Intraoperative Coregistration of Magnetic Resonance Imaging, Positron Emission Tomography, and Electrocorticographic Data for Neocortical Lesional Epilepsies May Improve the Localization of the Epileptogenic Focus: A Pilot Study

Chandra, Sarat P; Bal, Chandrasekhar; Jain, Shreyans; Joshua, Shejoy P; Gaikwad, Shailesh; Garg, Ajay; Ansari, AbuZar; Nehra, Ashima; Sarkar, Chitra; Tripathi, Manjari

doi:10.1016/j.wneu.2013.02.057

Cited by 14 publications

(11 citation statements)

References 36 publications

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“…Senior author advocates use of ECoG and wherever possible and required intraoperative co-registration of MRI, positron emission tomography and ECoG for improving the localization of the epileptogenic focus . 25 ,[ 26 ]…”

Section: Discussionmentioning

confidence: 99%

Ganglioglioma: Single-institutional experience of 24 cases with review of literature

et al. 2016

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Background:Ganglioglioma is a common seizure associated tumor. The goal of this study was to observe the postoperative outcome in patients with gangliogliomas.Material and Methods:A total 24 patients with gangliogliomas who underwent surgery at our institute from 2008 to 2011 were included. There were 13 males (54%) in our study. A retrospective analysis for the demographic profile, surgery and outcome was performed using STATA software. Literature on this subject was also reviewed, MEDLINE and PUBMED databases were searched.Observations:Sixteen patients presented with signs and symptoms of raised intracranial pressure and 12 patients had seizure disorder. Average age at surgery was 20 years (range 7-50 years). Twelve each were located in the temporal lobe and extra-temporal location. Intra-operative electrocorticography (ECoG) alone in three and image guidance alone were used in two patients, respectively. Both ECoG and image guidance were used in one patient and none of them was used in 18 patients. Gross total resection was achieved in 17 patients. After a mean follow-up of 1.6 years (range 3 months to 2.5 years), out of 12 patients with preoperative seizures, 10 (83.3%) were seizure free (Engel class-I) and 2 (16.6%) belonged to Engel class-II. None of the factors, including age at surgery, seizure duration prior to surgery, type of seizures, use of intra-operative ECoG and image guidance, extent of tumor resection, and surgical strategy proved to have significant correlation with postoperative seizure outcome.Conclusions:Surgical treatment is effective and safe for patients with gangliogliomas. Neither intra-operative ECoG nor image guidance necessarily leads to better seizure control, although they are useful adjunct for achieving safe and complete tumor resection.

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Section: Discussionmentioning

confidence: 99%

Ganglioglioma: Single-institutional experience of 24 cases with review of literature

et al. 2016

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“…Despite its widespread usage, there are still controversies regarding its utility especially keeping in mind its short period of application. [ 27 28 29 30 ] It also should be kept in mind that any electrode used potentially records from millions of neurons, for example, a circular electrode of the EcoG grid sits over 10 6 neurons, each having about 10 4 connections. Thus, this is equivalent to hanging a microphone among a population of 1 million people, each talking to 10,000 persons!…”

Section: Tools To Study Epileptogenic Networkmentioning

confidence: 99%

Epileptogenic networks and drug-resistant epilepsy: Present and future perspectives of epilepsy research-Utility for the epileptologist and the epilepsy surgeon

Banerjee¹,

Chandra²,

Kurwale³

et al. 2014

Ann Indian Acad Neurol

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A multidisciplinary approach is required to understand the complex intricacies of drug-resistant epilepsy (DRE). A challenge that neurosurgeons across the world face is accurate localization of epileptogenic zone. A significant number of patients who have undergone resective brain surgery for epilepsy still continue to have seizures. The reason behind this therapy resistance still eludes us. Thus to develop a cure for the difficult to treat epilepsy, we need to comprehensively study epileptogenesis. Till date, most of the studies on DRE is focused on undermining the abnormal functioning of receptors involved in synaptic transmission and reduced levels of antiepileptic drugs around there targets. But recent advances in imaging and electrophysiological techniques have suggested the role epileptogenic networks in the process of epileptogenesis. According to this hypothesis, the local neurons recruit distant neurons through complex oscillatory circuits, which further recruit more distant neurons, thereby generating a hypersynchronus neuronal activity. The epileptogenic networks may be confined to the lesion or could propagate to distant focus. The success of surgery depends on the precision by which the epileptogenic network is determined while planning a surgical intervention. Here, we summarize various modalities of electrophysiological and imaging techniques to determine the functionally active epileptogenic networks. We also review evidence pertaining to the proposed role of epileptogenic network in abnormal synaptic transmission which is one of the major causes of epileptiform activity. Elucidation of current concepts in regulation of synaptic transmission by networks will help develop therapies for epilepsy cases that cannot be managed pharmacologically.

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“…Studies have shown that coregistration of multimodal techniques improves the detection of epileptogenic abnormalities and ultimately the surgical outcomes in patients with epilepsy [39][40][41]. To our knowledge, no studies have examined the feasibility of superimposing functional 3D Fig.…”

Section: Future Directions: Combining Structural and Functional Methodsmentioning

confidence: 99%

Magnetoencephalography and New Imaging Modalities in Epilepsy

et al. 2017

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The success of epilepsy surgery is highly dependent on correctly identifying the entire epileptogenic region. Current state-of-the-art for localizing the extent of surgically amenable areas involves combining high resolution three-dimensional magnetic resonance imaging (MRI) with electroencephalography (EEG) and magnetoencephalography (MEG) source modeling of interictal epileptiform activity. Coupling these techniques with newer quantitative structural MRI techniques, such as cortical thickness measurements, however, may improve the extent to which the abnormal epileptogenic region can be visualized. In this review we assess the utility of EEG, MEG and quantitative structural MRI methods for the evaluation of patients with epilepsy and introduce a novel method for the co-localization of a structural MRI measurement to MEG and EEG source modeling. When combined, these techniques may better identify the extent of abnormal structural and functional areas in patients with medically intractable epilepsy.

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Intraoperative Coregistration of Magnetic Resonance Imaging, Positron Emission Tomography, and Electrocorticographic Data for Neocortical Lesional Epilepsies May Improve the Localization of the Epileptogenic Focus: A Pilot Study

Cited by 14 publications

References 36 publications

Ganglioglioma: Single-institutional experience of 24 cases with review of literature

Ganglioglioma: Single-institutional experience of 24 cases with review of literature

Epileptogenic networks and drug-resistant epilepsy: Present and future perspectives of epilepsy research-Utility for the epileptologist and the epilepsy surgeon

Magnetoencephalography and New Imaging Modalities in Epilepsy

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