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Sample records for amytal

  1. Determination of hemisphere dominance for language: comparison of frontal and temporal fMRI activation with intracarotid amytal testing

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    Spreer, J.; Arnold, S.; Ziyeh, S.; Klisch, J.; Schumacher, M. [Section of Neuroradiology, Neurozentrum, University of Freiburg (Germany); Quiske, A.; Altenmueller, D.; Schulze-Bonhage, A. [Section for Presurgical Epilepsy Diagnosis, Neurozentrum, University of Freiburg (Germany); Wohlfarth, R.; Steinhoff, B.J. [Epilepsiezentrum, Kehl-Kork (Germany); Herpers, M.; Kassubek, J. [Department of Neurology, Neurozentrum, University of Freiburg (Germany); Honegger, J. [Department of Neurosurgery, Neurozentrum, University of Freiburg (Germany)

    2002-06-01

    The reliability of frontal and temporal fMRI activations for the determination of hemisphere language dominance was evaluated in comparison with intracarotid amytal testing (IAT). Twenty-two patients were studied by IAT (bilateral in 13, unilateral in 9 patients) and fMRI using a paradigm requiring semantic decisions. Global and regional (frontal and temporoparietal) lateralisation indices (LI) were calculated from the number of activated (r>0.4) voxels in both hemispheres. Frontolateral activations associated with the language task were seen in all patients, temporoparietal activations in 20 of 22. Regional LI corresponded better with IAT results than global LI. Frontolateral LI were consistent with IAT in all patients with bilateral IAT (including three patients with right dominant and one patient with bilateral language representation) and were not conflicting in any of the patients with unilateral IAT. Temporoparietal LI were discordant with IAT in two patients with atypical language representation. In the determination of hemisphere dominance for language, regional analysis of fMRI activation is superior to global analysis. In cases with clear-cut fMRI lateralisation, i.e. consistent lateralised activation of frontal and temporoparietal language zones, IAT may be unnecessary. FMRI should be performed prior to IAT in all patients going to be operated in brain regions potentially involved in language. (orig.)

  2. MRI language dominance assessment in epilepsy patients at 1.0 T: region of interest analysis and comparison with intracarotid amytal testing

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    Deblaere, K.; Vandemaele, P.; Tieleman, A.; Achten, E. [Department of Neuroradiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent (Belgium); Boon, P.A.; Vonck, K. [Reference Center for Refractory Epilepsy of the Department of Neurology, Ghent University Hospital, Ghent (Belgium); Vingerhoets, G. [Labaratory for Neuropsychology, Neurology Section of the Department of Internal Medicine, Ghent University, Ghent (Belgium); Backes, W. [Department of Neuroradiology, University Hospital Maastricht, Maastricht (Netherlands); Defreyne, L. [Department of Interventional Radiology, Ghent University Hospital, Ghent (Belgium)

    2004-06-01

    The primary goal of this study was to test the reliability of presurgical language lateralization in epilepsy patients with functional magnetic resonance imaging (fMRI) with a 1.0-T MR scanner using a simple word generation paradigm and conventional equipment. In addition, hemispherical fMRI language lateralization analysis and region of interest (ROI) analysis in the frontal and temporo-parietal regions were compared with the intracarotid amytal test (IAT). Twenty epilepsy patients under presurgical evaluation were prospectively examined by both fMRI and IAT. The fMRI experiment consisted of a word chain task (WCT) using the conventional headphone set and a sparse sequence. In 17 of the 20 patients, data were available for comparison between the two procedures. Fifteen of these 17 patients were categorized as left hemispheric dominant, and 2 patients demonstrated bilateral language representation by both fMRI and IAT. The highest reliability for lateralization was obtained using frontal ROI analysis. Hemispherical analysis was less powerful and reliable in all cases but one, while temporo-parietal ROI analysis was unreliable as a stand-alone analysis when compared with IAT. The effect of statistical threshold on language lateralization prompted for the use of t-value-dependent lateralization index plots. This study illustrates that fMRI-determined language lateralization can be performed reliably in a clinical MR setting operating at a low field strength of 1 T without expensive stimulus presentation systems. (orig.)

