Presurgical evaluation for patients with drug-resistant epilepsy requires the definition of various zones that have a variable spatial relationship with the epileptogenic zone. All the available methods to directly measure the actual seizure-onset zone and to define "the minimum amount of cortical tissue that must be resected to produce seizure-freedom" have significant limitations. We report on the case of a patient with dual pathology (hippocampal sclerosis and a post-traumatic scar) and discuss the contribution of the various presurgical investigations that led to surgery and seizure-freedom.
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Epilepsy Behav
January 2025
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address:
Purpose: Concurrent electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) have been used to assist in the presurgical localization of seizure foci in people with epilepsy. Our study aimed to examine the clinical feasibility of an optimized concurrent EEG-fMRI protocol.
Methods: The optimized protocol employed a fast-fMRI sequence (sampling rate = 10 Hz) with a spare arrangement, which allowed a time window of 1.
Acta Neurochir (Wien)
January 2025
Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands.
Purpose: In resective epilepsy surgery for drug-resistant focal epilepsy (DRE), good seizure outcome is strongly associated with visualization of an epileptogenic lesion on MRI. Standard clinical MRI (≤ 3 Tesla (T)) may fail to detect subtle lesions. 7T MRI enhances detection and delineation, the potential benefits of increasing field strength to 9.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
January 2025
From the School of Biomedical Engineering (B.C., H.H., J.L., S.Y., Y.C., J.L.), Shanghai Jiao Tong University, Shanghai, China; Department of Neurosurgery (S.J., J.H., L.C.), and PET Center (W.B.), Huashan Hospital, Fudan University, Shanghai, China.
Background And Purpose: Epilepsy, a globally prevalent neurological disorder, necessitates precise identification of the epileptogenic zone (EZ) for effective surgical management. While the individual utilities of FDG PET and FMZ PET have been demonstrated, their combined efficacy in localizing the epileptogenic zone remains underexplored. We aim to improve the non-invasive prediction of epileptogenic zone (EZ) in temporal lobe epilepsy (TLE) by combining FDG PET and FMZ PET with statistical feature extraction and machine learning.
View Article and Find Full Text PDFProc Int Brain Comput Interface Conf
September 2024
Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
In this study, we developed and validated an online analysis framework in MATLAB Simulink for recording and analysis of intracranial electroencephalography (iEEG). This framework aims to detect interictal spikes in patients with epilepsy as the data is being recorded. An online spike detection was performed over 10-minute interictal iEEG data recorded with Brain Interchange CorTec in three human subjects.
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