scholarly journals Localizing Seizure-Onset Zones in Presurgical Evaluation of Drug-Resistant Epilepsy by Electroencephalography/fMRI: Effectiveness of Alternative Thresholding Strategies

2012 ◽  
Vol 33 (9) ◽  
pp. 1818-1824 ◽  
Author(s):  
M. Hauf ◽  
K. Jann ◽  
K. Schindler ◽  
O. Scheidegger ◽  
K. Meyer ◽  
...  
Keyword(s):  
Drug Resistant ◽  
Seizure Onset ◽  
Presurgical Evaluation ◽  
Drug Resistant Epilepsy ◽  
Seizure Onset Zones

Overnight ictal magnetoencephalography

2020 ◽  
pp. 10.1212/CPJ.0000000000000937
Author(s):  
Jeremy T. Moreau ◽  
Elisabeth Simard-Tremblay ◽  
Steffen Albrecht ◽  
Bernard Rosenblatt ◽  
Sylvain Baillet ◽  
...  
Keyword(s):  
Epileptic Activity ◽  
Added Value ◽  
Drug Resistant ◽  
Seizure Onset ◽  
Presurgical Evaluation ◽  
Seizure Onset Zone ◽  
Drug Resistant Epilepsy

The added value of magnetoencephalography (MEG) in the presurgical evaluation for drug-resistant epilepsy is well-recognised 1-4. However, MEG remains mostly limited to analysis of interictal epileptic activity 1,5. Seizures are uncommonly captured due to logistical considerations despite mounting evidence of the value of ictal MEG in localising the seizure onset zone 5-7. Here we report the recording and analysis of ictal MEG recordings in two drug-resistant epilepsy presurgical candidates that spent a night sleeping in the MEG.

scholarly journals Multimodal neuroimaging in presurgical evaluation of drug-resistant epilepsy

2014 ◽  
Vol 4 ◽  
pp. 35-44 ◽  
Author(s):  
Jing Zhang ◽  
Weifang Liu ◽  
Hui Chen ◽  
Hong Xia ◽  
Zhen Zhou ◽  
...  
Keyword(s):  
Drug Resistant ◽  
Multimodal Neuroimaging ◽  
Presurgical Evaluation ◽  
Drug Resistant Epilepsy

scholarly journals Comparison of Ictal Brain Perfusion SPECT With 99mTc-HMPAO Versus 99mTc-ECD for Identification of The Epileptic Seizure Onset Zone

2020 ◽  
Author(s):  
Mariam Jaber ◽  
Jila Taherpour ◽  
Berthold Voges ◽  
Ivayla Apostolova ◽  
Thomas Sauvigny ◽  
...  
Keyword(s):  
Brain Perfusion ◽  
Drug Resistant ◽  
Seizure Onset ◽  
Tracer Injection ◽  
Brain Perfusion Spect ◽  
Temporal Epilepsy ◽  
Large Patient ◽  
Seizure Onset Zone ◽  
Perfusion Spect ◽  
Drug Resistant Epilepsy

