The Experts below are selected from a list of 132 Experts worldwide ranked by ideXlab platform
Fernández Fernández Santiago - One of the best experts on this subject based on the ideXlab platform.
-
Utilidad de la neuroimagen funcional multimodal en el estudio de la epilepsia focal fármacorresistente
'Edicions de la Universitat de Barcelona', 2017Co-Authors: Fernández Fernández SantiagoAbstract:[spa] Antecedentes: Para que la cirugía de epilepsia (tratamiento aceptado en la epilepsia farmacorresistente) tenga éxito es fundamental determinar con exactitud al área cerebral que genera las crisis, conocida como zona epileptogénica (ZE). Con el objeto de mejorar la precisión en la localización y definición de la extensión de la ZE, se han ido desarrollando pruebas de neuroimagen funcional multimodal que utilizan corregistros entre diversas técnicas. Esta aproximación multimodal también se está utilizando para identificar estructuras y redes funcionales involucradas en la generación de crisis. Un ejemplo es la epilepsia por sobresalto, que suele ser farmacorresistente y altamente invalidante para el paciente. Aunque estudios previos sugieren la participación del área motora suplementaria y otras estructuras cerebrales en la generación de estas crisis, no está del todo clara la red involucrada. Hipótesis y objetivos: la neuroimagen funcional multimodal constituye una herramienta útil para el estudio de la epilepsia focal farmacorresistente, tanto para la localización de la ZE como para el estudio de las redes neuronales implicadas en la generación de crisis. Es útil también para estudiar un tipo concreto de epilepsia refractaria, la epilepsia por sobresalto. Metodología: Se ha incluido una serie de pacientes evaluados para una eventual cirugía de epilepsia, a los que se realizó una evaluación prequirúrgica completa, así como pruebas de neuroimagen funcional multimodal mediante corregistros entre diversas técnicas, especialmente PET/RM y PET/RM/SISCOM. Se ha incluído también una serie más pequeña de pacientes con epilepsia poe sobresalto estudiados también con neuroimagen funcional multimodal. Resultados y conclusiones: La neuroimagen funcional multimodal es una aproximación muy valiosa en la evaluación prequirúrgica de la epilepsia focal refractaria. El corregistro PET/RM permite identificar en algunos casos posibles lesiones epileptogénicas que ambas técnicas por separado no muestran. El corregistro PET/RM muestra la zona hipometabólica con mayor precisión y definición anatómica que el PET aislado. El corregistro PET/RM/SISCOM permite mejorar la hipótesis sobre la localización de la ZE, ayuda como guía para la colocación de electrodos invasivos y permite que algunos pacientes puedan beneficiarse del tratamiento quirúrgico. El corregistro PET/RM/SISCOM permite estudiar las relaciones espaciales de ambas técnicas en una sola imagen. La hiperperfusión mostrada por el SISCOM suele estar contenida en el hipometabolismo mostrado por el PET. Este hecho se correlaciona con una mayor probabilidad de quedar libre de crisis tras la cirugía. La concordancia entre los hallazgos del corregistro PET/RM/SISCOM y el inicio de la zona ictal mostrada por la monitorización invasiva es elevada. Las técnicas de neuroimagen funcional multimodal permiten profundizar en el conocimiento de las estructuras neuronales que intervienen en la epilepsia por sobresalto, en las que se que incluye el córtex frontal motor y promotor, el córtex sensitivo primario y el área motora suplementaria, conformando una red fronto-parietal mesial implicada en la generación y mantenimiento de las crisis, con posibles variaciones individuales dependiendo del paciente.[eng] Background: In order to obtain success in Epilepsy surgery is essential to determine accurately the brain area which generates seizures, which is called the epileptogenic zone (EZ). To improve accuracy in localizing the extent of the EZ, it has been developed multimodal functional neuroimaging techniques. This multimodal approach is also used to identify functional networks in the brain and structures involved in the generation of seizures. Hypothesis and objectives: A multimodal functional imaging approach is a useful tool to study drug-resistant focal Epilepsy, both to localize the ZE as for the study of neural networks involved in the generation of seizures. It is also useful to study a particular type of refractory Epilepsy, Startle Epilepsy. Methodology: We have included a number of patients evaluated for Epilepsy surgery. A complete presurgical evaluation was conducted, and we performed multimodal neuroimaging techniques: PET/RM and PET/RM/SISCOM co-registers. It has also included a small series of patients with Startle Epilepsy whose also been studied with this functional multimodal neuroimaging approach. Results and conclusions: The multimodal functional neuroimaging is a very valuable approach in presurgical evaluation of refractory focal Epilepsy. PET / MRI co-registration in some cases identifies epileptogenic lesions that both techniques separately do not show. PET / MRI co-registration shows the hypometabolic area more accurately and