  3. MRI language dominance assessment in epilepsy patients at 1.0 T: region of interest analysis and comparison with intracarotid amytal testing

    International Nuclear Information System (INIS)

    The primary goal of this study was to test the reliability of presurgical language lateralization in epilepsy patients with functional magnetic resonance imaging (fMRI) with a 1.0-T MR scanner using a simple word generation paradigm and conventional equipment. In addition, hemispherical fMRI language lateralization analysis and region of interest (ROI) analysis in the frontal and temporo-parietal regions were compared with the intracarotid amytal test (IAT). Twenty epilepsy patients under presurgical evaluation were prospectively examined by both fMRI and IAT. The fMRI experiment consisted of a word chain task (WCT) using the conventional headphone set and a sparse sequence. In 17 of the 20 patients, data were available for comparison between the two procedures. Fifteen of these 17 patients were categorized as left hemispheric dominant, and 2 patients demonstrated bilateral language representation by both fMRI and IAT. The highest reliability for lateralization was obtained using frontal ROI analysis. Hemispherical analysis was less powerful and reliable in all cases but one, while temporo-parietal ROI analysis was unreliable as a stand-alone analysis when compared with IAT. The effect of statistical threshold on language lateralization prompted for the use of t-value-dependent lateralization index plots. This study illustrates that fMRI-determined language lateralization can be performed reliably in a clinical MR setting operating at a low field strength of 1 T without expensive stimulus presentation systems. (orig.)

  4. Bizarre behavior during intracarotid sodium amytal testing (Wada test: are they predictable? Reações bizarras durante o teste do amital sódico intracarotídeo (TASI ou Teste de Wada: é possível prevê-las?

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    Luciano de Paola

    2004-06-01

    Full Text Available The intracarotid sodium amytal test (ISAT or Wada Test is a commonly performed procedure in the evaluation of patients with clinically refractory epilepsy candidates to epilepsy surgery. Its goal is to promote selective and temporary interruption of hemispheric functioning, seeking to define language lateralization and risk for memory compromise following surgery. Behavioral modification is expected during the procedure. Even though it may last several minutes, in most cases it is subtle and easily manageable. We report a series of patients in whom those reactions were unusually bizarre, including agitation and aggression. Apart of the obvious technical difficulties (patients required physical restraining those behaviors potentially promote testing delay or abortion and more importantly, inaccurate data. We reviewed those cases, seeking for features that might have predicted their occurrence. Overall, reactions are rare, seen in less than 5% of the ISAT procedures. The barbiturate effect, patients' psychiatric profiles, hemisphere dominance or selectiveness of the injection were not validated as predictors. Thorough explanation, repetition and simulation may be of help in lessening the risk of those reactions.O teste do amital sódico intracarotídeo (TASI ou teste de Wada é procedimento comum na avaliação de pacientes portadores de epilepsia clinicamente refratária candidatos a cirurgia de epilepsia. Tem por objetivo promover interrupção seletiva e temporária da função hemisferial, definindo lateralização de linguagem e risco de comprometimento de memória no pós-operatório. São esperadas mudanças comportamentais durante o teste, as quais podem durar vários minutos, porém, em geral, são sutis e facilmente manejáveis. Relatamos uma série de casos em que ocorreram comportamentos pouco usuais, bizarros, incluindo agitação e agressividade. Estes comportamentos comprometem o teste (paciente deve ser contido, podendo levar a

  5. The regulation of respiration of guinea pig taenia coli in high-K medium: the role of nicotinamide-adenine dinucleotide, adenosine diphosphate and Ca++.

