Expanding the role of surgery in intractable extratemporal pediatric epilepsy

Goyal, Monisha; Robinson, Shenandoah

doi:10.3171/foc/2008/25/9/e15

Cited by 8 publications

(2 citation statements)

References 27 publications

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“…Our surgical outcome based on conventional visual inspection criteria alone yielded a 58% seizure‐free rate, comparable to previously published seizure‐free rates for pediatric epilepsy surgery series (Wyllie et al., 1998; Bauman et al., 2008; Goyal & Robinson, 2008). Resection of HFOs yielded a higher seizure‐free outcome (82%), although not quite approaching statistical significance.…”

Section: Discussionsupporting

confidence: 83%

Resection of ictal high‐frequency oscillations leads to favorable surgical outcome in pediatric epilepsy

et al. 2012

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Summary Purpose Intracranial electroencephalography (EEG) is performed as part of an epilepsy surgery evaluation when noninvasive tests are incongruent or the putative seizure-onset zone is near eloquent cortex. Determining the seizure-onset zone using intracranial EEG has been conventionally based on identification of specific ictal patterns with visual inspection. High-frequency oscillations (HFOs, >80 Hz) have been recognized recently as highly correlated with the epileptogenic zone. However, HFOs can be difficult to detect because of their low amplitude. Therefore, the prevalence of ictal HFOs and their role in localization of epileptogenic zone on intracranial EEG are unknown. Methods We identified 48 patients who underwent surgical treatment after the surgical evaluation with intracranial EEG, and 44 patients met criteria for this retrospective study. Results were not used in surgical decision making. Intracranial EEG recordings were collected with a sampling rate of 2,000 Hz. Recordings were first inspected visually to determine ictal onset and then analyzed further with time-frequency analysis. Forty-one (93%) of 44 patients had ictal HFOs determined with time-frequency analysis of intracranial EEG. Key Findings Twenty-two (54%) of the 41 patients with ictal HFOs had complete resection of HFO regions, regardless of frequency bands. Complete resection of HFOs (n = 22) resulted in a seizure-free outcome in 18 (82%) of 22 patients, significantly higher than the seizure-free outcome with incomplete HFO resection (4/19, 21%). Significance Our study shows that ictal HFOs are commonly found with intracranial EEG in our population largely of children with cortical dysplasia, and have localizing value. The use of ictal HFOs may add more promising information compared to interictal HFOs because of the evidence of ictal propagation and followed by clinical aspect of seizures. Complete resection of HFOs is a favorable prognostic indicator for surgical outcome.

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Section: Discussionsupporting

confidence: 83%

Resection of ictal high‐frequency oscillations leads to favorable surgical outcome in pediatric epilepsy

et al. 2012

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“…Since then, PDGF signaling has been widely implicated not only in brain tumors, but also in several other human malignances. Human glioma specimens and glioma cell lines frequently co-express PDGF ligands and receptors (Di Rocco et al, 1998;Goyal and Robinson 2008;Nister et al, 1988), and PDGFRa is amplified in some high-grade glioma cases (Shoshan et al, 1999), suggesting the existence of an autocrine loop comprised of PDGF and its receptors (Guha et al, 1995). Later, mouse models demonstrated that an autocrine loop is a crucial event in tumor development (Uhrbom et al, 2000) and verified that PDGF is causally related to the formation of gliomas (reviewed in (Calzolari and Malatesta 2010;Shih and Holland 2006)).…”

Section: Mouse Models Of Pdgf-driven Gliomasmentioning

confidence: 99%

Genetic modeling of gliomas in mice: New tools to tackle old problems

Hambardzumyan

Parada

Holland

et al. 2011

Glia

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The recently published comprehensive profiles of genomic alterations in glioma have led to a refinement in our understanding of the molecular events that underlie this cancer. Using state-of-the-art genomic tools, several laboratories have created and characterized accurate genetically engineered mouse models of glioma based on specific genetic alterations observed in human tumors. These in vivo brain tumor models faithfully recapitulate the histopathology, etiology, and biology of gliomas and provide an exceptional experimental system to discover novel therapeutic targets and test therapeutic agents. This review focuses on mouse models of glioma with a special emphasis on genetically engineered models developed around key genetic glioma signature mutations in the PDGFR, EGFR and NF1 genes and pathways. The resulting animal models have provided insight into many fundamental and mechanistic facets of tumor initiation, maintenance and resistance to therapeutic intervention and will continue to do so in the future.

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Surgery for extratemporal nonlesional epilepsy in children: a meta-analysis

et al. 2009

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This study confirms previous reports: Surgical outcomes for ETLE epilepsy are significantly worse than those for temporal lobe epilepsy. The reasons for this difference may include the diffuse nature of the pathology involved in ETLE, difficulty in localizing the seizure focus in young children, and involvement of "eloquent" nonresectable cortex in epileptogenesis. Because of the reporting variability among different epilepsy centers, more uniform protocols are necessary for fair evaluation and comparison of outcomes among the different centers.

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Expanding the role of surgery in intractable extratemporal pediatric epilepsy

Cited by 8 publications

References 27 publications

Resection of ictal high‐frequency oscillations leads to favorable surgical outcome in pediatric epilepsy

Resection of ictal high‐frequency oscillations leads to favorable surgical outcome in pediatric epilepsy

Genetic modeling of gliomas in mice: New tools to tackle old problems

Surgery for extratemporal nonlesional epilepsy in children: a meta-analysis

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