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Journals Neurosurgery Clinics of North ...

Neurosurgery Clinics of North America

https://read.qxmd.com/read/38000847/evolution-in-epilepsy-surgery-and-the-need-to-address-a-public-health-crisis-of-underutilization
#1
EDITORIAL
R Mark Richardson, Jimmy C Yang
No abstract text is available yet for this article.
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000846/the-value-of-stereo-electroencephalography-in-temporal-lobe-epilepsy-huashan-experience
#2
REVIEW
Shize Jiang, Yanming Zhu, Jie Hu
Temporal lobe epilepsy (TLE) is one of the most common drug-refractory epilepsies. However, the diagnosis and treatment of TLE may be improved by better understanding its complex network. In this article, the authors summarize their experience with TLE and discuss their process for using stereo-electroencephalography (SEEG) as part of presurgical evaluation in the past 10 years. The authors demonstrate the value of SEEG in different types of TLE and discuss how their findings have impacted treatment options...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000845/evolution-of-stereo-electroencephalography-at-massachusetts-general-hospital
#3
REVIEW
Pranav Nanda, R Mark Richardson
The practice of invasive monitoring for presurgical epilepsy workup has evolved at Massachusetts General Hospital (MGH) in parallel to the evolution in the field's understanding of epilepsy as a network disorder. Implantations have shifted from an emphasis on singularly finding single foci for the purpose of resection to a network-hypothesis-driven approach aiming to delineate patients' seizure networks with the goal of developing surgical interventions that disrupt critical nodes of these networks. Here, the authors review all invasive monitoring cases at MGH from April 2016 through June 2023 to describe how this paradigm shift has taken form...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000844/evolution-of-seeg-strategy-stanford-experience
#4
REVIEW
Vivek P Buch, Josef Parvizi
Overall stereoelectroencephalography (SEEG) has a favorable risk profile, patient tolerability, and superior investigative capability of individualized 3-dimensional seizure onset activity over subdural electrodes. Further, our recent surgical approach to safely enable multinuclear thalamic propagation mapping can only be performed with SEEG. For these reasons, SEEG has become the gold standard of phase II monitoring at our institution, and believe the ability to develop precision network-centric approaches to therapy will be critical to enhance our ability to care for medically refractory, and importantly, even complex multifocal, generalized, or surgically refractory epilepsy patients...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000843/interpretation-of-the-intracranial-electroencephalogram-of-the-human-hippocampus
#5
REVIEW
Vasileios Kokkinos
Understanding and discriminating the normal and abnormal elements of the intracranial electroencephalogram (iEEG) is essential in decision-making for epilepsy surgery. The hippocampus is widely acknowledged as a key structure in decision-making processes for surgical treatment in temporal lobe epilepsy and epilepsies that involve the mesial temporal structures. This review will provide a summary of the current state of our knowledge and understanding regarding normal and abnormal features of the iEEG of the human hippocampus...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000842/imaging-and-stereotactic-electroencephalography-functional-networks-to-guide-epilepsy-surgery
#6
REVIEW
Derek J Doss, Graham W Johnson, Dario J Englot
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...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000841/epilepsy-surgery-for-cognitive-improvement-in-epileptic-encephalopathy
#7
REVIEW
John R McLaren, Kristopher T Kahle, R Mark Richardson, Catherine J Chu
Epileptic encephalopathies are defined by the presence of frequent epileptiform activity that causes neurodevelopmental slowing or regression. Here, we review evidence that epilepsy surgery improves neurodevelopment in children with epileptic encephalopathies. We describe an example patient with epileptic encephalopathy without drug refractory seizures, who underwent successful diagnostic and therapeutic surgeries. In patients with epileptic encephalopathy, cognitive improvement alone is a sufficient indication to recommend surgical intervention in experienced centers...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000840/neurostimulation-for-generalized-epilepsy-should-therapy-be-syndrome-specific
#8
REVIEW
Aaron E L Warren, Steven Tobochnik, Melissa M J Chua, Hargunbir Singh, Michaela A Stamm, John D Rolston
Current applications of neurostimulation for generalized epilepsy use a one-target-fits-all approach that is agnostic to the specific epilepsy syndrome and seizure type being treated. The authors describe similarities and differences between the 2 "archetypes" of generalized epilepsy-Lennox-Gastaut syndrome and Idiopathic Generalized Epilepsy-and review recent neuroimaging evidence for syndrome-specific brain networks underlying seizures. Implications for stimulation targeting and programming are discussed using 5 clinical questions: What epilepsy syndrome does the patient have? What brain networks are involved? What is the optimal stimulation target? What is the optimal stimulation paradigm? What is the plan for adjusting stimulation over time?...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000839/deep-brain-stimulation-for-children-with-generalized-epilepsy
#9
REVIEW
Rory J Piper, George M Ibrahim, Martin M Tisdall
Intracranial neuromodulation is an evolving therapy for patients with drug-resistant epilepsy (DRE). Deep brain stimulation (DBS) is now available as a therapy for patients with DRE and focal-onset seizures in select health care systems; however, there remains a substantial need of efficacy data before DBS can be more widely adopted into routine clinical practice. This review and commentary focuses on a particular shifting paradigm: DBS as a therapy for children with generalized-onset seizures.