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    Tsuda, S; Urakawa, N; Saito, Y; Fukami, J

    1975-10-01

    In an attempt to elucidate the regulation mechanism of respiration in the smooth muscle cell, we investigated the roles of nicotinamide-adenine dinucleotide (NAD), adenosine diphosphate (ADP) and Ca++ in the muscle respiration using the tissues and subcellular fractions from guinea pig taenia coli. The tension in the strips of taenia coli increased with a concomitant increase in O2 consumption in high-K medium (40 mM K) containing 2.5 mM Ca. 10(-3) M amytal and 10(-5)M ouabain decreased the high-K induced tension and O2 consumption of the muscle. 10(-4)M 2,4-dinitrophenol (DNP) relieved the decreased respiration induced by ouabain, but not that with amytal. From these data it is suggested that NADH-linked respiration plays an important role in the respiration of the muscle. Ca++ in concentrations ranging from 0.5 to 2.5 mM in the high-K medium resulted in an increase in tension and in O2 concumption progressively. In spectrophotometric observations of subcellular fractions of the taenia coli, ADP increased in absorbance change at 340 m mu. Such occurred in mitochondrial fractions and was initiated by the addition of NADH. Therefore it is deduced that the increase in ADP level of the cytoplasm is primarily due to a contraction triggered by Ca++ thus stimulating respiration. On the other hand, at 0.1 mM of Ca++ concentration, the muscle strip increased O2 consumption without tension development in high-K medium. In the spectrophotometric observations, Ca++ and Sr++ increased the absorbance change in the homogenate and in the mitochondrial fraction. Hence, it seems that one part of the Ca++ entering into the smooth muscle treated with the high-K increased O2 consumption in mitochondia independent of an increase in muscle tension. From these results it is concluded that NADH-linked respiration plays an important role in the smooth muscle respiration in high-K medium and that ADP and Ca++ also play a role in regulating respiration. PMID:176493

  6. Wada test for evaluation of language and memory function in medically intractable epilepsy

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    Hong, Yong Kook; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Kim, Eun Kyung; Lee, Byung In; Huh, Kyun [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    1992-05-15

    The Wada test was performed for lateralization of language and memory function, using intracarotid injection of Sodium Amytal. But the internal carotid artery (ICA) Wada test has some limitations for testing memory function. The posterior cerebral artery (PCA) Wada test has been designed to modify the ICA Wada test for testing memory function selectively. In our study, 10 patients out of 12 patients with intractable seizure underwent only the ICA Wada test and the other 2 patients underwent both the ICA and the selective PCA Wada test. In all 12 patients undergoing the ICA Wada test, we successfully localized speech and language dominance. Four of 12 patients who underwent the ICA Wada test for evaluation of memory function displayed superior memory functions in one hemisphere, but the other hemisphere also significantly contributed to memory. The selective PCA Wada test, performed in 2 patients, showed successful results of memory function test in both patients. Four of 12 patients underwent temporal lobectomy and there was no major post-operative language or memory deficits. We concluded that the ICA and PCA Wada tests are useful for preoperative evaluation of medically intractable epilepsy, and the PCA Wada test is valuable in memory evaluation in some patients who have high risk of postoperative global amnesia after temporal lobectomy following equivocal results of memory function by the ICA Wada test.

  7. Transcortical mixed aphasia due to cerebral infarction in left inferior frontal lobe and temporo-parietal lobe

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    Maeshima, S.; Matsumoto, T.; Ueyoshi, A. [Department of Physical Medicine and Rehabilitation, Wakayama Medical University, Wakayama (Japan); Toshiro, H.; Sekiguchi, E.; Okita, R.; Yamaga, H.; Ozaki, F.; Moriwaki, H. [Department of Neurological Surgery, Hidaka General Hospital, Wakayama (Japan); Roger, P. [School of Communication Sciences and Disorders, University of Sydney, Sydney, NSW (Australia)

    2002-02-01

    We present a case of transcortical mixed aphasia caused by a cerebral embolism. A 77-year-old right-handed man was admitted to our hospital with speech disturbance and a right hemianopia. His spontaneous speech was remarkably reduced, and object naming, word fluency, comprehension, reading and writing were all severely disturbed. However, repetition of phonemes and sentences and reading aloud were fully preserved. Although magnetic resonance imaging (MRI) showed cerebral infarcts in the left frontal and parieto-occipital lobe which included the inferior frontal gyrus and angular gyrus, single photon emission CT revealed a wider area of low perfusion over the entire left hemisphere except for part of the left perisylvian language areas. The amytal (Wada) test, which was performed via the left internal carotid artery, revealed that the left hemisphere was dominant for language. Hence, it appears that transcortical mixed aphasia may be caused by the isolation of perisylvian speech areas, even if there is a lesion in the inferior frontal gyrus, due to disconnection from surrounding areas. (orig.)

