Publications by authors named "William Bingaman"
Article Synopsis
- The study investigated how to manage patients with medically resistant epilepsy caused by temporal encephaloceles, focusing on the importance of ancillary testing before surgery to improve surgical outcomes.
- Researchers analyzed medical records from the Cleveland Clinic over two decades, specifically looking at patients who had surgery for drug-resistant temporal lobe epilepsy linked to encephaloceles.
- Results showed that 63% of the 19 patients had successful seizure control one year post-surgery, with detailed patterns of seizure activity revealed through advanced EEG evaluations, indicating a need for personalized surgical strategies.
Background And Objectives: Stereoelectroencephalography (SEEG) is an important method for invasive monitoring to establish surgical candidacy in approximately half of refractory epilepsy patients. Identifying factors affecting lead placement can mitigate potential surgical risks. This study applies multivariate analyses to identify perioperative factors affecting stereotactic electrode placement.
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- The study focused on the prognostic factors affecting the outcomes of resective epilepsy surgery (RES) in older adults (60+ years), emphasizing the importance of comorbidities in managing epilepsy.
- A cohort of 94 older adults who underwent RES was analyzed, revealing that 57% of patients remained seizure-free after surgery, with factors like aura and specific EEG patterns influencing seizure recurrence.
- The findings highlight the need for further research in larger, multicenter studies to better understand the prognosis of RES in older adults and to encourage appropriate surgical interventions for eligible patients.
Article Synopsis
- The study looked at patients with polymicrogyria (PMG) who had epilepsy that didn't get better with medicine, using a special procedure called ICEEG to see where the seizures started.
- Out of 35 patients, those who had surgery to remove parts of the brain had a better chance of stopping seizures completely compared to those who didn’t have surgery.
- The researchers found that knowing exactly where the seizures came from helped doctors decide how best to treat the patients, suggesting that just removing visible brain areas on scans doesn’t always mean the seizures will stop.
For medically-refractory epilepsy patients, stereoelectroencephalography (sEEG) is a surgical method using intracranial electrode recordings to identify brain networks participating in early seizure organization and propagation (i.e. the epileptogenic zone, EZ).
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- Hydrocephalus can happen after brain surgery for epilepsy, but how it occurs isn't fully understood.
- A patient with this condition was treated with a special medication that helps reduce inflammation, and after 6 months, they showed improvements in their health and school performance.
- More research is needed to learn how this inflammation treatment might help other patients after epilepsy surgery.
Hemispherectomy is an effective procedure used in the treatment of drug-resistant hemispheric epilepsy, especially in the pediatric population. A number of resective and disconnective techniques are used, and selection of surgical strategy is paramount to achieving successful results. Notably, disconnective (or functional) hemispherotomy maximizes the benefits of safe, surgical disconnection while minimizing hemispheric tissue resection, thereby avoiding some of the perioperative factors contributing to morbidity in traditional anatomical hemispherectomy procedures.
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- A new noninvasive fiducial attachment for stereotactic registration in sEEG was created and validated, eliminating the need for extra scalp surgery while increasing reference points.
- The study involved 25 patients, and measurements showed an average registration error of just 0.77 mm without significant complications.
- Results indicated low trajectory error for electrode placement, suggesting that the device is safe and effective for improving precision in epilepsy monitoring.
Responsive neurostimulation is a closed-loop neuromodulation therapy for drug resistant focal epilepsy. Responsive neurostimulation electrodes are placed near ictal onset zones so as to enable detection of epileptiform activity and deliver electrical stimulation. There is no standard approach for determining the optimal placement of responsive neurostimulation electrodes.
View Article and Find Full Text PDFObjective: The risk of hydrocephalus following hemispherectomy for drug resistant epilepsy (DRE) remains high. Patients with pre-existing hydrocephalus pose a postoperative challenge, as maintaining existing shunt patency is necessary but lacks a clearly defined strategy. This study examines the incidence and predictors of shunt failure in pediatric hemispherectomy patients with pre-existing ventricular shunts.
View Article and Find Full Text PDFWe sought to perform a systematic review and individual participant data meta-analysis to identify predictors of treatment response following thalamic neuromodulation in pediatric patients with medically refractory epilepsy. Electronic databases (MEDLINE, Ovid, Embase, and Cochrane) were searched, with no language or data restriction, to identify studies reporting seizure outcomes in pediatric populations following deep brain stimulation (DBS) or responsive neurostimulation (RNS) implantation in thalamic nuclei. Studies featuring individual participant data of patients with primary or secondary generalized drug-resistant epilepsy were included.
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- - The study focuses on pediatric patients who undergo hemispherectomy surgery for intractable epilepsy and examines the complication of hydrocephalus that can arise post-surgery, highlighting the need to understand its mechanisms better for improved patient care.
- - A retrospective review of 204 patients from the Cleveland Clinic looked at various factors like demographics, surgical history, and complications to identify those contributing to hydrocephalus, with 14% of patients developing the condition post-operation.
- - Findings indicated that 46% of patients with hydrocephalus experienced symptoms within 90 days post-surgery, and certain factors, like postoperative aseptic meningitis, were significantly linked to the development of hydrocephalus.
Article Synopsis
- The study aimed to identify factors that influence successful epileptogenic zone (EZ) identification and seizure freedom in pediatric patients with drug-resistant epilepsy who received stereoelectroencephalography (SEEG).
- Researchers analyzed data from 101 patients under 18 years old treated between July 2009 and June 2020, excluding those with previous failed surgery.
- Results showed that older onset of epilepsy and suspected developmental lesions increased the likelihood of EZ identification, while having an MRI lesion positively affected seizure freedom after surgical treatment.