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000838/interneuron-transplantation-for-drug-resistant-epilepsy
#10
REVIEW
Derek G Southwell
Current epilepsy surgical techniques, such as brain resection, laser ablation, and neurostimulation, target seizure networks macroscopically, and they may yield an unfavorable balance between seizure reduction, procedural invasiveness, and neurologic morbidity. The transplantation of GABAergic interneurons is a regenerative technique for altering neural inhibition in cortical circuits, with potential as an alternative and minimally invasive approach to epilepsy treatment. This article (1) reviews some of the preclinical evidence supporting interneuron transplantation as an epilepsy therapy, (2) describes a first-in-human study of interneuron transplantation for epilepsy, and (3) considers knowledge gaps that stand before the effective clinical application of this novel treatment...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000837/electrode-development-for-epilepsy-diagnosis-and-treatment
#11
REVIEW
Angelique C Paulk, Pariya Salami, Rina Zelmann, Sydney S Cash
Recording neural activity has been a critical aspect in the diagnosis and treatment of patients with epilepsy. For those with intractable epilepsy, intracranial neural monitoring has been of substantial importance. Clinically, however, methods for recording neural information have remained essentially unchanged for decades. Over the last decade or so, rapid advances in electrode technology have begun to change this landscape. New systems allow for the observation of neural activity with high spatial resolution and, in some cases, at the level of the activity of individual neurons...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000836/utility-of-chronic-intracranial-electroencephalography-in-responsive-neurostimulation-therapy
#12
REVIEW
Ankit N Khambhati
Responsive neurostimulation (RNS) therapy is an effective treatment for reducing seizures in some patients with focal epilepsy. Utilizing a chronically implanted device, RNS involves monitoring brain activity signals for user-defined patterns of seizure activity and delivering electrical stimulation in response. Devices store chronic data including counts of detected activity patterns and brief recordings of intracranial electroencephalography signals. Data platforms for reviewing stored chronic data retrospectively may be used to evaluate therapy performance and to fine-tune detection and stimulation settings...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000835/sensing-enabled-deep-brain-stimulation-in-epilepsy
#13
REVIEW
Jimmy C Yang, Andrew I Yang, Robert E Gross
Deep brain stimulation has demonstrated efficacy in reducing seizure frequency in patients with drug-resistant epilepsy who may otherwise not be candidates for other surgical procedures. Recently, a clinical device that can monitor neural activity in the form of local field potentials around the deep brain stimulator lead implant site has been introduced. While this technology has been clinically adopted in other disorders treated with deep brain stimulation, such as Parkinson's disease, its application in epilepsy remains unclear...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000834/acute-effect-of-vagus-nerve-stimulation-in-patients-with-drug-resistant-epilepsy-a-preliminary-exploration-via-stereoelectroencephalogram
#14
REVIEW
Xiaoya Qin, Yuan Yuan, Huiling Yu, Yi Yao, Luming Li
As the pathophysiological mechanisms of vagus nerve stimulation (VNS) causing individual differences in the vagal ascending network remains unclear, stereoelectroencephalography (SEEG) provides a unique platform to explore the brain networks affected by VNS and helps to understand the anti-seizure mechanism of VNS more comprehensively. This study presents a preliminary exploration of the acute effect of VNS. SEEG signals were collected to assess the acute effect of VNS on neural synchronization in patients with drug-resistant epilepsy, especially in epileptogenic networks...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/38000833/pediatric-neurostimulation-and-practice-evolution
#15
REVIEW
Saadi Ghatan
Since the late nineteenth century, the prevailing view of epilepsy surgery has been to identify a seizure focus in a medically refractory patient and eradicate it. Sadly, only a select number of the many who suffer from uncontrolled seizures benefit from this approach. With the development of safe, efficient stereotactic methods and targeted surgical therapies that can affect deep structures and modulate broad networks in diverse disorders, epilepsy surgery in children has undergone a paradigmatic evolutionary change...