  8. Successful management of a giant spinal arteriovenous malformation with multiple communications between primitive arterial and venous structures by embolization: report of a case.

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    Kuga, T; Esato, K; Zempo, N; Fujioka, K; Harada, M; Furutani, A; Akiyama, N; Toyota, S; Fujita, Y

    1996-01-01

    A 47-year-old woman was admitted to our hospital with a giant spinal arteriovenous malformation (AVM) causing heart failure and thoracic myelopathy. Angiography revealed that the spinal AVM had multiple feeding vessels branching from the 5th through 12th intercostal arteries. The drainage vein flowed to the azygos vein and superior vena cava. The AVM destroyed the 7th thoracic vertebra. The cardiac output was 16.7l/min and the shunt ratio was 64% before treatment. Embolization with cyanoacrylate was performed because the operation was considered to be associated with a significant risk of paraplegia and organ ischemia. The cardiac output decreased to 11.6l/min and the shunt ratio was reduced to 32%. After embolization the patient demonstrated no symptoms of either heart failure or sensory deficits. During embolization, provocative tests using sodium amytal and lidocaine with magnetic stimulation were also performed. The above findings suggest that provocative tests and magnetic stimulation are useful to predict paraplegia, which could result from embolization while, in addition, embolization is considered to be a useful treatment for multiple shunt and nidus in this region. PMID:8883257

  9. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    International Nuclear Information System (INIS)

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  10. Changes in oscillatory dynamics in the cell cycle of early Xenopus laevis embryos.

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    Tony Y-C Tsai

    2014-02-01

    Full Text Available During the early development of Xenopus laevis embryos, the first mitotic cell cycle is long (∼85 min and the subsequent 11 cycles are short (∼30 min and clock-like. Here we address the question of how the Cdk1 cell cycle oscillator changes between these two modes of operation. We found that the change can be attributed to an alteration in the balance between Wee1/Myt1 and Cdc25. The change in balance converts a circuit that acts like a positive-plus-negative feedback oscillator, with spikes of Cdk1 activation, to one that acts like a negative-feedback-only oscillator, with a shorter period and smoothly varying Cdk1 activity. Shortening the first cycle, by treating embryos with the Wee1A/Myt1 inhibitor PD0166285, resulted in a dramatic reduction in embryo viability, and restoring the length of the first cycle in inhibitor-treated embryos with low doses of cycloheximide partially rescued viability. Computations with an experimentally parameterized mathematical model show that modest changes in the Wee1/Cdc25 ratio can account for the observed qualitative changes in the cell cycle. The high ratio in the first cycle allows the period to be long and tunable, and decreasing the ratio in the subsequent cycles allows the oscillator to run at a maximal speed. Thus, the embryo rewires its feedback regulation to meet two different developmental requirements during early development.

  11. The Relation between Photosynthesis, Respiration, and Crassulacean Acid Metabolism in Leaf Slices of Aloe arborescens Mill.