with better anatomical definition than PET. PET / RM / SISCOM co-registration improves the hypothesis about the EZ location, helps to guide the placement of invasive electrodes and allows some patients may benefit from surgical treatment. PET / RM / SISCOM co-registration allows studying the spatial relationships of both techniques in a single image. Hyperperfusion showed by SISCOM usually is contained in the hypometabolism showed by PET. This correlates with a higher probability of being free of seizures after surgery. The agreement between the findings of PET / MR / SISCOM co-registration and the onset of the ictal area shown by invasive monitoring is high. The multimodal functional neuroimaging approach allows understanding better the neural structures involved in Startle Epilepsy: the frontal cortex motor, the primary sensory cortex and supplementary motor area, forming a mesial fronto-parietal network involved in the generation and maintenance seizures
-
Utilidad de la neuroimagen funcional multimodal en el estudio de la epilepsia focal fármacorresistente
'Edicions de la Universitat de Barcelona', 2016Co-Authors: Fernández Fernández SantiagoAbstract:Antecedentes: Para que la cirugía de epilepsia (tratamiento aceptado en la epilepsia farmacorresistente) tenga éxito es fundamental determinar con exactitud al área cerebral que genera las crisis, conocida como zona epileptogénica (ZE). Con el objeto de mejorar la precisión en la localización y definición de la extensión de la ZE, se han ido desarrollando pruebas de neuroimagen funcional multimodal que utilizan corregistros entre diversas técnicas. Esta aproximación multimodal también se está utilizando para identificar estructuras y redes funcionales involucradas en la generación de crisis. Un ejemplo es la epilepsia por sobresalto, que suele ser farmacorresistente y altamente invalidante para el paciente. Aunque estudios previos sugieren la participación del área motora suplementaria y otras estructuras cerebrales en la generación de estas crisis, no está del todo clara la red involucrada. Hipótesis y objetivos: la neuroimagen funcional multimodal constituye una herramienta útil para el estudio de la epilepsia focal farmacorresistente, tanto para la localización de la ZE como para el estudio de las redes neuronales implicadas en la generación de crisis. Es útil también para estudiar un tipo concreto de epilepsia refractaria, la epilepsia por sobresalto. Metodología: Se ha incluido una serie de pacientes evaluados para una eventual cirugía de epilepsia, a los que se realizó una evaluación prequirúrgica completa, así como pruebas de neuroimagen funcional multimodal mediante corregistros entre diversas técnicas, especialmente PET/RM y PET/RM/SISCOM. Se ha incluído también una serie más pequeña de pacientes con epilepsia poe sobresalto estudiados también con neuroimagen funcional multimodal. Resultados y conclusiones: La neuroimagen funcional multimodal es una aproximación muy valiosa en la evaluación prequirúrgica de la epilepsia focal refractaria. El corregistro PET/RM permite identificar en algunos casos posibles lesiones epileptogénicas que ambas técnicas por separado no muestran. El corregistro PET/RM muestra la zona hipometabólica con mayor precisión y definición anatómica que el PET aislado. El corregistro PET/RM/SISCOM permite mejorar la hipótesis sobre la localización de la ZE, ayuda como guía para la colocación de electrodos invasivos y permite que algunos pacientes puedan beneficiarse del tratamiento quirúrgico. El corregistro PET/RM/SISCOM permite estudiar las relaciones espaciales de ambas técnicas en una sola imagen. La hiperperfusión mostrada por el SISCOM suele estar contenida en el hipometabolismo mostrado por el PET. Este hecho se correlaciona con una mayor probabilidad de quedar libre de crisis tras la cirugía. La concordancia entre los hallazgos del corregistro PET/RM/SISCOM y el inicio de la zona ictal mostrada por la monitorización invasiva es elevada. Las técnicas de neuroimagen funcional multimodal permiten profundizar en el conocimiento de las estructuras neuronales que intervienen en la epilepsia por sobresalto, en las que se que incluye el córtex frontal motor y promotor, el córtex sensitivo primario y el área motora suplementaria, conformando una red fronto-parietal mesial implicada en la generación y mantenimiento de las crisis, con posibles variaciones individuales dependiendo del pacienteBackground: In order to obtain success in Epilepsy surgery is essential to determine accurately the brain area which generates seizures, which is called the epileptogenic zone (EZ). To improve accuracy in localizing the extent of the EZ, it has been developed multimodal functional neuroimaging techniques. This multimodal approach is also used to identify functional networks in the brain and structures involved in the generation of seizures. Hypothesis and objectives: A multimodal functional imaging approach is a useful tool to study drug-resistant focal Epilepsy, both to localize the ZE as for the study of neural networks involved in the generation of seizures. It is also useful to study a particular