January 2024: Neurosurgery Clinics of North America
https://read.qxmd.com/read/37718116/spinal-deformity-update
#16
EDITORIAL
Sigurd H Berven, Praveen V Mummaneni
No abstract text is available yet for this article.
October 2023: Neurosurgery Clinics of North America
https://read.qxmd.com/read/37718115/measuring-outcomes-in-spinal-deformity-surgery
#17
REVIEW
Stephen M Bergin, Muhammad M Abd-El-Barr, Oren N Gottfried, C Rory Goodwin, Christopher I Shaffrey, Khoi D Than
Outcome assessment in adult spinal deformity has evolved from radiographic analysis of curve correction to patient-centered perception of health-related quality-of-life. Oswestry Disability Index and the Scoliosis Research Society-22 Patient Questionnaire are the predominantly used patient-reported outcome (PRO) measurements for deformity surgery. Correction of sagittal alignment correlates with improved PRO. Functional outcomes and accelerometer measurements represent newer methods of measuring outcomes but have not yet been widely adopted or validated...
October 2023: Neurosurgery Clinics of North America
https://read.qxmd.com/read/37718114/enhanced-recovery-after-surgery-protocols-and-spinal-deformity
#18
REVIEW
Omar Sorour, Mohamed Macki, Lee Tan
The authors outline a review of preoperative, intraoperative, and postoperative considerations surrounding adult spinal deformity. Preoperative management topics include imaging, hemoglobin A1c levels before spine surgery, osteoporotic management, and prehabilitation. Topics surrounding intraoperative management include the use of antibiotics, liposomal bupivacaine, and Foley catheters. The authors also discuss postoperative questions surrounding analgesia, nausea and vomiting, thromboembolic prophylaxis, and early mobilization...
October 2023: Neurosurgery Clinics of North America
https://read.qxmd.com/read/37718113/complications-and-avoidance-in-adult-spinal-deformity-surgery
#19
REVIEW
Joseph R Linzey, Jock Lillard, Michael LaBagnara, Paul Park
Adult spinal deformity (ASD) is a complex disease that can result in significant disability. Although surgical treatment has been shown to be of benefit, the complication rate in the perioperative and postoperative periods can be as high as 70%. Some of the most common complications of ASD surgery include intraoperative cerebrospinal fluid leak, high blood loss, new neurologic deficit, hardware failure, proximal junctional kyphosis/failure, pseudarthrosis, surgical site infection, and medical complications...
October 2023: Neurosurgery Clinics of North America
https://read.qxmd.com/read/37718112/robotic-assisted-surgery-and-navigation-in-deformity-surgery
#20
REVIEW
Christine Park, Saman Shabani, Nitin Agarwal, Lee Tan, Praveen V Mummaneni
Deformity surgery is advancing quickly with the use of three-dimensional navigation and robotics. In spinal fusion, the use of robotics improves screw placement accuracy and reduces radiation, complications, blood loss, and recovery time. Currently, there is limited evidence showing that robotics is better than traditional freehand techniques. Most studies favoring robotics are small and retrospective due to the novelty of the technology in deformity surgery. Using these systems can also be expensive and time-consuming...
October 2023: Neurosurgery Clinics of North America
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