Epilepsy surgery in children: what the radiologist needs to know

Pearce, Kirsten; Dixon, Luke; D’Arco, Felice; Pujar, Suresh; Das, Krishna; Tahir, Zubair; Tisdall, Martin; Mankad, Kshitij

doi:10.1007/s00234-020-02448-2

Cited by 7 publications

(3 citation statements)

References 84 publications

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“…An immediate recognition of normal and abnormal patterns, a deep understanding of potential clinical pitfalls and need for additional investigations allows a smooth neuroradiology workflow and timely escalation to the appropriate specialist, whenever prompt surgical or medical treatments are needed. The advances achieved over the years in neurosurgical techniques and neuroanaesthesia have driven a parallel expansion in the array of conditions, which are potentially treatable with surgery (37,38). As such, the range of surgical options is now wider than ever, and includes minimally invasive procedures amenable for service improvement projects focused around the concepts of early recovery after surgery and prompt discharge from neurosurgical centres (39)(40)(41).…”

Section: Discussionmentioning

confidence: 99%

“…As such, the range of surgical options is now wider than ever, and includes minimally invasive procedures amenable for service improvement projects focused around the concepts of early recovery after surgery and prompt discharge from neurosurgical centres (39)(40)(41). An awareness of the surgical thinking and planning of neurosurgical interventions in children, and the practical knowledge of the operative steps involved, can truly lead to enhance accuracy in radiology reporting of the postoperative scan (37).…”

Section: Discussionmentioning

confidence: 99%

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Pre-operative imaging and post-operative appearance of standard paediatric neurosurgical approaches: a training guide for neuroradiologists

2021

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A short-cut narrative review was conducted according to the SANRA guidelines to identify studies describing normal and abnormal postoperative radiological features of the most common paediatric neurosurgical procedures. Rather than focusing on the original pathology addressed by neurosurgical means, this review explored three main areas of operative neurosurgery: ventricular access, supratentorial & infratentorial craniotomies, and posterior fossa/craniocervical junction decompression. A total of twenty-three landmark papers were included for review based on their relevance to address the research question and serve as a practical guide for paediatric neuroradiology trainees and fellows. Accurate in text referencing of the ClinicalTrials.gov identifier, and weblink, has also been provided for all trials discussed in the results section. All the above is complemented by relevant iconography meant to describe a wide range of postoperative changes and early complications. Finally, the review is enriched by a discussion touching upon haemostatic agents, intentionally retained foreign bodies and the future of machine learning for neuroradiology reporting. Overall, the information presented in a systematic fashion will not only help trainees and fellows to deepen these topics and expand their knowledge in preparation for written and oral boards, but will also represent a useful resource for everyone including trained neuroradiologists and neurosurgeons themselves.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pre-operative imaging and post-operative appearance of standard paediatric neurosurgical approaches: a training guide for neuroradiologists

2021

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“…Epilepsy is a chronic brain disorder characterized by sudden, recurrent, and transient central nervous system dysfunction caused by the excessive firing of neurons in the brain (1). The clinical manifestations include disorders of movement, sensation, consciousness, behavior, and autonomic nerve function (2), depending on the site of the invaded neurons and the range of discharge diffusion.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of lamotrigine after failure of the first administration of valproate in treating epilepsy: a systematic review and meta-analysis

He¹,

Wu²,

Dong³

2022

Ann Palliat Med

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Background: Epilepsy is a long-term recurrent chronic brain disease that can cause significant emotional burden to the patient and their family, as well as huge economic costs to society. Timely and accurate diagnosis of epilepsy, together with early and standardized treatments can effectively control seizures and restore the patient's quality of life and reduce the economic burden. This meta-analysis examined the efficacy of lamotrigine administration in patients with epilepsy.Methods: A literature search was performed in the PubMed, Embase, and OVID-Medline databases to identify articles related to epilepsy and lamotrigine that were published from the establishment of the database to April 2021. The keywords used for the literature search included "epilepsy", "sodium valproate", "lamotrigine", "effectiveness", and "therapeutic effect". It uses Cochrane review manual 5.3 to evaluate the quality of the included literature and review manager 5.3 software for meta-analysis.Results: A total of 9 studies involving 1,864 patients with epilepsy were included in this meta-analysis.The results revealed that, after treatment failure with the first drug of valproic acid, the total effective rate of lamotrigine treatment had an odds ratio (OR) of 2.21 with a 95% confidence interval (CI) of 1.15 to 4.27 (Z=2.37; P=0.02). The total adverse reaction rate (OR =0.70; 95% CI: 0.55 to 0.88; Z=2.98; P=0.003) and the improvement rate of epilepsy associated with lamotrigine treatment (OR =4.22; 95% CI: 1.00 to 17.84; Z=1.96; P=0.05) were all significantly higher than that of other drug treatments.Discussion: A total of 9 articles were included in this meta-analysis to examine the efficacy of lamotrigine in the treatment of epilepsy. The clinical efficacy of lamotrigine addition therapy was found to be superior to lamotrigine replacement therapy, and the incidence of adverse reactions was lower than that of lamotrigine replacement therapy. However, due to the low methodological quality of the included literatures, this conclusion should be further verified using large sample and high-quality randomized double-blinded experiments.

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Superior lesion detection on 3D FSE T1WI with magnetization transfer and CHESS preparation pulses in children with focal epilepsy: Preliminary results

Wei,

Assis,

Sherriff

et al. 2024

Epileptic Disorders

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In childhood drug‐resistant focal epilepsy, the identification of a magnetic resonance imaging lesion significantly affects the management and prognosis, although it is often challenging. Herein we report the preliminary results of a modified MR sequence, in which both magnetization transfer and chemical shift selective preparation pulses are added to a 3D fast spin echo T1‐weighted sequence to recognize focal cortical dysplasia. The scan time is short, and the images have expected uniform suppression of the background normal gray and white matter. We report four children with focal epilepsy, in whom the focal cortical and subcortical lesions are superiorly conspicuous on the aforementioned MR sequence compared to the high‐resolution fluid‐attenuated inversion recovery images obtained with typical epilepsy MR protocols.

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Epilepsy surgery in children: what the radiologist needs to know

Cited by 7 publications

References 84 publications

Pre-operative imaging and post-operative appearance of standard paediatric neurosurgical approaches: a training guide for neuroradiologists

Pre-operative imaging and post-operative appearance of standard paediatric neurosurgical approaches: a training guide for neuroradiologists

The efficacy of lamotrigine after failure of the first administration of valproate in treating epilepsy: a systematic review and meta-analysis

Superior lesion detection on 3D FSE T1WI with magnetization transfer and CHESS preparation pulses in children with focal epilepsy: Preliminary results

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