106942. Epub 2022 May 11.

Texas Institute for Restorative Neurotechnologies, The University of Texas Health Science Center at Houston, Houston, TX, USA; Department of Neurology, McGovern Medical School at UT Health Houston, Houston, TX, USA; Memorial Hermann Hospital, Texas Medical Center, Houston, TX, USA.

Thalamic neuromodulation can be an effective therapeutic option for select patients with medically refractory epilepsy. However, successful outcome depends on several factors, beginning with appropriate patient and thalamic target selection. Among thalamic targets, the anterior (ANT) and centromedian (CeM) nuclei have the greatest clinical evidence for efficacy. Read More