Epilepsy surgery is a potentially curative treatment of drug-resistant epilepsy that has remained underutilized both due to inadequate referrals and incomplete localization hypotheses. The complexity of patients evaluated for epilepsy surgery has increased, thus new approaches are necessary to treat these patients. The paradigm of epilepsy surgery has evolved to match this challenge, now considering the entire seizure network with the goal of disrupting it through resection, ablation, neuromodulation, or a combination. The network paradigm has the potential to aid in identification of the seizure network as well as treatment selection.
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http://dx.doi.org/10.1016/j.nec.2023.09.001 | DOI Listing |
Eur J Neurol
January 2025
Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
Background: Temporal lobe epilepsy (TLE) can lead to structural brain abnormalities, with thalamus atrophy being the most common extratemporal alteration. This study used probabilistic tractography to investigate the structural connectivity between individual thalamic nuclei and the hippocampus in TLE.
Methods: Thirty-six TLE patients who underwent pre-surgical 3 Tesla magnetic resonance imaging (MRI) and 18 healthy controls were enrolled in this study.
J Clin Med
December 2024
Degenerative and Chronic Diseases of the Faculty of Health Sciences (FGW), University Potsdam, 14469 Potsdam, Germany.
: About 65 million people worldwide are affected by epilepsy, with temporal lobe epilepsy being the most common type resistant to drugs and often requiring surgical treatment. Although open surgical approaches, such as temporal lobectomy, have been the method of choice for decades, minimally invasive MRgLITT has demonstrated promising results. However, it remains unknown whether patients who underwent one of these two approaches would show better performance on vestibulo-spatial tasks.
View Article and Find Full Text PDFSensors (Basel)
December 2024
Mines Saint-Etienne, Centre CMP, Département BEL, F-13541 Gardanne, France.
The primary method of treatment for patients suffering from drug-resistant focal-onset epilepsy is resective surgery, which adversely impacts neurocognitive function. Radio frequency (RF) ablation and laser ablation are the methods with the most promise, achieving seizure-free rates similar to resection but with less negative impact on neurocognitive function. However, there remains a number of concerns and open technical questions about these two methods of thermal ablation, with the primary ones: (1) heating; (2) hemorrhage and bleeding; and (3) poor directionality.
View Article and Find Full Text PDFClin Neurol Neurosurg
January 2025
Department of Neurosurgery, Hospital Clínic de Barcelona, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Objective: to study the anatomical feasibility of laser fiber insertion for interstitial thermal therapy via transorbital approach to the temporo-mesial structures (amygdala-hippocampus-parahippocampus complex).
Methods: Anatomical dissections were performed bilaterally on two human cadaveric heads via a transorbital approach, in which screws and laser fibers were used for magnetic resonance imaging-guided laser interstitial thermal therapy (MRIgLITT) assisted by neuronavigation. In addition, eight transorbital trajectories were simulated using the transorbital entry points obtained from a cadaveric radiological study of four patients previously operated on for mesial temporal lobe epilepsy.
Sci Rep
January 2025
Department of Neurosurgery, Affiliated Hospital of Zunyi Medical University, Dalian Road 149, Huichuan District, Zunyi, 563000, Guizhou Province, China.
The aim of the study was to evaluate the concomitant psychiatric disorders of anxiety and depression in patients with epilepsy caused by low-grade brain tumors (LBTs). We retrospectively reviewed the clinical data of patients who underwent preoperative neuropsychological evaluations of anxiety and depression and subsequent epilepsy surgery for LBTs. The univariate and multivariate analyses were conducted to analyze the risk factors of the occurrence of anxiety and depression.
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