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    Denius, H R; Homann, P H

    1972-06-01

    Leaves and leaf slices from Aloe arborescens Mill. were used to study the interrelations between Crassulacean acid metabolism, photosynthesis, and respiration. Oxygen exchange of leaf slices was measured polarographically. It was found that the photosynthetic utilization of stored malic acid resulted in a net evolution of oxygen. This oxygen production, and the decrease in acid content of the leaf tissue, were completely inhibited by amytal, although the rate of respiratory oxygen uptake was hardly affected by the presence of this inhibitor of mitochondrial electron transport. Other poisons of respiration (cyanide) and of the tricarboxylic acid cycle (trifluoroacetate, 2-diethyl malonate) also were effective in preventing acid-dependent oxygen evolution. It is concluded that the mobilization of stored acids during light-dependent deacidification of the leaves depends on the operation of the tricarboxylic acid cycle and of the electron transport of the mitochondria.A comparison of enzyme activities in extracts from Aloe leaves and from other plants and studies of leaf anatomy and chloroplast morphology revealed typical characteristics of C(3)-, as well as C(4)-, plants in Aloe. PMID:16658075

  12. Mitochondria mediate tumor necrosis factor-alpha/NF-kappaB signaling in skeletal muscle myotubes

    Science.gov (United States)

    Li, Y. P.; Atkins, C. M.; Sweatt, J. D.; Reid, M. B.; Hamilton, S. L. (Principal Investigator)

    1999-01-01

    Tumor necrosis factor-alpha (TNF-alpha) is implicated in muscle atrophy and weakness associated with a variety of chronic diseases. Recently, we reported that TNF-alpha directly induces muscle protein degradation in differentiated skeletal muscle myotubes, where it rapidly activates nuclear factor kappaB (NF-kappaB). We also have found that protein loss induced by TNF-alpha is NF-kappaB dependent. In the present study, we analyzed the signaling pathway by which TNF-alpha activates NF-kappaB in myotubes differentiated from C2C12 and rat primary myoblasts. We found that activation of NF-kappaB by TNF-alpha was blocked by rotenone or amytal, inhibitors of complex I of the mitochondrial respiratory chain. On the other hand, antimycin A, an inhibitor of complex III, enhanced TNF-alpha activation of NK-kappaB. These results suggest a key role of mitochondria-derived reactive oxygen species (ROS) in mediating NF-kappaB activation in muscle. In addition, we found that TNF-alpha stimulated protein kinase C (PKC) activity. However, other signal transduction mediators including ceramide, Ca2+, phospholipase A2 (PLA2), and nitric oxide (NO) do not appear to be involved in the activation of NF-kappaB.

  13. [Inhibition of respiratory enzymes in mitochondria of green leaves].

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    Nordhorn, G; Willenbrink, J

    1972-06-01

    1. Of the buffer substances introduced by Good, only N-2-hydroxy-ethylpiperazine-N-2-ethanesulfonic acid (HEPES) and N-tris(hydroxymethyl)-methyl-2-aminoethanesulfonic acid (TES) were found suitable for the isolation of mitochondria by means of density gradient centrifugation in a silica sol. Addition of 1% polyvinylpyrrolidone remarkably reduced the respiration rate and diminished the respiratory control, whereas 2% dextran improved the rates. 2. Fifty mM malonate inhibited succinate oxidation by 55-72% compared with the controls; in addition an uncoupling effect was observed. Similar results were obtained with 2.5 mM amytal. 3. Antimycin A, in contrast, did not affect the respiratory control, while the respiration rate was depressed to 55% of that in the control. 4. Azide (20 mM) had only a slight effect on the two parameters of leaf mitochondria. 5. It can be concluded that mitochondria of leaf cells are provided with the same respiratory enzymes as those of other plant materials. PMID:24481523

