Pediatric intractable epilepsy: the role of presurgical evaluation and seizure outcome

2000 ◽  
Vol 16 (5) ◽  
pp. 278-285 ◽  
Author(s):  
Seung-Ki Kim ◽  
Kyu-Chang Wang ◽  
Yong-Seung Hwang ◽  
Ki Joong Kim ◽  
I.-O. Kim ◽  
...  
Keyword(s):  
Intractable Epilepsy ◽  
Seizure Outcome ◽  
Presurgical Evaluation

scholarly journals The Utility of Positron Emission Tomography in Epilepsy

2015 ◽  
Vol 42 (6) ◽  
pp. 360-371 ◽  
Author(s):  
Jorge G. Burneo ◽  
Raymond Poon ◽  
Sarah Kellett ◽  
O. Carter Snead
Keyword(s):  
Positron Emission Tomography ◽  
Intractable Epilepsy ◽  
High Sensitivity ◽  
Emission Tomography ◽  
Inclusion Criteria ◽  
Seizure Onset ◽  
Presurgical Evaluation ◽  
Positron Emission ◽  
Intracranial Electrodes

AbstractThe role of fludeoxyglucose F 18 positron emission tomography (PET) in the presurgical evaluation of patients with medically intractable epilepsy continues to be refined. The purpose of this study was to systematically review the literature to assess the diagnostic accuracy and utility of PET in this setting. Thirty-nine studies were identified through MEDLINE and EMBASE databases that met the inclusion criteria. In adult patients, PET hypometabolism showed a 56 to 90% agreement with seizure onset localized by intracranial electroencephalogram (pediatric: 21 to 86%). In temporal lobe epilepsy patients with good surgical outcome, PET displayed moderate to high sensitivity in localizing the seizure focus (range: 71 to 89%). The sensitivity increased by 8 to 23% when PET results were combined with magnetic resonance imaging or electroencephalogram. PET has been shown to affect patient management by improving the guidance of intracranial electrodes placement, altering the decision to perform surgery, or excluding patients from further evaluation.

scholarly journals The Neuroinflammatory Role of Pericytes in Epilepsy

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 759
Author(s):  
Gaku Yamanaka ◽  
Fuyuko Takata ◽  
Yasufumi Kataoka ◽  
Kanako Kanou ◽  
Shinichiro Morichi ◽  
...  
Keyword(s):  
Proinflammatory Cytokines ◽  
Current Knowledge ◽  
Morphological Changes ◽  
Cell Damage ◽  
Neurovascular Unit ◽  
Experimental Studies ◽  
Intractable Epilepsy ◽  
In Vivo Studies

Pericytes are a component of the blood–brain barrier (BBB) neurovascular unit, in which they play a crucial role in BBB integrity and are also implicated in neuroinflammation. The association between pericytes, BBB dysfunction, and the pathophysiology of epilepsy has been investigated, and links between epilepsy and pericytes have been identified. Here, we review current knowledge about the role of pericytes in epilepsy. Clinical evidence has shown an accumulation of pericytes with altered morphology in the cerebral vascular territories of patients with intractable epilepsy. In vitro, proinflammatory cytokines, including IL-1β, TNFα, and IL-6, cause morphological changes in human-derived pericytes, where IL-6 leads to cell damage. Experimental studies using epileptic animal models have shown that cerebrovascular pericytes undergo redistribution and remodeling, potentially contributing to BBB permeability. These series of pericyte-related modifications are promoted by proinflammatory cytokines, of which the most pronounced alterations are caused by IL-1β, a cytokine involved in the pathogenesis of epilepsy. Furthermore, the pericyte-glial scarring process in leaky capillaries was detected in the hippocampus during seizure progression. In addition, pericytes respond more sensitively to proinflammatory cytokines than microglia and can also activate microglia. Thus, pericytes may function as sensors of the inflammatory response. Finally, both in vitro and in vivo studies have highlighted the potential of pericytes as a therapeutic target for seizure disorders.

