Prediction of Seizure Outcome Using Combinations of Four Noninvasive Presurgical Modalities in Magnetic Resonance Imaging-negative Focal Intractable Epilepsy.

In focal epilepsy cases, precise identification and resection of the epileptogenic zone increase the likelihood of achieving a seizure-free outcome. Nevertheless, localizing the source of epilepsy in magnetic resonance imaging-negative epilepsy cases presents significant challenges for clinicians. In this study, we evaluated the diagnostic efficacy and impact on the seizure outcome by using 4 noninvasive modalities, including scalp video electroencephalography, magnetoencephalography, fluorodeoxyglucose-positron emission tomography, and iomazenil single-photon emission computed tomography, in a cohort of patients with magnetic resonance imaging-negative focal epilepsy who underwent resective surgery.

Risk factors for wound dehiscence after surgery for epilepsy.

Objective: Wound dehiscence following craniotomy is a complication for which patients are subjected to additional procedures to achieve wound closure. During surgery for epilepsy, a craniotomy is performed at various sites to cure or palliate seizures in patients with intractable epilepsy. Collaborations between medicine and engineering have provided many surgical devices and materials for various stages of craniotomy, from skin incision to wound closure.

Magnetoencephalographic detection of synchronized epileptic activity between the hippocampus and insular cortex.

Most magnetoencephalographic signals are derived from synchronized activity in the brain surface cortex. By contrast, the contribution of synchronized activity in the deep brain to magnetoencephalography (MEG) has remained unclear. We compared stereotactic electroencephalography (sEEG) with simultaneous MEG findings in a patient with temporal lobe epilepsy to determine the conditions under which MEG could also detect sEEG findings.

Retained Intracerebral Depth Electrode after Stereotactic Electroencephalography Monitoring: A Case Report.

Stereotactic electroencephalography (SEEG) is an increasingly popular surgical modality for localizing the epileptogenic zone. Robot-guided stereotactic electrode placement has been covered in Japan by National Health Insurance since 2020. However, several surgical devices, such as the anchor bolt (a thin, hollow, metal shaft that serves as a guide screw or fixing for each electrode), have not been approved.

Magnetoencephalographic spikes with small spikes on simultaneous electroencephalography have high spatial clustering in temporal lobe epilepsy.

Objective: To classify magnetoencephalographic (MEG) spikes according to the findings of simultaneous scalp electroencephalography (EEG) to study dipole estimation in patients with temporal lobe epilepsy.

Methods: We analyzed MEG and simultaneous scalp EEG in 27 patients with intractable temporal lobe epilepsy. We classified MEG spikes into three groups (H-EM-spikes, L-EM-spikes, M-spikes) based on the amplitude of simultaneous EEG (50 μV or higher, lower than 50 μV, no spike morphology on EEG, respectively).

Hippocampal volumetry to determine the resection side in patients with intractable non-lesional bilateral temporal lobe epilepsy.

Bilateral Temporal lobe epilepsy (BTLE) cases may result in poor surgical outcomes due to the difficulty in determining/localizing the epileptogenic zone. In this study, we investigated whether hippocampal volume (HV) would be useful for the determination of the best resection side in BTLE. Eighteen cases of BTLE determined by a scalp video electroencephalogram (SVEEG) underwent resection via intracranial electroencephalography (IVEEG).

Characterization of cortical activity in juvenile myoclonic epilepsy by gradient magnetic field topography.

Objective: Gradient magnetic field topography (GMFT) illustrates the magnetic field gradients of epileptic spike or polyspikes (S/PS) activities on a volume-rendered brain surface. The purpose is to characterize cortical activation in juvenile myoclonic epilepsy (JME).

Methods: We compared interictal S/PS activities in 10 patients with JME to five patients with Lennox-Gastaut syndrome (LGS).

Comparison of seizure outcomes and ADL recovery period after total or anterior corpus callosotomy in adolescent and young adults with drop attacks and severe mental retardation.

Purpose: The aim of this study was to evaluate seizure outcomes and postoperative neurologic complications, with an emphasis on the recovery period of activities of daily living (ADL) between anterior partial corpus callosotomy (ACC) and total corpus callosotomy (TCC) in adolescent and young adults with drop attacks and severe mental retardation.

Methods: We retrospectively reviewed the clinical records of consecutive patients with intractable epilepsy who underwent corpus callosotomy (CC) for drop attacks between 2010 and 2019 in the Department of Neurosurgery, Hiroshima University hospital, with a minimum follow-up of one year. Inclusion criteria of this study were 1) age at surgery: 11-39 years, 2) preoperative intelligence quotient <35, and 3) preoperative Barthel index (BI) ≥30.

Secondary epileptogenesis on gradient magnetic-field topography correlates with seizure outcomes after vagus nerve stimulation.

Objective: To determine the correlation between secondary unilateral or bilateral spreading on gradient magnetic-field topography (GMFT) before and after vagus nerve stimulation (VNS), and postoperative seizure outcomes.

Methods: We analyzed pre- and post-VNS magnetoencephalography (MEG) in 15 patients with VNS implants. We applied McHugh classification to evaluate seizure outcomes.

Preservation of Memory Despite Unresected Contralateral Hippocampal Volume Loss After Resection of Hippocampal Sclerosis in Seizure-Free Patients.

Objective: To determine postoperative long-term changes of hippocampal volume (HV) correlating with cognitive functions in patients who underwent surgery for hippocampal sclerosis with postoperative freedom from seizures.

Methods: We studied 1.5T magnetic resonance imaging before and after surgery in 24 patients (mean ± SD age, 36.

Anti-seizure effect and neuronal activity change in the genetic-epileptic model rat with acute and chronic vagus nerve stimulation.

Background: VNS showed time-dependent anti-seizure effect. However, the precise mechanism of VNS in acute and chronic anti-seizure effect has not been fully elucidated. Noda epileptic rat (NER) is genetic epilepsy model rat which exhibits spontaneous generalized tonic-clonic seizure (GTC) approximately once per 30 h and frequent dialeptic seizure (DS).

Ruptured large basilar artery aneurysm associated with an arteriovenous malformation in hereditary hemorrhagic telangiectasia.

A 53-year-old woman presented with intracranial hemorrhage caused by a ruptured cerebral aneurysm. Digital subtraction angiography revealed a large aneurysm arising from the top of the basilar artery and a Spetzler-Martin grade 3 arteriovenous malformation. Endovascular embolization of the aneurysm was completed with a slight neck remnant.

[Six cases of organized chronic subdural hematoma].

Surgical procedures for chronic subdural hematoma (CSDH) are performed using various methods on the basis of burr hole irrigation and drainage, but treatment for organized CSDH is rarely required. Primary operation for CSDH was performed in our hospital for 535 patients (391 men, 144 woman; age, 8 months to 104 years) between December 1991 and March 2007. Of these, 6 patients diagnosed with organized CSDH were reviewed.

[Evaluation of ruptured cerebral aneurysms under 5 mm in size on 3D-rotation angiography].

According to the recent guideline of the Japanese Society for Detection of Asymptomatic Brain Diseases, it should be considered that the operative indication for unruptured cerebral aneurysms is larger than 5 mm, but we have often encountered patients with subarachnoid hemorrhage (SAH) caused by small ruptured cerebral aneurysms. The aim of our study was to evaluate retrospectively the characteristics of ruptured cerebral aneurysms under 5 mm in size on 3-dimensional digital rotation angiography (3D-RA). Eighty patients who presented with acute SAH caused by ruptured aneurysms were admitted in our hospital between January 2003 and September 2007.