Abstract:
OBJECTIVE:Magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (MRg-LITT) is an alternative to open epilepsy surgery. We assess safety and effectiveness of MRg-LITT for extratemporal lobe epilepsy (ETLE) in patients who are considered less favorable for open resection. METHODS:We retrospectively reviewed sequential cases of patients with focal ETLE who underwent MRg-LITT between 2012 and 2019. Epileptogenic zones were determined from standard clinical and imaging data ± stereoelectroencephalography (SEEG). Standard stereotactic techniques, MRI thermometry, and a commercial laser thermal therapy system were used for ablations. Anatomic MRI was used to calculate ablation volumes. Clinical outcomes were determined longitudinally. RESULTS:Thirty-five patients with mean epilepsy duration of 21.3 ± 12.2 years underwent MRg-LITT for focal ETLE at a mean age 36.4 ± 12.7 years. A mean 2.59 ± 1.45 trajectories per patient were used to obtain ablation volumes of 8.8 ± 7.5 cm3 . Mean follow-up was 27.3 ± 19.5 months. Of 32 patients with >12 months of follow-up, 17 (53%) achieved good outcomes (Engel class I + II) of whom 14 (44%) were Engel class I. Subgroup analysis revealed better outcomes for patients with lesional ETLE than for those who were nonlesional, multifocal, or who had failed prior interventions (P = .02). Of 13 patients showing favorable seizure-onset patterns (localized low voltage fast activity or rhythmic spiking on SEEG) prior to ablation, 9 (69%) achieved good outcomes, whereas only 3 of 11 (27%) who show other slower onset patterns achieved good outcomes. Minor adverse events included six patients with transient sensorimotor neurologic deficits and four patients with asymptomatic hemorrhages along the fiber tract. Major adverse events included one patient with a brain abscess that required stereotactic drainage and one patient with persistent hypothalamic obesity. Three deaths-two seizure-associated and one suicide-were unrelated to surgical procedures. SIGNIFICANCE:MRI-guided laser interstitial thermal therapy (or MRg-LITT) was well-tolerated and yielded good outcomes in a heterogeneous group of ETLE patients. Lesional epilepsy and favorable seizure-onset patterns on SEEG predicted higher likelihoods of success.
journal_name
Epilepsiajournal_title
Epilepsiaauthors
Gupta K,Cabaniss B,Kheder A,Gedela S,Koch P,Hewitt KC,Alwaki A,Rich C,Ramesha S,Hu R,Drane DL,Gross RE,Willie JTdoi
10.1111/epi.16614subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1723-1734issue
8eissn
0013-9580issn
1528-1167journal_volume
61pub_type
杂志文章相关文献
EPILEPSIA文献大全abstract::Steady-state plasma antiepileptic drug (AED) concentrations were measured at intervals throughout pregnancy and during the postnatal period in 105 women who underwent 134 pregnancies. Phenytoin (PHT) dosage had to be increased in 85% of pregnancies in which the drug was received, carbamazepine (CBZ) dosage in 70%, and...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1991.tb05253.x
更新日期:1991-03-01 00:00:00
abstract::Rare individuals suffer epileptic seizures when they view certain images, particularly stripes. Contrast-threshold functions (the ability to see faint stripes of various widths) were determined for two pattern-sensitive brothers, and the epileptogenicity of various patterns was assessed for one of them. Sine wave grat...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1980.tb04075.x
更新日期:1980-06-01 00:00:00
abstract::Severe Myoclonic Epilepsy in infancy (SMEI, or Dravet syndrome) is a drug-resistant epilepsy that occurs in the first year of life of previously healthy children. The main clinical features are prolonged and repeated febrile and afebrile generalized or unilateral convulsive seizures. In the course of the epilepsy, cog...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2006.00688.x
更新日期:2006-01-01 00:00:00
abstract::Twenty-three infants and children underwent cortical resection (n = 15) or hemispherectomy (n = 8) for intractable infantile spasms. Infantile spasms were present at the time of surgery in 17 of the 23 patients; in six, spasms had evolved to other seizure types during surgical evaluation. Children with a remote histor...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1993.tb00459.x
更新日期:1993-07-01 00:00:00
abstract::Cortical malformations are highly epileptogenic lesions associated with complex, unanticipated, and often aberrant electrophysiologic and functional relationships. These relationships are inextricably linked to widespread cortical networks subserving eloquent functions, particularly language and motor ability. Cytomeg...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1167.2009.02291.x
