Selective Middle Cerebral Artery Wada Tests as a Part of Presurgical Evaluation in Patients with Drug‐resistant Epilepsies

Urbach, Horst; Oertzen, Tim J. von; Klemm, E.; Koenig, Roy; Linke, D. B.; Kurthen, Martin; Schramm, Johannes; Elger, Christian E.

doi:10.1046/j.1528-1157.2002.13302.x

Cited by 21 publications

(21 citation statements)

References 18 publications

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“…All patients were studied on 1.5 T-scanners (Gyroscan ACS-NT and NT-Intera, Philips Medical Systems, Best, The Netherlands) with an epilepsy-dedicated MRI protocol that has been reported previously [2,5]. Part of this protocol is a coronal T2-weighted fast spin echo sequence angulated perpendicularly to the length axis of the temporal lobe.…”

Section: Mri Acquisitionmentioning

confidence: 99%

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MRT-Längsschnittuntersuchungen bei Patienten mit erworbener Hippokampussklerose

et al. 2006

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Background and Purpose: It is still a matter for debate as to whether hippocampal sclerosis (HS) is acquired during the course of a patient's seizure history or is present at the onset. Serial MRI scans in patients with acquired HS may be helpful for the understanding of the pathogenesis of HS. Methods: During a period of seven years we collected 14 patients with serial MRI scans who developed a sclerotic hippocampus during the course of their disease. Clinical history, presentation and further clinical course of these patients were related to MRI findings. Results: In 11 patients, MRI initially showed a swollen hippocampus (unilateral n = 8, bilateral n = 3) that became atrophic within 34 days to 22 months. HS developed as a consequence of seizures (n = 2), after (intrathecal) chemotherapy (n = 2), or related to limbic encephalitis (n = 5). Conclusion: Several conditions (seizures, chemotherapy, limbic encephalitis) may induce the development of HS, which can be monitored by MRI. ZusammenfassungHintergrund und Fragestellung: Es ist immer noch unklar, ob die Hippokampussklerose Folge von epileptischen Anfällen ist oder bereits bei Beginn der Epilepsieerkrankung vorhanden ist. Serielle MRT-Untersuchungen, die die Entstehung einer Hippokampussklerose dokumentieren, sind daher für das Verständnis der Pathogenese der Hippokampussklerose von Interesse. Methodik: Innerhalb eines Zeitraumes von sieben Jahren beobachteten wir 14 Patienten, die eine Hippokampussklerose während des Verlaufs ihrer Erkrankung entwickelten. Anamnese, klinische Präsentation und weiterer klinischer Verlauf wurden mit den MRT-Veränderungen korreliert. Ergebnisse: Bei elf Patienten zeigte das initiale MRT geschwollene Hippokampi (einseitig n = 8; beidseitig, n = 3), die innerhalb eines Zeitraumes von 34 Tagen bis 22 Monaten atroph wurden. Eine Hippokampussklerose entwickelte sich als Folge von Anfällen (n = 2), nach (intrathekaler) Chemotherapie (n = 2) oder bei limbischer Enzephalitis (n = 5). Schlussfolgerung: Verschiedene Bedingungen (Epilepsieanfälle, Chemotherapie, limbische Enzephalitis) können die Entstehung einer Hippokampussklerose induzieren, deren zeitliche Entwicklung mittels serieller MRT-Untersuchungen dokumentiert werden kann.

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Section: Mri Acquisitionmentioning

confidence: 99%

“…Using coronal, 2 to 3 mm thick FLAIR or T2-weighted fast spin echo images angulated perpendicularly to the hippocampal length axis, sensitivity and specificity are almost 100% [2]. In doubtful cases, T2 relaxometry can be of diagnostic help [3].…”

Section: Introductionmentioning

confidence: 99%

MRT-Längsschnittuntersuchungen bei Patienten mit erworbener Hippokampussklerose

et al. 2006

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“…It consists of the injection of sodium amobarbital into the internal carotid artery via a transfemorally placed intraarterial catheter in the awake patient for global hemispherical evaluation. For more precise assessment an endovascular catheter may be placed superselectively in the anterior choroidal artery in order to perform more or less complex memory tasks during the test, or in the middle or posterior cerebral artery for the evaluation of other specific performance tasks 18,19 .…”

Section: Wada-testmentioning

confidence: 99%

Epilepsy-Surgery and Invasive Diagnostic Procedures

Schaller

2004

Rivista di Neuroradiologia

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“…Selective AT's [27] of branches of the MCA or ACA are rarely performed to determine the intrahemispheric distribution of language cortices in patients with lesions close to putative language areas and ambiguous fMRI results. In most of these patients, electrical stimulation mapping via chronically implanted subdural grid electrodes is preferred, but in some patients there may be relative contraindications for implantation.…”

Section: Standard and Selective Carotid Amobarbital Testsmentioning

confidence: 99%

Preoperative Evaluation for Epilepsy Surgery (Bonn Algorithm)

Kral

Clusmann²,

Urbach³

et al. 2002

Zentralbl Neurochir

139

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Epilepsy surgery has been established as a successful treatment in patients with drug-resistant focal epilepsies. Different standardized surgical approaches were developed for resective or functional treatment. Successful surgical treatment, however, necessitates a careful presurgical evaluation. Although there are international standards for non invasive and invasive presurgical procedures most centers differ in their diagnostic strategy. This article gives a survey of the Bonn Epilepsy surgery program within which more than 1300 patients have been treated. After the method of patient selection different we describe tools of non invasive and invasive evaluation. This article serves only as a description of current practice in one center with a relatively large volume of cases. It presents just one opinion of a specific group within a wide spectrum of possible algorithms for presurgical evaluation that have briefly been outlined for 33 centers in Engels book [4].

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Selective Middle Cerebral Artery Wada Tests as a Part of Presurgical Evaluation in Patients with Drug‐resistant Epilepsies

Cited by 21 publications

References 18 publications

MRT-Längsschnittuntersuchungen bei Patienten mit erworbener Hippokampussklerose

MRT-Längsschnittuntersuchungen bei Patienten mit erworbener Hippokampussklerose

Epilepsy-Surgery and Invasive Diagnostic Procedures

Preoperative Evaluation for Epilepsy Surgery (Bonn Algorithm)

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