Abstract Background: The chemical microspheres 99mTc-HMPAO and 99mTc-ECD are widely used as tracers in ictal brain perfusion SPECT for identification of the seizure onset zone (SOZ) in presurgical evaluation of patients with drug-resistant epilepsy and uncertainty of SOZ localization after standard diagnostic workup. For both tracers there are theoretical arguments to favor it over the other for this task. The aim of this study was to compare the performance of ictal brain perfusion SPECT between 99mTc-HMPAO and 99mTc-ECD in a rather large patient sample.Methods: The study retrospectively included 196 patients from clinical routine in whom ictal perfusion SPECT had been performed with stabilized 99mTc-HMPAO (n = 110) or 99mTc-ECD (n = 86). Lateralization and localization of the SOZ was obtained by the consensus of two independent readers who visually inspected the SPECT images retrospectively. Results: The 99mTc-HMPAO group and the 99mTc-ECD group were well matched with respect to age, sex, age at first seizure, duration of disease, seizure frequency, history of previous brain surgery, and findings of presurgical MRI. The tracer groups differed significantly with respect to the latency of tracer injection (median latency 4 s longer in the 99mTc-HMPAO group), duration of the seizure after tracer injection (25 s shorter in the 99mTc-HMPAO group), tracer dose (70 MBq higher in the 99mTc-HMPAO group), and delay of the SPECT acquisition after tracer injection (63 min longer in the 99mTc-HMPAO group). The fraction of lateralising ictal SPECT did not differ significantly between the 99mTc-HMPAO and the 99mTc-ECD group (65.5% versus 72.1%, p = 0.355). Sensitivity of ictal perfusion SPECT (independent of the tracer) for correct localization of the SOZ in 62 patients with temporal lobe epilepsy and at least worthwhile improvement (Engel scale ≤ III) 12 months after temporal epilepsy surgery was 63%.Conclusions: This study does not provide evidence to favor 99mTc-HMPAO or 99mTc-ECD for identification of the SOZ by ictal perfusion SPECT in patients with drug resistant epilepsy.

A probabilistic approach for lateralization of seizure onset zone in drug-resistant epilepsy with bilateral cerebral pathology

2016 ◽  
Vol 277 ◽  
pp. 136-140
Author(s):  
Ravindra Arya ◽  
Siva Sivaganesan ◽  
Katherine D. Holland ◽  
Hansel M. Greiner ◽  
Francesco T. Mangano ◽  
...  
Keyword(s):  
Probabilistic Approach ◽  
Drug Resistant ◽  
Seizure Onset ◽  
Seizure Onset Zone ◽  
Cerebral Pathology ◽  
Drug Resistant Epilepsy

scholarly journals Health Technology Assessment report on the presurgical evaluation and surgical treatment of drug-resistant epilepsy

Epilepsia ◽  
2013 ◽  
Vol 54 ◽  
pp. 49-58 ◽  
Author(s):  
Carlo Efisio Marras ◽  
Maria Paola Canevini ◽  
Gabriella Colicchio ◽  
Renzo Guerrini ◽  
Guido Rubboli ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Drug Resistant ◽  
Presurgical Evaluation ◽  
Assessment Report ◽  
Health Technology Assessment Report ◽  
Drug Resistant Epilepsy

scholarly journals Use of Innovative SPECT Techniques in the Presurgical Evaluation of Patients with Nonlesional Extratemporal Drug-Resistant Epilepsy

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ahmed Yassin ◽  
Khalid El-Salem ◽  
Abdel-Hameed Al-Mistarehi ◽  
Aiman Momani ◽  
Anas M. Zein Alaabdin ◽  
...  
Keyword(s):  
Single Photon ◽  
Photon Emission ◽  
Vital Role ◽  
Emission Computed Tomography ◽  
Drug Resistant ◽  
Presurgical Evaluation ◽  
Ictal Spect ◽  
Seizure Onset Zone ◽  
Drug Resistant Epilepsy ◽  
Patients With Epilepsy

Up to 30% of patients with epilepsy may not respond to antiepileptic drugs. Patients with drug-resistant epilepsy (DRE) should undergo evaluation for seizure onset zone (SOZ) localization to consider surgical treatment. Cases of drug-resistant nonlesional extratemporal lobe epilepsy (ETLE) pose the biggest challenge in localizing the SOZ and require multiple noninvasive diagnostic investigations before planning the intracranial monitoring (ICM) or direct resection. Ictal Single Photon Emission Computed Tomography (i-SPECT) is a unique functional diagnostic tool that assesses the SOZ using the localized hyperperfusion that occurs early in the seizure. Subtraction ictal SPECT coregistered to MRI (SISCOM), statistical ictal SPECT coregistered to MRI (STATISCOM), and PET interictal subtracted ictal SPECT coregistered with MRI (PISCOM) are innovative SPECT methods for the determination of the SOZ. This article comprehensively reviews SPECT and sheds light on its vital role in the presurgical evaluation of the nonlesional extratemporal DRE.

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