更新日期:2009-10-01 00:00:00
abstract::Cardiac changes may occasionally occur during vagus nerve stimulation (VNS) used in epileptic patients. As they can be potentially life-threatening, it is important to detect them, and this is why an intraoperative test is performed during the implantation. Few cases of asystole during this test have been described. O...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2008.01918.x
更新日期:2009-04-01 00:00:00
abstract:PURPOSE:To describe four patients with stimulus-sensitive seizures and myoclonus following severe hypoxic-ischemic injury. METHODS:In 22 months, four adult patients with myoclonus, generalized tonic-clonic, and clonic seizures following tactile stimulation were identified. EEG and hospital records were reviewed. RESU...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1996.tb00040.x
更新日期:1996-09-01 00:00:00
abstract::A case-control study of 305 children was done to evaluate the relationship between toxocariasis and seizures and risk factors associated with toxocariasis transmission and seizure onset. A significant association existed between seropositivity for anti-Toxocara canis and seizures (p less than 0.05); the correlation wa...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1990.tb05356.x
更新日期:1990-01-01 00:00:00
abstract::Eleven patients had seizures with unilateral temporal lobe onset recorded with simultaneous bilateral medial temporal depth electrodes and neocortical (subdural) electrodes at least on the side of seizure onset. Of a total of 55 seizures, four had simultaneous onset in neocortex and hippocampus, and 51 had onset in un...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1987.tb03676.x
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:To identify features of ablations and trajectories that correlate with optimal seizure control and minimize the risk of neurocognitive deficits in patients undergoing laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE). METHODS:Clinical and radiographic data were reviewed from a prosp...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.13715
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:To investigate possible predictive factors for seizure control in a group of children and adults with low IQs (IQ, < or =70) who underwent resective surgery for intractable focal epilepsy and to study outcome with respect to seizures and neuropsychological functioning. We also studied psychosocial outcome in th...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.0013-9580.2004.34003.x
更新日期:2004-02-01 00:00:00
abstract:PURPOSE:Hypothalamic regulation of the reproductive axis in temporal lobe epilepsy (TLE), represented by the ultradian pulsatile secretion of luteinizing hormone (LH), has been shown to be altered interictally and postictally. Our objective is to determine if epilepsy or seizures disrupt normal circadian fluctuations o...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2006.00617.x
更新日期:2006-09-01 00:00:00
abstract::[3H]Nimodipine and high-affinity [125I]omega-conotoxin GVIA (CgTX) binding were investigated in membranes from rat cerebral cortex, cerebellum, and hippocampus after electrically and chemically induced seizures. Animals were decapitated 30 min after a single electroconvulsive shock (ECS) or lidocaine-induced seizure a...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1989.tb05330.x
更新日期:1989-07-01 00:00:00
abstract::Since it was originally described nearly 70 years ago, insular epilepsy has been increasingly recognized and may explain failures after apparently well-planned operations. We review the history of awareness of the phenomenon, techniques for its assessment, and its surgical management. Insular epilepsy can mimic featur...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/epi.13682
更新日期:2017-04-01 00:00:00
abstract::The authors report the study of a 30-month-old girl with refractory myoclonic epilepsy associated with mental retardation, growth delay, peculiar facial appearance, and minor physical anomalies. Extensive genetic studies were performed, including an array-based comparative genomic hybridization (array-CGH) that showed...
journal_title:Epilepsia
pub_type: 古典文章,杂志文章
doi:10.1111/j.1528-1167.2009.02078.x
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:We examine improvement and worsening in quality of life (QOL) in terms of proportions achieving minimum clinically important change (MCID), and factors related to MCID, in patients with temporal lobe epilepsy randomized to medical or surgical treatment. METHODS:Eighty patients with temporal lobe epilepsy ran...
