Abstract:
:Invasive evaluations play important roles in identifying epileptogenic zones and functional areas in patients with intractable focal epilepsy. This article reviews the usefulness, methods, and limitations of invasive evaluations for epilepsy surgery. Invasive evaluations include various types of intracranial electrodes such as stereotactically implanted intracranial depth electrodes (stereo-EEG), chronic subdural electrodes, and intraoperative electrocorticography. Scalp EEG is distorted by the skull, meninges, and skin. On the other hand, intracranial electrodes provide spatial information with higher resolution than scalp electrodes, thereby enabling further delineation of epileptogenic zones and mapping of functional areas with electrical stimulation. In addition, intracranial electrodes record a wide frequency range of electrical activity, which is not possible with scalp electrodes. The very slow potentials in ictal recordings, known as ictal direct current (DC) shifts and ictal/interictal high frequency oscillations, such as ripples (100-200 Hz) and fast ripples (200-500 Hz), have been correlated with the ictal onset zone and are a sensitive and specific marker for epileptogenicity. Furthermore, several studies reported that the electrical stimulation of epileptogenic zones elicited enhanced cortical evoked potentials, abnormal delayed or repetitive responses, and fast ripples. These responses may assist in the delineation of the epileptogenic cortex as a potential new marker. There are definite risks of complications associated with the use of intracranial electrodes. However, when an invasive evaluation is selected based on careful consideration of the risks and benefits, it provides useful information for establishing a strategy for epilepsy surgery.
journal_name
Neurol Med Chir (Tokyo)journal_title
Neurologia medico-chirurgicaauthors
Enatsu R,Mikuni Ndoi
10.2176/nmc.ra.2015-0319subject
Has Abstractpub_date
2016-05-15 00:00:00pages
221-7issue
5eissn
0470-8105issn
1349-8029journal_volume
56pub_type
杂志文章,评审abstract::A 67-year-old man first noticed loss of pubic and axillary hair in 1992 and then a visual field defect in 2001. He experienced loss of consciousness attributed to hyponatremia in April 2002. Magnetic resonance imaging showed a giant intrasellar cystic mass, 40 mm in diameter, that had compressed the optic chiasm. The ...
journal_title:Neurologia medico-chirurgica
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abstract::A 54-year-old female presented subarachnoid hemorrhage from an aneurysm arising from the anterior (dorsal) wall of the internal carotid artery (ICA). During four-vessel angiography, an extravasated saccular pooling of contrast medium emerged in the suprasellar area unrelated to any arterial branch. The saccular poolin...
journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
pub_type: 杂志文章
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journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
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journal_title:Neurologia medico-chirurgica
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