type of refractory Epilepsy, Startle Epilepsy. Methodology: We have included a number of patients evaluated for Epilepsy surgery. A complete presurgical evaluation was conducted, and we performed multimodal neuroimaging techniques: PET/RM and PET/RM/SISCOM co-registers. It has also included a small series of patients with Startle Epilepsy whose also been studied with this functional multimodal neuroimaging approach. Results and conclusions: The multimodal functional neuroimaging is a very valuable approach in presurgical evaluation of refractory focal Epilepsy. PET / MRI co-registration in some cases identifies epileptogenic lesions that both techniques separately do not show. PET / MRI co-registration shows the hypometabolic area more accurately and with better anatomical definition than PET. PET / RM / SISCOM co-registration improves the hypothesis about the EZ location, helps to guide the placement of invasive electrodes and allows some patients may benefit from surgical treatment. PET / RM / SISCOM co-registration allows studying the spatial relationships of both techniques in a single image. Hyperperfusion showed by SISCOM usually is contained in the hypometabolism showed by PET. This correlates with a higher probability of being free of seizures after surgery. The agreement between the findings of PET / MR / SISCOM co-registration and the onset of the ictal area shown by invasive monitoring is high. The multimodal functional neuroimaging approach allows understanding better the neural structures involved in Startle Epilepsy: the frontal cortex motor, the primary sensory cortex and supplementary motor area, forming a mesial fronto-parietal network involved in the generation and maintenance seizures
Hiroyuki Shimizu - One of the best experts on this subject based on the ideXlab platform.
-
Startle Epilepsy with Infantile Hemiplegia: Report of Two Cases Improved by Surgery
Epilepsia, 1998Co-Authors: Hirokazu Oguni, Kitami Hayashi, Norihisa Usui, Makiko Osawa, Hiroyuki ShimizuAbstract:Summary: Purpose: To study the effectiveness of surgical therapy on 2 patients with Startle Epilepsy with infantile brain damage (SEIBD), a rare but distinctive epileptic syndrome characterized by motor seizures resistant to antiepileptic drugs (AEDs). Methods: The patients with SEIBD both had hemiplegia, due to gross contralateral hemispheric lesions, and suffered from tonic postural seizures, frequently provoked by sudden unexpected somatosensory stimuli on the paretic side of the body. These attacks occasionally caused the patients to drop to the floor, and mild-to-moderate injuries had been sustained; they were resistant to all currently available AEDs. Consequently, these daily drop attacks severely restricted the patients' social lives and school participation. Both patients underwent corpus callosotomy and resection of epileptogenic premotor and supplementary motor lesions. One patient also underwent additional multiple subpial transections of the primary sensorimotor area. Results: Seizures, as well as quality of life, improved dramatically in both patients after surgery. Conclusions: Startle Epilepsy with infantile hemiplegia is distinct epileptic syndrome characterized by structural brain damage restricted primarily to one hemisphere, large ipsilateral epileptogenic lesions involving the perisensorimotor area, refractory Startle-provoked drop attacks, and a good response to Epilepsy surgery.
Hirokazu Oguni - One of the best experts on this subject based on the ideXlab platform.
-
Startle Epilepsy with Infantile Hemiplegia: Report of Two Cases Improved by Surgery
Epilepsia, 1998Co-Authors: Hirokazu Oguni, Kitami Hayashi, Norihisa Usui, Makiko Osawa, Hiroyuki ShimizuAbstract:Summary: Purpose: To study the effectiveness of surgical therapy on 2 patients with Startle Epilepsy with infantile brain damage (SEIBD), a rare but distinctive epileptic syndrome characterized by motor seizures resistant to antiepileptic drugs (AEDs). Methods: The patients with SEIBD both had hemiplegia, due to gross contralateral hemispheric lesions, and suffered from tonic postural seizures, frequently provoked by sudden unexpected somatosensory stimuli on the paretic side of the body. These attacks occasionally caused the patients to drop to the floor, and mild-to-moderate injuries had been sustained; they were resistant to all currently available AEDs. Consequently, these daily drop attacks severely restricted the patients' social lives and school participation. Both patients underwent corpus callosotomy and resection of epileptogenic premotor and supplementary motor lesions. One patient also underwent additional multiple subpial transections of the primary sensorimotor area. Results: Seizures, as well as quality of life, improved dramatically in both patients after surgery. Conclusions: Startle Epilepsy with infantile hemiplegia is distinct epileptic syndrome characterized by structural brain damage restricted primarily to one hemisphere, large ipsilateral epileptogenic lesions involving the perisensorimotor area, refractory Startle-provoked drop attacks, and a good response to Epilepsy surgery.