journal_title:Epilepsia
pub_type: 杂志文章,随机对照试验
doi:10.1111/epi.12625
更新日期:2014-06-01 00:00:00
abstract::The practice of epileptology at a molecular level, where gene products are identified by gene mapping, will soon be possible for a growing number of epilepsies. Juvenile myoclonic epilepsy (JME) is the first of such epilepsies to be mapped to a chromosome, namely chromosome 6p21.3. Family studies of 68 JME probands fr...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/j.1528-1157.1989.tb05835.x
更新日期:1989-01-01 00:00:00
abstract::Study of patients with temporal lobe epilepsy and generalized epilepsy revealed no overall seizure type differences, nor overall age-at-onset effects, on MMPI measures of psychopathology. However, statistically significant interactions between seizure type and age at onset were obtained on several MMPI measures, and s...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1980.tb04040.x
更新日期:1980-02-01 00:00:00
abstract::The anticonvulsant hypersensitivity syndrome (AHS) is an idiosyncratic immunologic reaction to certain anticonvulsant medications, in which internal organ involvement may lead to fatal multisystemic failure. This syndrome has been associated with the use of aromatic ring-containing agents such as phenytoin, carbamazep...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2008.01720.x
更新日期:2008-12-01 00:00:00
abstract::The possibility of sudden unexpected death in epilepsy (SUDEP) should affect the management of virtually every patient with proven or suspected epilepsy by (a) underlining the need to make all reasonable efforts to render each patient seizure-free; (b) emphasizing the importance of minimizing avoidable seizures; (c) b...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1997.tb06131.x
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:Studies have found that affected individuals who believe the cause of their disorder is genetic may react in various ways, including optimism for improved treatments and pessimism due to perceived permanence of the condition. This study assessed the psychosocial impact of genetic attribution among people with...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.16352
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To identify the brain networks that are involved in the different electroencephalography (EEG) abnormalities in patients with ring chromosome 20 [r(20)] syndrome. We hypothesize the existence of both distinctive and common brain circuits for the paroxysmal high voltage sharp waves (hSWs), the seizures, and th...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.12539
更新日期:2014-03-01 00:00:00
abstract:PURPOSE:Vigabatrin (VGB) and lamotrigine (LTG) are two new antiepileptic drugs (AEDs) with different mechanisms of action for treatment of refractory epilepsies. Previous reports have indicated efficacy of both drugs in a number of epileptic syndromes. METHODS:We compared these new AEDs drugs to determine their respec...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1157.1998.tb01184.x
更新日期:1998-08-01 00:00:00
abstract:PURPOSE:To assess the visual system excitability of photosensitive patients with idiopathic generalized epilepsy (IGE) with the paired-pulse flash-evoked potential (paired F-VEP) technique. METHODS:We studied 19 photosensitive patients with IGE (16 women) showing a photoparoxysmal electroencephalographic (EEG) respons...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/j.1528-1167.2012.03411.x
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:Approximately 25 million individuals older than age 15 identify as transgender, representing about 0.3-0.9% of the world's population. The aim of this paper is to identify and describe important medical and social considerations facing transgender persons with epilepsy. METHODS:We performed literature search...
journal_title:Epilepsia
pub_type: 杂志文章,评审
doi:10.1111/epi.13864
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:In CSWS (continuous spike waves during sleep) activation of spike waves during slow wave sleep has been causally linked to neuropsychological deficits, but the pathophysiologic mechanisms are still unknown. In healthy subjects, the overnight decrease of the slope of slow waves in NREM (non-rapid eye movement)...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.12576
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:The cardiac component of risk for sudden unexpected death in epilepsy (SUDEP) and alterations in cardiac risk by vagus nerve stimulation (VNS) are not well understood. We determined changes in T-wave alternans (TWA), a proven noninvasive marker of risk for sudden cardiac death in patients with cardiovascular ...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1111/epi.12855
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:To conduct the first randomized trial on classical and medium-chain triglyceride (MCT) versions of the ketogenic diet, examining efficacy and tolerability after 3, 6, and 12 months. METHODS:One hundred forty-five children with intractable epilepsy were randomized to receive a classical or an MCT diet. Seizure ...
journal_title:Epilepsia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1528-1167.2008.01870.x
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety, tolerability, and comparative pharmacokinetics (PK) of intravenous and oral carbamazepine. METHODS:In this phase 1, open-label study, adult patients with epilepsy on a stable oral carbamazepine dosage (400-2,000 mg/day) were converted to intravenous carbamazepine (administered at 70% ...
journal_title:Epilepsia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/epi.13012
更新日期:2015-06-01 00:00:00
abstract:PURPOSE:To evaluate the potential pharmacokinetic interactions between topiramate (TPM) and phenytoin (PHT) in patients with epilepsy by studying their pharmacokinetics (PK) after monotherapy and concomitant TPM/PHT treatment. METHODS:Twelve patients with epilepsy stabilized on PHT monotherapy were enrolled in this st...
journal_title:Epilepsia
pub_type: 杂志文章
doi:10.1046/j.1528-1157.2002.41701.x
更新日期:2002-07-01 00:00:00