Chronic stereotactic implantation of depth electrodes for psychomotor epilepsy

Rand, Robert W.; Crandall, Paul H.; Walter, Richard D.

doi:10.1007/bf01402136

Cited by 21 publications

(9 citation statements)

References 4 publications

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“…Briefly, patients received bilateral arrays of chronically implanted electrodes in medial temporal lobe sites (hippocampal formation and amygdala) and, occasionally, selected suprasylvian sites, utilizing stereotaxic placement techniques (Talairach et al, 1958;Rand et al, 1964). Surface records were derived from orthopedic nails implanted bilaterally in the outer table of the calvarium at sites designated by the International placement system.…”

Section: Patient Selection Implantation and Monitoringmentioning

confidence: 99%

“…Previous studies (Lieb et al, 1976(Lieb et al, , 1980u, 1981aEngel et'al., 1981) give detailed information concerning the criteria used for selecting patients for stereotaxic implantation of depth electrodes, the procedures used for ensuring subject protection and informed patient consent, the techniques used for hardwired and telemetry monitoring of surface/deep activity, and the methods for capturing spontaneous seizures on videotape. Briefly, patients received bilateral arrays of chronically implanted electrodes in medial temporal lobe sites (hippocampal formation and amygdala) and, occasionally, selected suprasylvian sites, utilizing stereotaxic placement techniques (Talairach et al, 1958;Rand et al, 1964). Surface records were derived from orthopedic nails implanted bilaterally in the outer table of the calvarium at sites designated by the International placement system.…”

Section: Patient Selection Implantation and Monitoringmentioning

confidence: 99%

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Changes in Intelligence Following Temporal Lobectomy: Relationship to EEG Activity, Seizure Relief, and Pathology

Lieb¹,

Rausch²,

Engel³

et al. 1982

Epilepsia

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Pre- and posttemporal lobectomy measures of intelligence and memory in 36 patients with medically refractory complex partial seizures were compared with (1) various aspects of presurgical ictal and interictal EEG activity derived from surface and deep electrodes, (2) postlobectomy seizure relief, and (3) pathological findings in the resected lobe. With respect to interictal EEG data, bilaterally synchronous surface spikes (accompanied or unaccompanied by simultaneous deep spikes) and sharp waves were significantly correlated with lower prelobectomy intelligence scores and a drop in these scores following lobectomy. With respect to ictal EEG data, bilaterally synchronous and multifocal onsets were significantly correlated with a postlobectomy drop in intelligence scores. Patients with poor postlobectomy seizure relief tended to have lower presurgical intelligence scores and a drop in intelligence scores following lobectomy. The patients most likely to show a postlobectomy drop in intelligence were those demonstrating some combination of poor seizure relief, an absence of pathology in the resected specimen, or EEG signs indicative of poor seizure relief. Postlobectomy changes in intellectual status are therefore not necessarily exclusively attributable to the amount of postlobectomy seizure relief experienced by these patients, but might be due to a combination of factors.

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Section: Patient Selection Implantation and Monitoringmentioning

confidence: 99%

Section: Patient Selection Implantation and Monitoringmentioning

confidence: 99%

Changes in Intelligence Following Temporal Lobectomy: Relationship to EEG Activity, Seizure Relief, and Pathology

Lieb¹,

Rausch²,

Engel³

et al. 1982

Epilepsia

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show abstract

“…Several previous studies (Crandall et al, 1963(Crandall et al, , 1971Walter, 1973;Babb et al, 1974;Lieb et al, 1976Lieb et al, , 1978Lieb et al, , 1981bEngel et al, 1981) have given detailed information concerning the criteria used for selecting patients for stereotaxic placement of depth electrodes, the procedures used for ensuring subject protection and informed patient consent, techniques for biotelemetric 24-h monitoring of electrode sites, methods for identifying suspected electrographic seizure episodes, methods for videotaping spontaneous seizures, and criteria used for determining whether or not patients were likely to benefit from surgical treatment. Of relevance to the present study is that for each patient, depth electrodes were stereotaxically placed (Talairach et al, 1958;Rand et al, 1964) bilaterally in the amygdala and in anterior, mid, and posterior sites of the pes hippocampi and hippocampal gyrus. It was thus possible to assess hyperexcitability along the anteroposterior axis of the hippocampal formation, and following temporal lobectomy, the anteroposterior distribution of cell densities could be related quantitatively to the preoperative "zones" of spontaneous hyperexcitability.…”