Article Synopsis
- - The study focused on the safety and complication rates of pediatric stereoencephalography (SEEG) electrode placement in children under 12, noting that their thinner skulls pose challenges compared to adults.
- - Out of 53 patients reviewed, the median skull thickness was 4.1 mm, and only 1.9% experienced hardware complications, with a small rate (9.4%) of asymptomatic hemorrhages.
- - The findings suggest that despite potential risks, SEEG is generally safe for younger patients, and using sutures to secure electrodes may be beneficial for those with thinner skulls.
Article Synopsis
- - Radiofrequency thermocoagulation (RFTC) has been used since 2004 as a safe method for creating lesions to treat epilepsy, but is not widely practiced in the U.S. due to lack of FDA-approved technologies for in situ sEEG electrodes.
- - A case study of a young woman with drug-resistant temporal lobe epilepsy shows successful seizure freedom for 18 months following sEEG-guided RFTC performed with a specialized probe, despite the procedure's primary intent being diagnostic.
- - The authors emphasize the limited application of this technique in the U.S., advocating for it as a temporary solution while stressing the urgent need for new FDA-approved devices to safely perform RFTC with sEEG electrodes.
Background And Objectives: The aim of this study was to characterize short-term outcomes in episodic memory, as assessed by the Children's Memory Scale (CMS), after temporal lobe resection in children with epilepsy using empirical methods for assessing cognitive change (i.e., reliable change indices [RCI] and standardized regression-based change scores [SRB]) and develop and internally validate clinically applicable models to predict postoperative memory decline.
View Article and Find Full Text PDFPolytherapy with antiseizure medications (ASMs) is often used to control seizures in patients suffering from epilepsy, where about 30% of patients are pharmacoresistant. While drug combinations are intended to be beneficial, the consequence of CYP-dependent drug interactions on apoptotic protein levels and mitochondrial function in the epileptic brain remains unclear. We examined the interactions of ASMs given prior to surgery in surgically resected brain tissues and of three ASMs (lacosamide, LCM; oxcarbazepine, OXC; levetiracetam LEV) in isolated brain cells from patients with drug-resistant epilepsy ( = 23).
View Article and Find Full Text PDFObjective: The significance of ictal magnetoencephalography (MEG) is not well appreciated. We evaluated the relationships between ictal MEG, MRI, intracranial electroencephalography (ICEEG), surgery and postoperative seizure outcome.
Methods: A total of 45 patients (46 cases) with ictal MEG who underwent epilepsy surgery was included.
Article Synopsis
- Neurosurgery can help people with epilepsy who don’t respond to medicine, but it’s important to also think about how it affects their everyday life and thinking skills.
- In a study of 196 adults who had surgery for epilepsy, most were seizure-free afterward, which generally made their quality of life better, even if some had trouble with thinking afterwards.
- People who struggled with both having seizures come back and thinking problems had a harder time with their quality of life, but overall, better seizure control typically led to a better quality of life, despite some cognitive changes.
Article Synopsis
- The study looked at how surgery helps people with epilepsy who don’t get better with medication, focusing on long-term effects over many years.
- They found that a lot of patients had fewer seizures and some even became seizure-free, with many feeling better after a while even if they weren’t better right away.
- Overall, the results showed that even if someone still has seizures after surgery, they can still experience significant improvements over time.
Objective: Stereoelectroencephalography (SEEG) has gained popularity as an invasive monitoring modality for epileptogenic zone (EZ) localization. The need and indications for SEEG in patients with evident brain lesions or associated abnormalities on imaging is debated. We report our experience with SEEG as a presurgical evaluation tool for patients with lesional epilepsy.
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- The study looked at EEG (brain wave) changes in patients who had part of their brain removed (hemispherectomy) and were not having seizures anymore.
- Researchers collected information on these patients before and after the surgery to see how their brain activity changed.
- Most patients still had some unusual brain wave patterns after the surgery, but many were able to stop taking their seizure medications after a few years.
The glucocorticoid receptor (GR) at the blood−brain barrier (BBB) is involved in the pathogenesis of drug-resistant epilepsy with focal cortical dysplasia (FCD); however, the roles of GR isoforms GRα and GRβ in the dysplastic brain have not been revealed. We utilized dysplastic/epileptic and non-dysplastic brain tissue from patients who underwent resective epilepsy surgery to identify the GRα and GRβ levels, subcellular localization, and cellular specificity. BBB endothelial cells isolated from the dysplastic brain tissue (EPI-ECs) were used to decipher the key BBB proteins related to drug regulation and BBB integrity compared to control and transfected GRβ-overexpressed BBB endothelial cells.
View Article and Find Full Text PDFBackground: Rasmussen encephalitis (RE) is a rare inflammatory disease affecting one hemisphere, causing progressive neurological deficits and intractable seizures.
Objective: To report long-term seizure outcomes, reoperations, and functional outcomes in patients with RE who underwent hemispherectomy at our institution.
Methods: Retrospective review was performed for all patients with RE who had surgery between 1998 and 2020.
Objective: Neuropsychological profiles are heterogeneous both across and within epilepsy syndromes, but especially in frontal lobe epilepsy (FLE), which has complex semiology and epileptogenicity. This study aimed to characterize the cognitive heterogeneity within FLE by identifying cognitive phenotypes and determining their demographic and clinical characteristics.
Method: One hundred and six patients (age 16-66; 44% female) with FLE completed comprehensive neuropsychological testing, including measures within five cognitive domains: language, attention, executive function, processing speed, and verbal/visual learning.