Closed-loop stimulation in the control of focal epilepsy of insular origin.

Background: Previous studies have shown that closed-loop or responsive neurostimulation can abort induced or spontaneous epileptiform discharges.

Objective: To assess the effectiveness of a programmable cranially implanted closed-loop neurostimulation system in the control of seizures originating from an area relatively inaccessible by open craniotomy.

Method: A patient with drug-resistant partial epilepsy had previously undergone open resection of the left frontal opercular cortex and the underlying insular area.

Gamma Knife stereotactic radiosurgical treatment of idiopathic trigeminal neuralgia: long-term outcome and complications.

Object: Stereotactic radiosurgery (SRS) with the Gamma Knife (GK) is a rapidly emerging surgical modality in the management of medically refractory idiopathic trigeminal neuralgia (TN). The current study examines the long-term outcome in patients with drug-resistant idiopathic TN who underwent GK surgery at the authors' institution.

Methods: One hundred and six consecutive patients (38 men and 68 women) with proven medically refractory idiopathic TN were included in this retrospective study.

Intracranial stimulation study of lateralization of affect.

As part of their evaluation for epilepsy surgery, 53 patients underwent stimulation of depth or subdural electrodes. Responses obtained from depth stimulation included motor responses at 34 sites, sensory responses at 114 sites, language alterations at 6 sites, and affective responses at 22 sites. Responses obtained from subdural stimulation included motor responses at 19 sites, sensory responses at 31 sites, speech alterations at 10 sites, and affective responses at 1 site.

Implantation of a closed-loop stimulation in the management of medically refractory focal epilepsy: a technical note.

Open-loop stimulation studies have shown varying control of seizures with stimulation of different anatomical targets. A recent multi-institutional clinical study utilizing an external closed-loop stimulation system had promising results. A novel implantable closed-loop Responsive Neurostimulation System (RNS) (Neuropace, Inc.

Spontaneous motor cortex encephalocele presenting with simple partial seizures and progressive hemiparesis. Case report and review of the literature.

Several cases of congenital or acquired temporal encephaloceles have been reported in the literature as the causative mechanism of simple and/or complex partial seizures. In this report the authors describe a rare case of spontaneous parietal encephalocele presenting with simple partial seizures and progressively increasing contralateral upper-extremity motor deficit. The unusual anatomical location of an encephalocele associated with seizures and the delayed seizure onset represent distinctive characteristics in this case.

MR-based stereotactic mesencephalic tractotomy.

Introduction: Medically refractory pain related to cancer is a major indication for pain surgery. Stereotactic mesencephalic tractotomy (SMT) constitutes a widely accepted procedure in treating unilateral head and neck cancer pain.

Material And Method: We report a case of a MRI-based right-sided SMT for treating intractable craniofacial pain, in a 38-year-old patient, related to a previously resected adenocystic carcinoma of the parotid gland.

Nonhabitual seizures in patients with implanted subdural electrodes.

The implantation of subdural electrodes has been widely employed in the invasive monitoring of patients with medically refractory epilepsy. The use of subdural electrodes, though, has been associated with rare but occasionally troublesome complications. We report the occurrence of nonhabitual seizures after implanting subdural grid electrodes.

A 10-year experience with magnetic source imaging in the guidance of epilepsy surgery.

Magnetic source imaging (MSI) of interictal epileptiform dipoles was studied in 100 epilepsy surgery candidates. Sixty underwent surgery. MSI epileptiform data were classified as focal, regional, multifocal, scattered or none.