Section: Patient Selection and Monitoringmentioning

confidence: 99%

Distribution of Pyramidal Cell Density and Hyperexcitability in the Epileptic Human Hippocampal Formation

et al. 1984

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Pyramidal cell densities in various regions of the anterior and posterior hippocampal formation were measured from en bloc temporal lobe resections and compared with presurgical stereoelectroencephalography (SEEG) data derived from depth electrodes in 12 patients with temporal lobe epilepsy. These data were compared with cell densities observed in four nonepileptic control patients. Patients who consistently exhibited anterior focal changes in the SEEG accompanying onset of ictus had cell densities that were selectively reduced in the anterior hippocampal formation but normal with respect to controls in the posterior hippocampal formation. Patients who exhibited more regional changes in the SEEG at onset of ictus had reduced cell densities in both the anterior and posterior hippocampal formation. Patients who exhibited focal spike activity in the anterior hippocampal formation as their predominant interictal SEEG pattern also had selectively reduced cell densities in the anterior hippocampal formation, while patients with widespread spiking throughout the hippocampal formation had reduced cell densities both anteriorly and posteriorly. These data support the concept that epileptogenesis occurs in or near those areas of epileptic hippocampus that are most damaged. Hippocampal sclerosis must be viewed as related to adjacent hyperexcitable or epileptogenic neurons and not solely as a passive result of repeated anoxia or ischemia.

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“…They received chronic bilateral implantation of depth electrodes in anterior, mid, and posterior hippocampal pes, in anterior, mid, and posterior hippocampal gyrus, and in amygdaloid and occasionally thalamic or uncal sites through a stereotactic implantation technique utilizing the radiologic localization of electrode placement (Rand et al, 1964).' They received chronic bilateral implantation of depth electrodes in anterior, mid, and posterior hippocampal pes, in anterior, mid, and posterior hippocampal gyrus, and in amygdaloid and occasionally thalamic or uncal sites through a stereotactic implantation technique utilizing the radiologic localization of electrode placement (Rand et al, 1964).'…”

Section: Me Th 0 Dsmentioning

confidence: 99%

A Comparison of EEG Seizure Patterns Recorded with Surface and Depth Electrodes in Patients with Temporal Lobe Epilepsy

et al. 1976

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Surface and depth EEG seizure patterns were compared in 34 patients with intractable temporal lobe epilepsy in whom depth EEG electrodes had been chronically implanted in order to localize epileptogenic sites with a view to surgery. EEG records accompanied by clinical seizures, auras, no behavioral changes, as well as records for which no behavioral observations had been made, were judged with respect to the manner in which seizure activity originating unilaterally in the depth of one of the temporal lobes spread to the surface. For each EEG record, the onset of seizure activity in depth was classified as being focal or regional in form, and seizure activity was judged as: (1) not spreading to the surface, (2) spreading bilaterally and synchronously to the surface, (3) spreading initially to the surface ipsilateral to the depth site(s) in which the electrographic seizure first appeared, or (4) spreading initially to the surface contralateral to the depth site(s) in which the seizure activity initially occurred. EEG seizure activity was found to be less likely to propagate to the surface for those records that were either unaccompanied by behavior changes or accompanied only by auras than for those records accompanied by clinical seizures. In records accompanied by clinical seizures, seizure activity commonly propagated to the surface in a bilateral and synchronous fashion and was also found to spread initially to the ipsilateral but not to the contralateral surface. Anatomical and electrophysiological data accounting for the occurrence of ipsilateral spread were discussed. Diagnostic usefulness of surface recordings during clinical seizures in temporal lobe epilepsy was discussed.

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Chronic stereotactic implantation of depth electrodes for psychomotor epilepsy

Cited by 21 publications

References 4 publications

Changes in Intelligence Following Temporal Lobectomy: Relationship to EEG Activity, Seizure Relief, and Pathology

Changes in Intelligence Following Temporal Lobectomy: Relationship to EEG Activity, Seizure Relief, and Pathology

Distribution of Pyramidal Cell Density and Hyperexcitability in the Epileptic Human Hippocampal Formation

A Comparison of EEG Seizure Patterns Recorded with Surface and Depth Electrodes in Patients with Temporal Lobe Epilepsy

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