An Unusual Case of Hypothalamic Hamartoma With Nongelastic Seizures and Posterior Cortex Connectivity.

Background: To describe a rare seizure semiology originating from a hypothalamic hamartoma in a child, along with unusual ictal onset and connectivity pattern, and provide a review of the pathophysiology of epilepsy associated with hypothalamic hamartoma and management.

Methods: A detailed retrospective chart review and literature search were performed using Pubmed and Embase.

Results: We present a case of a three-year-old male who presented with dyscognitive seizures with onset at age 22 months.

The changing landscape of palliative epilepsy surgery for Lennox Gastaut Syndrome.

Lennox Gastaut Syndrome (LGS) is characterized by drug-resistant epilepsy that typically leads to decreased quality of life and deleterious neurodevelopmental comorbidities from medically refractory seizures. In recent years there has been a dramatic increase in the development and availability of novel treatment strategies for Lennox Gastaut Syndrome patient to improve seizure. Recent advances in neuromodulation and minimally invasive magnetic resonance guided laser interstitial thermal therapy (MRgLITT) have paved the way for new treatments strategies including deep brain stimulation (DBS), responsive neurostimulation (RNS), and MRgLITT corpus callosum ablation.

Intracranial investigation of piriform cortex epilepsy during odor presentation.

The piriform cortex (PC) is part of the olfactory system, principally receiving input from the lateral olfactory tract and projecting to downstream components of the olfactory network, including the amygdala. Based on preclinical studies, PC is vulnerable to injury and can be easily kindled as an onset site for seizures. While the role of PC in human epilepsy has been studied indirectly and the subject of speculation, cases of demonstrated PC seizure onset from direct intracranial recording are rare.

Mapping the Central Sulcus Extraoperatively Using Stereoelectroencephalography: A New Application of an Established Method.

Purpose: Central sulcus localization is undertaken intraoperatively with subdural electrodes through a phase reversal technique using somatosensory evoked potentials from sensorimotor cortices. Extraoperative central sulcus localization using stereoelectroencephalography has not been described previously.

Methods: Six pediatric patients (aged 12-18 years, 50% females) were investigated with stereoelectroencephalography.

Functional outcomes of pediatric hemispherotomy: Impairment, activity, and medical service utilization.

Objective: The purpose of this study was to describe the functional outcomes of hemispherotomy in a pediatric cohort, including impairments, activity limitations, utilization of therapies and medical specialist services, and subsequent surgical intervention.

Methods: We conducted a retrospective review of patients who underwent hemispherotomy at UPMC Children's Hospital of Pittsburgh from 2001 to 2021. Data on impairments, activity limitations in mobility, self-care, and communication, and use of re/habilitative therapies and medical specialist services were collected pre-operatively and at 1, 5, 10, and 15 years postoperatively.

The precuneal cortex: anatomy and seizure semiology.

The purpose of this review is to describe the functional anatomy of the precuneal cortex and outline some semiological features of precuneal seizures. The precuneal cortex is a structure that occupies the posterior medial portion of the parietal lobe, and it has broad cortical and subcortical connections. Neuroanatomical tracing, functional imaging, as well as electrical stimulation studies of humans and other primates have elucidated many complex integrative functions of the precuneus including visuo-spatial imagery, sensorimotor functions, and consciousness.