What is the diagnostic value of repeating a nondiagnostic video-EEG study?

Repeat video-EEG (VEEG) may increase diagnostic yield, but the test is resource intensive, time-consuming, and expensive and poses some potential risks to patients. It is also relatively common to monitor a patient for several days without capturing any clinical events. The purpose of this study was to determine the diagnostic value of repeat admissions for VEEG and to determine if the commonly available clinical information could predict the diagnostic outcome, "diagnostic" or "nondiagnostic," of a repeat study.

Preference-based quality-of-life measures for neocortical epilepsy surgery.

Critical to decision analysis studies are measures of outcome utilities. In epilepsy surgery the benefit versus risk ratio is of particular interest in neocortical resections. Using the standard gamble, we measured preferences of 30 epilepsy patients for 10 outcome states specific to neocortical epilepsy surgery.

Effect of detection parameters on automated electroencephalography spike detection sensitivity and false-positive rate.

Purpose: Most seizure monitoring units use the Gotman algorithm or a variation on it for EEG spike detection, but the effect of various detection parameters on its accuracy has not been well established. The authors report sensitivities and false-positive rates for several different sets of detection parameters.

Methods: Nine patients were studied.

Effect of epilepsy magnetic source imaging on intracranial electrode placement.

Objective: Intracranial electroencephalography (ICEEG) with chronically implanted electrodes is a costly invasive diagnostic procedure that remains necessary for a large proportion of patients who undergo evaluation for epilepsy surgery. This study was designed to evaluate whether magnetic source imaging (MSI), a noninvasive test based on magnetoencephalography source localization, can supplement ICEEG by affecting electrode placement to improve sampling of the seizure onset zone(s).

Methods: Of 298 consecutive epilepsy surgery candidates (between 2001 and 2006), 160 patients were prospectively enrolled by insufficient localization from seizure monitoring and magnetic resonance imaging results.

Functional imaging: II. Prediction of epilepsy surgery outcome.

Objective: To gain information on the value of magnetic source imaging (MSI), 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and ictal single photon emission computed tomography (SPECT) to predict seizure-free outcome following epilepsy surgery in patients who require intracranial electroencephalography (ICEEG).

Methods: This work was part of a prospective observation study of epilepsy surgery candidates not sufficiently localized with scalp EEG and MRI. Of 160 patients enrolled 62 completed ICEEG and subsequent surgical resection.

Functional imaging: I. Relative predictive value of intracranial electroencephalography.

Objective: To gain information on the predictive and prognostic value of magnetic source imaging (MSI), 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography ((18)FDG-PET), and ictal single-photon emission computed tomography (SPECT) as compared with intracranial electroencephalography (ICEEG) localization in epilepsy surgery.

Methods: This work was part of a cohort study of epilepsy surgery candidates not sufficiently localized with noninvasive studies. Of 160 patients enrolled over 4 years, 77 completed ICEEG seizure monitoring.

Magnetic source imaging versus intracranial electroencephalogram in epilepsy surgery: a prospective study.

Objective: Noninvasive brain imaging tests can potentially supplement or even replace the use of intracranial electroencephalogram (ICEEG), an invasive, costly procedure used in presurgical epilepsy evaluation. This study prospectively examined the agreement between magnetic source imaging (MSI) and ICEEG localization in epilepsy surgery candidates.

Methods: Patients completing video monitoring with scalp EEG who had intractable partial epilepsy based on ictal electro-clinico-anatomical features were screened.

Improved depiction of small anatomic structures in MR images using Gaussian-weighted spirals and zero-filled interpolation.

Partial-volume artifacts reduce the contrast and continuity of small structures in magnetic resonance images. Zero-filled interpolation (ZFI) has been known for some time as a useful technique to reduce partial-volume artifacts and improve the appearance of small structures and edges. However, its use is limited by the fact that ZFI can exacerbate image artifacts.