Engagement of cortico-cortical and cortico-subcortical networks in a patient with epileptic spasms: An integrated neurophysiological study

Inoue, Takeshi; Kobayashi, Katsuya; Matsumoto, Riki; Inouchi, Morito; Togo, Masaya; Togawa, Jumpei; Usami, Kiyohide; Shimotake, Akihiro; Matsuhashi, Masao; Kikuchi, Takayuki; Yoshida, Kazumichi; Kawawaki, Hisashi; Sawamoto, Nobukatsu; Kunieda, Takeharu; Miyamoto, Susumu; Takahashi, Ryōsuke; Ikeda, Akio

doi:10.1016/j.clinph.2020.04.167

Cited by 7 publications

(5 citation statements)

References 52 publications

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“…In a subset of the NE group, PMA was spared because of early myelination before birth, whereas the association fiber pathways become gradually myelinated after birth 31–33 . Recent integrated neurophysiological techniques have provided converging evidence for the involvement of abnormal cortico‐cortical networks in multilobar epileptic zones, relatively sparing the PMA in the generation of ES 16,17,33–36 . Subtotal hemispherotomy could be considered the last resort for patients with drug‐resistant LOES in the NE group.…”

Section: Discussionmentioning

confidence: 99%

“…If lateralization of the EEG is confirmed after CC, the subsequent epilepsy surgery, that is, subtotal hemispherotomy, anterior quadrant disconnection (AQD), or posterior quadrant disconnection (PQD), is actively considered to eliminate all types of seizures. Subtotal hemispherotomy consists of AQD, PQD, and CC of the central part after undergoing intracranial video‐EEG using chronic subdural grid electrodes to identify the seizure network and confirm the primary motor area (PMA) could be preserved 16–18 . In a subset of patients with apparent unilateral MRI lesions and EEG abnormalities, subtotal hemispherotomy, hemispherotomy, or other disconnection surgeries would be chosen, considering age and presence, degree, and extent of hemiplegia.…”

Section: Methodsmentioning

confidence: 99%

“…Subtotal hemispherotomy consists of AQD, PQD, and CC of the central part after undergoing intracranial video-EEG using chronic subdural grid electrodes to identify the seizure network and confirm the primary motor area (PMA) could be preserved. [16][17][18] In a subset of patients with apparent unilateral MRI lesions and EEG abnormalities, subtotal hemispherotomy, hemispherotomy, or other disconnection surgeries would be chosen, considering age and presence, degree, and extent of hemiplegia.…”

Section: Surgeriesmentioning

confidence: 99%

“…Last follow-up Sz Follow-up (y) ES ( 11) FS ( 6) GS ( 7) SS (4) techniques have provided converging evidence for the involvement of abnormal cortico-cortical networks in multilobar epileptic zones, relatively sparing the PMA in the generation of ES. 16,17,[33][34][35][36] Subtotal hemispherotomy could be considered the last resort for patients with drugresistant LOES in the NE group. The etiologies of LOES in the PE group consisted of eight patients with AESD, 6,37 two with other viral encephalitis, 22 and one each with HSES 38 and febrile infectionrelated epilepsy syndrome.…”

Section: Age Of Additional Surgeriesmentioning

confidence: 99%

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Comparing late‐onset epileptic spasm outcomes after corpus callosotomy and subsequent disconnection surgery between post‐encephalitis/encephalopathy and non‐encephalitis/encephalopathy

et al. 2023

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Objective: We aimed to analyze the efficiency of corpus callosotomy (CC) and subsequent disconnection surgeries in patients with late-onset epileptic spasms (LOES) by comparing post-encephalitis/encephalopathy (PE) and nonencephalitis/encephalopathy (NE). We hypothesized these surgeries can control potential focal onset epileptic spasms (ES) in the NE group but not in the PE group. Methods:We retrospectively included 23 patients (12 with PE and 11 with NE) who initially underwent CC and subsequent disconnection surgeries (five NE).We compared the clinical courses, seizure types, MRI, video-EEG, epilepsy surgery, and seizure outcomes between the two groups. Results:The median age of LOES onset in the PE group was 2.8 (range 1.0-10.1 years) and 2.9 years (range 1.1-12.6) in the NE group. Bilateral MRI abnormalities were observed in both groups (PE, n = 12; NE, n = 3; P < 0.05). The PE group presented ES alone (n = 2), ES + focal seizures (FS) (n = 3), ES + generalized seizures (GS) (n = 3), and ES + FS + GS (n = 4) in addition to stimulusinduced startle seizures (SS) (n = 8) (mean 3.1 seizure types/patient). The NE group presented ES alone (n = 1), ES + FS (n = 2), and ES + FS + GS (n = 8) (mean 2.7 seizure types/patient). In the PE group, CC stopped ES (n = 1) and SS (n = 1) and achieved <50% SS (n = 3). In the NE group, CC achieved immediate ES-free status (n = 2) and < 50% ES (n = 1), and additional disconnection surgeries subsided all seizure types (n = 3) based on lateralized interictal/ictal EEG findings. LOES was significantly remitted by surgery in the NE group (6/11[55%]) compared with the PE group (1/12 [8%]) (P < 0.05).Significance: LOES is a drug-resistant, focal/generalized/unknown onset ES.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Surgeriesmentioning

confidence: 99%

Section: Age Of Additional Surgeriesmentioning

confidence: 99%

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Comparing late‐onset epileptic spasm outcomes after corpus callosotomy and subsequent disconnection surgery between post‐encephalitis/encephalopathy and non‐encephalitis/encephalopathy

et al. 2023

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“…Fisher et al also found, in this moment, that the majority of nodes in the HFO network were connected to a single dominant component and that the percentage of nodes within the largest component grew significantly [ 82 ]. In the generation of epileptic spasms (ES), ictal HFOs revealed a network consisting of multilobar cortical regions (frontal, parietal, and temporal), but sparing the positive motor area [ 83 ]. At the beginning of temporal lobe epilepsy (TLE), different types of seizure onset activate distinct neuronal networks.…”

Section: Relationship Between the Hfo/hfo Network And The Epileptogen...mentioning

confidence: 99%

High-Frequency Oscillations and Epileptogenic Network

Zhang

Lai

et al. 2022

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: Epilepsy is a network disease caused by aberrant neocortical large-scale connectivity spanning regions on the scale of several centimeters. High-frequency oscillations, characterized by the 80–600 Hz signals in electroencephalography, have been proven to be a promising biomarker of epilepsy that can be used in assessing the severity and susceptibility of epilepsy as well as the location of the epileptogenic zone. However, the presence of a high-frequency oscillation network remains a topic of debate as high-frequency oscillations have been previously thought to be incapable of propagation, and the relationship between high-frequency oscillations and the epileptogenic network has rarely been discussed. Some recent studies reported that high-frequency oscillations may behave like networks that are closely relevant to the epileptogenic network. Pathological high-frequency oscillations are network-driven phenomena and elucidate epileptogenic network development; high-frequency oscillations show different characteristics coincident with the epileptogenic network dynamics, and cross-frequency coupling between high-frequency oscillations and other signals may mediate the generation and propagation of abnormal discharges across the network.

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