The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform

Ahmad Mayeli - One of the best experts on this subject based on the ideXlab platform.

Jorge Gonzalezmartinez - One of the best experts on this subject based on the ideXlab platform.

  • the stereo Electroencephalography the epileptogenic zone
    Journal of Clinical Neurophysiology, 2016
    Co-Authors: Jorge Gonzalezmartinez
    Abstract:

    The stereo-Electroencephalography (SEEG) methodology and technique was developed almost 60 years ago in Europe and it has proven its efficacy and safety over the last 55 years. The main advantage of the SEEG method is the possibility to study the epileptogenic neuronal network in its dynamic and tri-dimensional aspect, with an optimal time and space correlation with the clinical semiology. In this manuscript, the technical and methodological aspects of the SEEG will be discussed focusing on the planning of SEEG implantations, technical nuances, conceptualization of the epileptogenic zone, and the different methods of SEEG-guided surgical resections and ablations.

  • correlating magnetoencephalography to stereo Electroencephalography in patients undergoing epilepsy surgery
    Brain, 2016
    Co-Authors: Hiroatsu Murakami, Zhong I Wang, Ahmad Marashly, Balu Krishnan, Richard A Prayson, Yosuke Kakisaka, John C Mosher, Juan Bulacio, Jorge Gonzalezmartinez
    Abstract:

    Magnetoencephalography and stereo-Electroencephalography are often necessary in the course of the non-invasive and invasive presurgical evaluation of challenging patients with medically intractable focal epilepsies. In this study, we aim to examine the significance of magnetoencephalography dipole clusters and their relationship to stereo-Electroencephalography findings, area of surgical resection, and seizure outcome. We also aim to define the positive and negative predictors based on magnetoencephalography dipole cluster characteristics pertaining to seizure-freedom. Included in this retrospective study were a consecutive series of 50 patients who underwent magnetoencephalography and stereo-Electroencephalography at the Cleveland Clinic Epilepsy Center. Interictal magnetoencephalography localization was performed using a single equivalent current dipole model. Magnetoencephalography dipole clusters were classified based on tightness and orientation criteria. Magnetoencephalography dipole clusters, stereo-Electroencephalography findings and area of resection were reconstructed and examined in the same space using the patient’s own magnetic resonance imaging scan. Seizure outcomes at 1 year post-operative were dichotomized into seizure-free or not seizure-free. We found that patients in whom the magnetoencephalography clusters were completely resected had a much higher chance of seizure-freedom compared to the partial and no resection groups ( P = 0.007). Furthermore, patients had a significantly higher chance of being seizure-free when stereo-Electroencephalography completely sampled the area identified by magnetoencephalography as compared to those with incomplete or no sampling of magnetoencephalography results ( P = 0.012). Partial concordance between magnetoencephalography and interictal or ictal stereo-Electroencephalography was associated with a much lower chance of seizure freedom as compared to the concordant group ( P = 0.0075). Patients with one single tight cluster on magnetoencephalography were more likely to become seizure-free compared to patients with a tight cluster plus scatter ( P = 0.0049) or patients with loose clusters ( P = 0.018). Patients whose magnetoencephalography clusters had a stable orientation perpendicular to the nearest major sulcus had a better chance of seizure-freedom as compared to other orientations ( P = 0.042). Our data demonstrate that stereo-Electroencephalography exploration and subsequent resection are more likely to succeed, when guided by positive magnetoencephalography findings. As a corollary, magnetoencephalography clusters should not be ignored when planning the stereo-Electroencephalography strategy. Magnetoencephalography tight cluster and stable orientation are positive predictors for a good seizure outcome after resective surgery, whereas the presence of scattered sources diminishes the probability of favourable outcomes. The concordance pattern between magnetoencephalography and stereo-Electroencephalography is a strong argument in favour of incorporating localization with non-invasive tools into the process of presurgical evaluation before actual placement of electrodes. * Abbreviations : SECD : single equivalent current dipole SEEG : stereo-Electroencephalography

  • the usefulness of intraoperative cerebral c arm ct angiogram for implantation of intracranial depth electrodes in stereotactic Electroencephalography procedure
    Stereotactic and Functional Neurosurgery, 2016
    Co-Authors: Javad M Mirzayan, Juan Bulacio, Martin Von Roden, Felix Von Podewils, Jorge Gonzalezmartinez
    Abstract:

    Background: Stereotactic Electroencephalography (SEEG) is an invasive diagnostic tool for localizing the epileptic zone in patients with medically refractory foca

Stefan Fischer - One of the best experts on this subject based on the ideXlab platform.

Obada Al Zoubi - One of the best experts on this subject based on the ideXlab platform.

Arnaby R Scholefield - One of the best experts on this subject based on the ideXlab platform.

  • implementation and early evaluation of a quantitative Electroencephalography program for seizure detection in the picu
    Pediatric Critical Care Medicine, 2020
    Co-Authors: Tracey Rowberry, Hari Krishna Kanthimathinatha, Fay George, Lesley Notghi, Raja Gupta, Pete Ill, Evangeline Wassme, Heathe P Dunca, Kevi Morris, Arnaby R Scholefield
    Abstract:

    OBJECTIVES To describe implementation and early evaluation of using quantitative Electroencephalography for electrographic seizure detection by PICU clinician staff. DESIGN Prospective observational study of electrographic seizure detection by PICU clinicians in patients monitored with quantitative Electroencephalography. Quantitative Electroencephalography program implementation included a continuous education and training package. Continuous quantitative Electroencephalography monitoring consisted of two-channel amplitude-integrated Electroencephalography, color density spectral array, and raw-Electroencephalography. SETTING PICU. PATIENTS Children less than 18 years old admitted to the PICU during the 14-month study period and deemed at risk of electrographic seizure. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Real time electrographic seizure detection by a PICU team was analyzed for diagnostic accuracy and promptness, against electrographic seizure identification by a trained neurophysiologist, retrospectively reading the same quantitative Electroencephalography and blinded to patient details. One-hundred one of 1,510 consecutive admissions (6.7%) during the study period underwent quantitative Electroencephalography monitoring. Status epilepticus (35%) and suspected hypoxic-ischemic injury (32%) were the most common indications for quantitative Electroencephalography. Electrographic seizure was diagnosed by the neurophysiologist in 12% (n = 12) of the cohort. PICU clinicians correctly diagnosed all 12 patients (100% sensitivity and negative predictive value). An additional eleven patients had a false-positive diagnosis of electrographic seizure (false-positive rate = 52% [31-73%]) leading to a specificity of 88% (79-94%). Median time to detect seizures was 25 minutes (5-218 min). Delayed recognition of electrographic seizure (> 1 hr from onset) occurred in five patients (5/12, 42%). CONCLUSIONS Early evaluation of quantitative Electroencephalography program to detect electrographic seizure by PICU clinicians suggested good sensitivity for electrographic seizure detection. However, the high false-positive rate is a challenge. Ongoing work is needed to reduce the false positive diagnoses and avoid electrographic seizure detection delays. A comprehensive training program and regular refresher updates for clinical staff are key components of the program.