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The Value of Stereo-electroencephalography in Temporal Lobe Epilepsy
Temporal lobe epilepsy (TLE) is one of the most common drug-refractory epilepsies. However, the diagnosis and treatment of TLE may be improved by better understanding its complex network. In this article, the authors summarize their experience with TLE and discuss their process for using stereo-electroencephalography (SEEG) as part of presurgical evaluation in the past 10  years. The authors demonstrate the value of SEEG in different types of TLE and discuss how their findings have impacted treatment options. Ultimately, the authors’ experience will help other centers in addressing TLE cases. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 23, 2023 Category: Neurosurgery Authors: Shize Jiang, Yanming Zhu, Jie Hu Source Type: research

Epilepsy Surgery: Paradigm Shifts
NEUROSURGERY CLINICS OF NORTH AMERICA (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 23, 2023 Category: Neurosurgery Authors: R. Mark Richardson, Jimmy C. Yang Source Type: research

Copyright
ELSEVIER (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 23, 2023 Category: Neurosurgery Source Type: research

Contributors
RUSSELL R. LONSER, MD (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 23, 2023 Category: Neurosurgery Source Type: research

Contents
R. Mark Richardson and Jimmy C. Yang (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 23, 2023 Category: Neurosurgery Source Type: research

Forthcoming Issues
New Technologies in Spine Surgery (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - November 23, 2023 Category: Neurosurgery Source Type: research

Spinal Cord Injury
The mainstay of treatment for spinal cord injury includes decompressive laminectomy and elevation of mean arterial pressure. However, outcomes often remain poor. Extensive research and ongoing clinical trials seek to design new treatment options for spinal cord injury, including stem cell therapy, scaffolds, brain –spine interfaces, exoskeletons, epidural electrical stimulation, ultrasound, and cerebrospinal fluid drainage. Some of these treatments are targeted at the initial acute window of injury, during which secondary damage occurs; others are designed to help patients living with chronic injuries. (Source: Neurosurg...
Source: Neurosurgery Clinics of North America - November 9, 2023 Category: Neurosurgery Authors: Andrew M. Hersh, Carly Weber-Levine, Kelly Jiang, Nicholas Theodore Source Type: research

Evolution in Epilepsy Surgery and the Need to Address a Public Health Crisis of Underutilization
In patients with drug-resistant epilepsy, surgery is an effective option that can lead to seizure freedom in a majority of children and adults.1 However, despite publication of a practice parameter in 2003 that recommended referral of patients with drug-resistant epilepsy to a surgical epilepsy center,2 subsequent studies showed that the needle did not move, with the average time to surgical referral hovering around 18 years.3,4 The International League Against Epilepsy continues to support surgical referral of patients with drug-resistant epilepsy, recently publishing consensus recommendations that a surgical evaluation s...
Source: Neurosurgery Clinics of North America - October 12, 2023 Category: Neurosurgery Authors: R. Mark Richardson, Jimmy C. Yang Tags: Preface Source Type: research

Utility of Chronic Intracranial Electroencephalography in Responsive Neurostimulation Therapy
Responsive neurostimulation (RNS) therapy is an effective treatment for reducing seizures in some patients with focal epilepsy. Utilizing a chronically implanted device, RNS involves monitoring brain activity signals for user-defined patterns of seizure activity and delivering electrical stimulation in response. Devices store chronic data including counts of detected activity patterns and brief recordings of intracranial electroencephalography signals. Data platforms for reviewing stored chronic data retrospectively may be used to evaluate therapy performance and to fine-tune detection and stimulation settings. New frontie...
Source: Neurosurgery Clinics of North America - October 6, 2023 Category: Neurosurgery Authors: Ankit N. Khambhati Source Type: research