Presurgical Evaluation Strategies for Intractable Epilepsy of Childhood

2021 ◽  
Vol 39 ◽  
pp. 100915
Author(s):  
Keith Starnes ◽  
Dewi Depositario-Cabacar ◽  
Lily Wong-Kisiel
Keyword(s):  
Intractable Epilepsy ◽  
Presurgical Evaluation ◽  
Evaluation Strategies

scholarly journals Resection of cerebral gangliogliomas causing drug-resistant epilepsy: short- and long-term outcomes using intraoperative MRI and neuronavigation

2015 ◽  
Vol 38 (1) ◽  
pp. E5 ◽  
Author(s):  
Björn Sommer ◽  
Cornelia Wimmer ◽  
Roland Coras ◽  
Ingmar Blumcke ◽  
Bogdan Lorber ◽  
...  
Keyword(s):  
Diffusion Tensor ◽  
Intraoperative Imaging ◽  
Intractable Epilepsy ◽  
Complete Resection ◽  
Blood Oxygenation ◽  
Seizure Outcome ◽  
Incomplete Resection ◽  
Brain Areas ◽  
Total Resection

OBJECT Cerebral gangliogliomas (GGs) are highly associated with intractable epilepsy. Incomplete resection due to proximity to eloquent brain regions or misinterpretation of the resection amount is a strong negative predictor for local tumor recurrence and persisting seizures. A potential method for dealing with this obstacle could be the application of intraoperative high-field MRI (iopMRI) combined with neuronavigation. METHODS Sixty-nine patients (31 female, 38 male; median age 28.5 ± 15.4 years) suffering from cerebral GGs were included in this retrospective study. Five patients received surgery twice in the observation period. In 48 of the 69 patients, 1.5-T iopMRI combined with neuronavigational guidance was used. Lesions close to eloquent brain areas were resected with the implementation of preoperative diffusion tensor imaging tractography and blood oxygenation level–dependent functional MRI (15 patients). RESULTS Overall, complete resection was accomplished in 60 of 69 surgical procedures (87%). Two patients underwent biopsy only, and in 7 patients, subtotal resection was accomplished because of proximity to critical brain areas. Excluding the 2 biopsies, complete resection using neuronavigation/iopMRI was documented in 33 of 46 cases (72%) by intraoperative imaging. Remnant tumor mass was identified intraoperatively in 13 of 46 patients (28%). After intraoperative second-look surgery, the authors improved the total resection rate by 9 patients (up to 91% [42 of 46]). Of 21 patients undergoing conventional surgery, 14 (67%) had complete resection without the use of iopMRI. Regarding epilepsy outcome, 42 of 60 patients with seizures (70%) became completely seizure free (Engel Class IA) after a median follow-up time of 55.5 ± 36.2 months. Neurological deficits were found temporarily in 1 (1.4%) patient and permanently in 4 (5.8%) patients. CONCLUSIONS Using iopMRI combined with neuronavigation in cerebral GG surgery, the authors raised the rate of complete resection in this series by 19%. Given the fact that total resection is a strong predictor of long-term seizure control, this technique may contribute to improved seizure outcome and reduced neurological morbidity.

scholarly journals The role of presurgical EEG parameters and of reoperation for seizure outcome in temporal lobe epilepsy

Seizure ◽  
2017 ◽  
Vol 51 ◽  
pp. 174-179 ◽  
Author(s):  
B. Schmeiser ◽  
J. Zentner ◽  
B.J. Steinhoff ◽  
A. Brandt ◽  
A. Schulze-Bonhage ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Seizure Outcome

scholarly journals The Role of Pharmaceutical Care in Intractable Epilepsy

2010 ◽  
Vol 6 (1) ◽  
pp. 34-39
Author(s):  
Hiroyuki Ura ◽  
Ichiro Takumi ◽  
Osamu Fujino ◽  
Keiko Fukuda ◽  
Shiro Kobayashi ◽  
...  
Keyword(s):  
Pharmaceutical Care ◽  
Intractable Epilepsy

Role of Reflexology and Antiepileptic Drugs in Managing Intractable Epilepsy - a Randomized Controlled Trial

2013 ◽  
Vol 20 (2) ◽  
pp. 6-6 ◽  
Author(s):  
Krishna Dalal ◽  
Elanchezhiyan Devarajan ◽  
Ravindra Mohan Pandey ◽  
Vivekanandan Subbiah ◽  
Manjari Tripathi
Keyword(s):  
Randomized Controlled Trial ◽  
Antiepileptic Drugs ◽  
Controlled Trial ◽  
Intractable Epilepsy ◽  
Randomized Controlled
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