Mar Carreño - One of the best experts on this subject based on the ideXlab platform.
-
Functional neuroimaging in Startle Epilepsy: involvement of a mesial frontoparietal network.
Epilepsia, 2011Co-Authors: Santiago Fernández, Antonio Donaire, Iratxe Maestro, Eulalia Seres, Xavier Setoain, Núria Bargalló, Jordi Rumià, Teresa Boget, Carles Falcon, Mar CarreñoAbstract:Summary Purpose: Startle Epilepsy is a rare form of Epilepsy with seizures triggered by unexpected stimuli. Previous studies have suggested the participation of several brain regions, such as the supplementary motor area (SMA) or the mesial aspect of the frontal and parietal lobes in the generation of Startle Epilepsy. However, how these brain regions interact with each other during seizures remains largely unknown. The aim of this study was to get insight into brain structures involved in Startle-induced seizures using an approach with functional neuroimaging. Methods: Four patients with Startle Epilepsy secondary to unexpected sounds were studied. All of them underwent a presurgical evaluation including ictal–single-emission computed tomography/subtraction ictal SPECT coregistered to MRI (magnetic resonance imaging) (SPECT/SISCOM). We searched for areas with ictal changes of perfusion higher than two standard deviations (2 SD) above the reference. In one patient, a fluorodeoxyglucose–positron emission tomography (FDG-PET) and an ictal electroencephalography–functional MRI (EEG-fMRI) were also performed. In this patient, the results of FDG-PET and sequential analysis of EEG-fMRI were compared to SISCOM. Key Findings: All the patients had their typical Startle-induced seizures, consistent with bilateral asymmetric tonic seizures. Ictal-EEG pattern was located over the mesial centroparietal region in all of them. In three of four patients, a significant hyperperfusion over the mesial frontocentral region was seen, involving the SMA, the perirolandic region, and the precuneus. In one patient, who had a congenital bilateral perisylvian polymicrogyria, it was located over the lateral perirolandic region. 18F-FDG-PET results in the patient in whom it was done, were concordant with SISCOM findings. Ictal EEG-fMRI showed an initial activation located over the precuneus, SMA, cingulate gyrus, and the precentral/perirolandic area. Significance: By using a functional neuroimaging approach we have found that Startle-induced seizures could be generated by the interaction of a frontoparietal network located over the mesial surface of the brain.
Makiko Osawa - One of the best experts on this subject based on the ideXlab platform.
-
Startle Epilepsy with Infantile Hemiplegia: Report of Two Cases Improved by Surgery
Epilepsia, 1998Co-Authors: Hirokazu Oguni, Kitami Hayashi, Norihisa Usui, Makiko Osawa, Hiroyuki ShimizuAbstract:Summary: Purpose: To study the effectiveness of surgical therapy on 2 patients with Startle Epilepsy with infantile brain damage (SEIBD), a rare but distinctive epileptic syndrome characterized by motor seizures resistant to antiepileptic drugs (AEDs). Methods: The patients with SEIBD both had hemiplegia, due to gross contralateral hemispheric lesions, and suffered from tonic postural seizures, frequently provoked by sudden unexpected somatosensory stimuli on the paretic side of the body. These attacks occasionally caused the patients to drop to the floor, and mild-to-moderate injuries had been sustained; they were resistant to all currently available AEDs. Consequently, these daily drop attacks severely restricted the patients' social lives and school participation. Both patients underwent corpus callosotomy and resection of epileptogenic premotor and supplementary motor lesions. One patient also underwent additional multiple subpial transections of the primary sensorimotor area. Results: Seizures, as well as quality of life, improved dramatically in both patients after surgery. Conclusions: Startle Epilepsy with infantile hemiplegia is distinct epileptic syndrome characterized by structural brain damage restricted primarily to one hemisphere, large ipsilateral epileptogenic lesions involving the perisensorimotor area, refractory Startle-provoked drop attacks, and a good response to Epilepsy surgery.