排序方式： 共有6条查询结果，搜索用时 15 毫秒
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Gewalin Aungaroon Alonso Zea Vera Paul S. Horn Anna W. Byars Hansel M. Greiner Jeffrey R. Tenney Todd M. Arthur Nathan E. Crone Katherine D. Holland Francesco T. Mangano Ravindra Arya 《Clinical neurophysiology》2017,128(10):2078-2086
Objective
This study examined the incidence, thresholds, and determinants of electrical cortical stimulation (ECS)-induced after-discharges (ADs) and seizures.Methods
Electrocorticograph recordings were reviewed to determine incidence of ECS-induced ADs and seizures. Multivariable analyses for predictors of AD/seizure occurrence and their thresholds were performed.Results
In 122 patients, the incidence of ADs and seizures was 77% (94/122) and 35% (43/122) respectively. Males (odds ratio [OR] 2.92, 95% CI 1.21–7.38, p = 0.02) and MRI-negative patients (OR 3.69, 95% CI 1.24–13.7, p = 0.03) were found to have higher odds of ECS-induced ADs. A significant trend for decreasing AD thresholds with age was seen (regression co-efficient ?0.151, 95% CI ?0.267 to ?0.035, p = 0.011). ECS-induced seizures were more likely in patients with lateralized functional imaging (OR 6.62, 95% CI 1.36–55.56, p = 0.036, for positron emission tomography) and presence of ADs (OR 3.50, 95% CI 1.12–13.36, p = 0.043).Conclusions
ECS is associated with a high incidence of ADs and seizures. With age, current thresholds decrease and the probability for AD/seizure occurrence increases.Significance
ADs and seizures during ECS brain mapping are potentially hazardous and affect its functional validity. Thus, safer method(s) for brain mapping with improved neurophysiologic validity are desirable. 相似文献2.
Gewalin Aungaroon Andrew Trout Rupa Radhakrishnan Paul S. Horn Ravindra Arya Jeffrey R. Tenney Todd M. Arthur Katherine D. Holland Francesco T. Mangano James L. Leach Leonid Rozhkov Hansel M. Greiner 《Clinical neurophysiology》2018,129(9):1842-1848
Objective
We evaluated the impact of radiotracer injection latency and post-injection seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) test performance in identifying the epileptogenic zone (EZ) in children with drug-resistant epilepsy who had undergone a resective epilepsy surgery.Methods
SISCOM concordance with the EZ was retrospectively reviewed to evaluate its performance in 113 children. The impact of radiotracer injection latency and post-injection seizure duration was evaluated for their predictive value of SISCOM localization accuracy.Results
The overall sensitivity and specificity of SISCOM in identifying an EZ was 64.8% (95%CI?=?50.6–77.3) and 40.7% (95%CI?=?28.1–54.3). The positive likelihood ratio and diagnostic odd ratio was 1.09 (95%CI?=?0.80–1.48) and 1.26 (95%CI?=?0.59–2.71), respectively. Logistic regression showed that injection latency and post-injection seizure duration did not significantly predict the probability of true positive SISCOM (p-value?=?0.45 and 0.29, respectively).Conclusion
Radiotracer injection latency and post-injection seizure duration were not shown to have a statistical significant impact on SISCOM performance in identifying the EZ.Significance
This study demonstrates that further study of factors contributing to the performance of SISCOM in EZ identification in children is needed. 相似文献3.
Gewalin Aungaroon Katherine D. Holland Paul S. Horn Shannon M. Standridge Christina Mackell Imming 《The International journal of neuroscience》2017,127(10):849-853
Objective: To evaluate the outcome, including drug-resistant epilepsy (DRE) in children with newly diagnosed partial onset epilepsy treated with carbamazepine (CBZ). Methods: A retrospective medical records review and telephone questionnaire were undertaken on a total of 100 subjects. Results: Long-term follow-up was obtained on 79 children with a mean duration of 7.1 years from CBZ initiation. A total of 66 (83.5%) subjects achieved 2-year seizure remission, 48 (72.7%) subjects did so with CBZ monotherapy. Seven (10.6%) had seizure recurrence after 2-year seizure remission. DRE was diagnosed in seven (8.9%) subjects and five subjects had epilepsy surgery. The mean duration from seizure onset to epilepsy surgery was 5.3 (±2.1) years. Contributing factors for the prolonged duration from seizure onset to epilepsy surgery were identified including: relapsing–remitting course of seizure, family reluctance for epilepsy surgery and uncontrolled psychological problems. Conclusions: Over 80% of children with newly diagnosed partial onset epilepsy who were initially treated with CBZ achieved 2-year seizure remission, and more than 70% of this group did so with CBZ monotherapy. The majority of these patients maintained seizure remission overtime. However, 8.9% of this population met the criteria for DRE and most of them had epilepsy surgery. The duration from seizure onset to epilepsy surgery is an important potential area for improvement in DRE patient care. 相似文献
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Alonso Zea Vera Gewalin Aungaroon Paul S. Horn Anna W. Byars Hansel M. Greiner Jeffrey R. Tenney Todd M. Arthur Nathan E. Crone Katherine D. Holland Francesco T. Mangano Ravindra Arya 《Clinical neurophysiology》2017,128(10):2087-2093
Objective
To examine current thresholds and their determinants for language and motor mapping with extra-operative electrical cortical stimulation (ECS).Methods
ECS electrocorticograph recordings were reviewed to determine functional thresholds. Predictors of functional thresholds were found with multivariable analyses.Results
In 122 patients (age 11.9 ± 5.4 years), average minimum, frontal, and temporal language thresholds were 7.4 (± 3.0), 7.8 (± 3.0), and 7.4 (± 3.1) mA respectively. Average minimum, face, upper and lower extremity motor thresholds were 5.4 (± 2.8), 6.1 (± 2.8), 4.9 (± 2.3), and 5.3 (± 3.3) mA respectively.Functional and after-discharge (AD)/seizure thresholds were significantly related. Minimum, frontal, and temporal language thresholds were higher than AD thresholds at all ages. Minimum motor threshold was higher than minimum AD threshold up to 8.0 years of age, face motor threshold was higher than frontal AD threshold up to 11.8 years age, and lower subsequently. UE motor thresholds remained below frontal AD thresholds throughout the age range.Conclusions
Functional thresholds are frequently above AD thresholds in younger children.Significance
These findings raise concerns about safety and neurophysiologic validity of ECS mapping. Functional and AD/seizure thresholds relationships suggest individual differences in cortical excitability which cannot be explained by clinical variables. 相似文献5.
Gewalin Aungaroon Kishore Vedala Anna W. Byars Brian Ervin Leonid Rozhkov Paul S. Horn S. K. Z. Ihnen Katherine D. Holland Jeffrey R. Tenney Kelly Kremer Susan L. Fong Nan Lin Wei Liu Todd M. Arthur Hisako Fujiwara Jesse Skoch James L. Leach Francesco T. Mangano Hansel M. Greiner Ravindra Arya 《Epilepsia》2023,64(6):1527-1540
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Ravindra Arya Clayton Frink Christina Kargol Anna W. Byars David Huddleston Donna B. Diedenhofer Gewalin Aungaroon Brian Ervin Paul S. Horn S. K. Z. Ihnen Jeffrey R. Tenney Kelly Kremer Susan Fong Nan Lin Wei Liu Todd M. Arthur Jesse Skoch James L. Leach Francesco T. Mangano Tracy A. Glauser Hansel M. Greiner Katherine D. Holland 《European journal of neurology》2023,30(10):2986-2998
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