Epilepsy Surgery for Cognitive Improvement in Epileptic Encephalopathy
We describe an example patient with epileptic encephalopathy without drug refractory seizures, who underwent successful diagnostic and therapeutic surgeries. In patients with epileptic encephalopathy, cognitive improvement alone is a sufficient indication to recommend surgical intervention in experienced centers. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - October 3, 2023 Category: Neurosurgery Authors: John R. McLaren, Kristopher T. Kahle, Robert Mark Richardson, Catherine J. Chu Source Type: research

Deep Brain Stimulation for Children with Generalized Epilepsy
Intracranial neuromodulation is an evolving therapy for patients with drug-resistant epilepsy (DRE). Deep brain stimulation (DBS) is now available as a therapy for patients with DRE and focal-onset seizures in select health care systems; however, there remains a substantial need of efficacy data before DBS can be more widely adopted into routine clinical practice. This review and commentary focuses on a particular shifting paradigm:  DBS as a therapy for children with generalized-onset seizures. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - September 27, 2023 Category: Neurosurgery Authors: Rory J. Piper, George M. Ibrahim, Martin M. Tisdall Source Type: research

Imaging and Stereotactic Electroencephalography Functional Networks to Guide Epilepsy Surgery
Epilepsy surgery is a potentially curative treatment of drug-resistant epilepsy that has remained underutilized both due to inadequate referrals and incomplete localization hypotheses. The complexity of patients evaluated for epilepsy surgery has increased, thus new approaches are necessary to treat these patients. The paradigm of epilepsy surgery has evolved to match this challenge, now considering the entire seizure network with the goal of disrupting it through resection, ablation, neuromodulation, or a combination. The network paradigm has the potential to aid in identification of the seizure network as well as treatme...
Source: Neurosurgery Clinics of North America - September 23, 2023 Category: Neurosurgery Authors: Derek J. Doss, Graham W. Johnson, Dario J. Englot Source Type: research

Neurostimulation for Generalized Epilepsy
Current applications of neurostimulation for generalized epilepsy use a one-target-fits-all approach that is agnostic to the specific epilepsy syndrome and seizure type being treated. The authors describe similarities and differences between the 2 “archetypes” of generalized epilepsy—Lennox-Gastaut syndrome and Idiopathic Generalized Epilepsy—and review recent neuroimaging evidence for syndrome-specific brain networks underlying seizures. Implications for stimulation targeting and programming are discussed using 5 clinical questions: What epilepsy syndrome does the patient have? What brain networks are involved? Wh...
Source: Neurosurgery Clinics of North America - September 22, 2023 Category: Neurosurgery Authors: Aaron E.L. Warren, Steven Tobochnik, Melissa M.J. Chua, Hargunbir Singh, Michaela A. Stamm, John D. Rolston Source Type: research

Interneuron Transplantation for Drug-Resistant Epilepsy
This article (1) reviews some of the preclinical evidence supporting interneuron transplantation as an epilepsy therapy, (2) describes a first-in-human study of interneuron transplantation for epilepsy, and (3) considers knowledge gaps that stand before the effective clinical application of this novel treatment. (Source: Neurosurgery Clinics of North America)
Source: Neurosurgery Clinics of North America - September 22, 2023 Category: Neurosurgery Authors: Derek G. Southwell Source Type: research

Sensing-Enabled Deep Brain Stimulation in Epilepsy
Deep brain stimulation has demonstrated efficacy in reducing seizure frequency in patients with drug-resistant epilepsy who may otherwise not be candidates for other surgical procedures. Recently, a clinical device that can monitor neural activity in the form of local field potentials around the deep brain stimulator lead implant site has been introduced. While this technology has been clinically adopted in other disorders treated with deep brain stimulation, such as Parkinson ’s disease, its application in epilepsy remains unclear. Previous research using investigational devices has suggested that specific frequency ban...
Source: Neurosurgery Clinics of North America - September 21, 2023 Category: Neurosurgery Authors: Jimmy C. Yang, Andrew I. Yang, Robert E. Gross Source Type: research