Epilepsia
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Comparative Study
SEEG-guided RF thermocoagulation of epileptic foci: feasibility, safety, and preliminary results.
Depth electrodes recordings may be required in some cases of epilepsy surgery to delineate the best region for cortical resection. We usually implant depth electrodes according to Talairach's stereoelectroencephalography (SEEG) method. By using these permanently implanted depth electrodes, we are able to perform radiofrequency (RF)-thermolesions of the epileptic foci. We report the technical data required to perform such multiple cortical thermolesions, as well as preliminary results in terms of seizure outcome in a group of 20 patients. ⋯ SEEG-guided RF thermolesions is a safe technique. Our preliminary results indicate that such lesions can lead to a significant reduction of seizure frequency and could be proposed as a palliative procedure if no resective surgery is possible. A randomized controlled trial is needed to determine which patients are likely to respond to SEEG-guided RF thermolesions.
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Case Reports
Successful management of intractable epilepsy with lidocaine tapes and continuous subcutaneous lidocaine infusion.
We report the successful management of a 10-year-old girl with intractable frontal lobe epilepsy by using lidocaine tapes and continuous subcutaneous lidocaine infusion. ⋯ Lidocaine tape therapy and continuous subcutaneous lidocaine infusion therapy were considered to be useful for controlling this patient's seizures. This is the first report to describe the efficacy of continuous subcutaneous lidocaine infusion therapy for epilepsy.
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Comparative Study
Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study.
In this study, we report the clinical features of insular lobe seizures based on data from video and stereo-electroencephalographic (SEEG) ictal recordings and direct electric insular stimulation of the insular cortex performed in patients referred for presurgical evaluation of temporal lobe epilepsy (TLE). ⋯ This sequence of ictal symptoms looks reliable enough to characterize insular lobe epileptic seizures (ILESs). Observation of this clinical sequence at the onset of seizures on video-EEG recordings in TLE patients strongly suggests that the seizure-onset zone is located not in the temporal but in the insular lobe; recording directly from the insular cortex should occur before making any decision regarding epilepsy surgery.
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Comparative Study
A dissociation between implicit and explicit verbal memory in left temporal lobe epilepsy.
Temporal lobe epilepsy patients are well known to present deficits on explicit verbal memory procedures (e.g., recall, recognition). The integrity of implicit memory procedures in these patients is not established. Previous studies in this area used implicit memory measures contaminated by the effects of explicit memory. ⋯ The data demonstrate the integrity of implicit memory in LTLE patients. Finding a dissociation between the two forms of verbal memory in LTLE patients provides evidence that they rely on different neuroanatomic systems.