Analysis of Morbidity and Outcomes Associated With Use of Subdural Grids vs Stereoelectroencephalography in Patients With Intractable Epilepsy.
Nitin Tandon,Nitin Tandon,Brian A. Tong,Elliott R. Friedman,Jessica A. Johnson,Jessica A. Johnson,Gretchen Von Allmen,Melissa S. Thomas,Omotola A Hope,Giridhar P. Kalamangalam,Jeremy D. Slater,Stephen A. Thompson +11 more
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TLDR
This direct comparison of large matched cohorts undergoing SEEG and SDE implantation reveals distinctly better procedural morbidity favoring SEEG, with SEEG being more versatile and applicable to a range of scenarios, including nonlesional and bilateral cases, than SDE.Abstract:
Importance A major change has occurred in the evaluation of epilepsy with the availability of robotic stereoelectroencephalography (SEEG) for seizure localization. However, the comparative morbidity and outcomes of this minimally invasive procedure relative to traditional subdural electrode (SDE) implantation are unknown. Objective To perform a comparative analysis of the relative efficacy, procedural morbidity, and epilepsy outcomes consequent to SEEG and SDE in similar patient populations and performed by a single surgeon at 1 center. Design, Setting and Participants Overall, 239 patients with medically intractable epilepsy underwent 260 consecutive intracranial electroencephalographic procedures to localize their epilepsy. Procedures were performed from November 1, 2004, through June 30, 2017, and data were analyzed in June 2017 and August 2018. Interventions Implantation of SDE using standard techniques vs SEEG using a stereotactic robot, followed by resection or laser ablation of the seizure focus. Main Outcomes and Measures Length of surgical procedure, surgical complications, opiate use, and seizure outcomes using the Engel Epilepsy Surgery Outcome Scale. Results Of the 260 cases included in the study (54.6% female; mean [SD] age at evaluation, 30.3 [13.1] years), the SEEG (n = 121) and SDE (n = 139) groups were similar in age (mean [SD], 30.1 [12.2] vs 30.6 [13.8] years), sex (47.1% vs 43.9% male), numbers of failed anticonvulsants (mean [SD], 5.7 [2.5] vs 5.6 [2.5]), and duration of epilepsy (mean [SD], 16.4 [12.0] vs17.2 [12.1] years). A much greater proportion of SDE vs SEEG cases were lesional (99 [71.2%] vs 53 [43.8%];P Conclusions and Relevance This direct comparison of large matched cohorts undergoing SEEG and SDE implantation reveals distinctly better procedural morbidity favoring SEEG. These modalities intrinsically evaluate somewhat different populations, with SEEG being more versatile and applicable to a range of scenarios, including nonlesional and bilateral cases, than SDE. The significantly favorable adverse effect profile of SEEG should factor into decision making when patients with pharmacoresistant epilepsy are considered for intracranial evaluations.read more
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Spatiotemporal dynamics of orthographic and lexical processing in the ventral visual pathway.
Oscar Woolnough,Cristian Donos,Patrick S. Rollo,Kiefer J. Forseth,Yair Lakretz,Nathan E. Crone,Simon Fischer-Baum,Stanislas Dehaene,Stanislas Dehaene,Nitin Tandon,Nitin Tandon +10 more
TL;DR: It is found that mid-fusiform cortex is the first brain region sensitive to lexicality, preceding the traditional visual word form area, and points to its central role as the orthographic lexicon—the long-term memory representations of visual word forms.
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Language prediction mechanisms in human auditory cortex.
TL;DR: Intracranial recordings in 37 patients using depth probes implanted along the anteroposterior extent of the supratemporal plane are obtained, revealing two predictive mechanisms in early auditory cortex with distinct anatomical and functional characteristics.
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Stereoelectroencephalography Versus Subdural Strip Electrode Implantations: Feasibility, Complications, and Outcomes in 500 Intracranial Monitoring Cases for Drug-Resistant Epilepsy.
Holger Joswig,Jonathan C. Lau,Mahmoud Abdallat,Mahmoud Abdallat,Andrew G. Parrent,Keith W. MacDougall,Richard S. McLachlan,Jorge G. Burneo,David A. Steven +8 more
TL;DR: SeeG allows targeting deeply situated foci with a non-inferior safety profile to SSE and seizure outcome comparable to S SE, and this single-center study shows that this approach is effective in patients with drug-resistant epilepsy.
Journal ArticleDOI
Oblique trajectory angles in robotic stereo-electroencephalography.
TL;DR: The selective use of oblique trajectories during robotic implantation of sEEG electrodes to sample seizure networks was associated with excellent safety and efficacy, with no patient incidents, and the findings support the use of Oblique trajectory as an effective and safe means of investigating seizure networks.
Journal ArticleDOI
Comparative Effectiveness of Stereotactic Electroencephalography Versus Subdural Grids in Epilepsy Surgery.
Lara Jehi,Marcia Morita-Sherman,Thomas E. Love,Fabrice Bartolomei,William Bingaman,Kees P.J. Braun,Robyn M. Busch,John S. Duncan,Walter Hader,Guoming Luan,John D. Rolston,Stephan U. Schuele,Laura Tassi,Sumeet Vadera,Shehryar Sheikh,Imad Najm,Amir M. Arain,Justin Bingaman,Beate Diehl,Jane de Tisi,Matea Rados,Pieter van Eijsden,Sandra Wahby,Xiongfei Wang,Samuel Wiebe +24 more
TL;DR: In this article, the outcomes of subdural electrode (SDE) implantations versus stereotactic electroencephalography (SEEG), the two predominant methods of intracranial EEG (iEEG) performed in difficult-to-localize drug-resistant focal epilepsy, were compared.
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