  14. Anaesthetic and other treatments of shell shock: World War I and beyond.

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    McKenzie, A G

    2012-03-01

    Post-traumatic stress disorder (PTSD) is an important health risk factor for military personnel deployed in modern warfare. In World War I this condition (then known as shell shock or 'neurasthenia') was such a problem that 'forward psychiatry' was begun by French doctors in 1915. Some British doctors tried general anaesthesia as a treatment (ether and chloroform), while others preferred application of electricity. Four British 'forward psychiatric units' were set up in 1917. Hospitals for shell shocked soldiers were also established in Britain, including (for officers) Craiglockhart War Hospital in Edinburgh; patients diagnosed to have more serious psychiatric conditions were transferred to the Royal Edinburgh Asylum. Towards the end of 1918 anaesthetic and electrical treatments of shell shock were gradually displaced by modified Freudian methods psychodynamic intervention. The efficacy of 'forward psychiatry' was controversial. In 1922 the War Office produced a report on shell shock with recommendations for prevention of war neurosis. However, when World War II broke out in 1939, this seemed to have been ignored. The term 'combat fatigue' was introduced as breakdown rates became alarming, and then the value of pre-selection was recognised. At the Maudsley Hospital in London in 1940 barbiturate abreaction was advocated for quick relief from severe anxiety and hysteria, using i.v. anaesthetics: Somnifaine, paraldehyde, Sodium Amytal. 'Pentothal narcosis' and 'narco-analysis' were adopted by British and American military psychiatrists. However, by 1945 medical thinking gradually settled on the same approaches that had seemed to be effective in 1918. The term PTSD was introduced in 1980. In the UK the National Institute for Health and Clinical Excellence (NICE) guidelines for management (2005) recommend trauma-focussed Cognitive Behavioural Therapy and consideration of antidepressants.

  15. Unilateral mesial temporal atrophy after a systemic insult as a possible etiology of refractory temporal lobe epilepsy: case report Esclerose mesial temporal unilateral após insulto sistêmico como possível etiologia de epilepsia refratária do lobo temporal: relato de caso

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    Arthur Cukiert

    1997-09-01

    Full Text Available Mesial temporal sclerosis is the main pathological substrate present in refractory temporal lobe epilepsy and its presence is often related to the occurrence of febrile seizures in infancy. There is an on-going discussion on the nature of mesial temporal sclerosis as it related to epilepsy: cause or consequence. A previously normal child developed hyperosmolar coma after abdominal surgery at the age of 6. Three months afterwards he developed simple and complex partial seizures with an increasing frequency and refractory to multiple mono-and polytherapic drug regimens. He was evaluated for surgery at the age of 13. Ictal and interictal recordings showed left temporal lobe abnormalities. Early CT scaning suggested left temporal atrophy. MRI showed mesial temporal sclerosis. Neuropsichological testing showed verbal memory deficits and he passed a left carotid artery amytal injection. He was submitted to a cortico-amygdalo-hippocampectomy and has been seizure-free since then. The clinical data obtained from this patient suggest that at least in this case mesial temporal sclerosis would be related to the cause of epilepsy and not resultant from repeated seizure activity.A esclerose mesial temporal é o principal substrato anatomo-patológico envolvido na epilepsia refratária do lobo temporal e está frequentemente associada à ocorrência de convulsões febris na infância. Persiste até o momento intensa discussão se a esclerose mesial seria causa ou consequência da síndrome epiléptica. Uma criança previamente normal, desenvolveu coma hiperosmolar após intercorrência em cirurgia abdominal aos 6 anos de idade. Após 3 meses iniciaram-se crises parciais simples e complexas em frequência ascendente e refratárias a múltiplos esquemas terapêuticos em mono- e politerapia. Ele realizou investigação pré-operatória para epilepsia aos 13 anos de idade. Registros eletrencefalográficos de superfície ictais e interictais mostraram anormalidades

  16. The Role of Investigative Modalities in Epilepsy Work-up

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    Helen Nayeri

    2009-01-01

    epilepsy. In such patients, there is an approximately 97% satisfactory post-operative outcome. In cases with discordant EEG and MR findings or when confirmation of the epileptogenicity of the MR-identified lesion is lacking, intracranial EEG recording using subdural or parenchymal depth electrodes are warranted. Invasive electrophysiological studies are also indicated in cases with more than one MR abnormality, when MR shows a large atrophic region or developmental abnormality, and when functional mapping of the brain is indicated based on MR findings or other reasons. "nOther modalities for preoperative evaluation of surgical candidates with intractable epilepsy involve functional neuroimaging (include SPECT, PET, magnetoencephalography as well as neuropsychological assessment and lateralization of language and memory functions by Amytal procedure (IAP or Wada test. "nMR imaging protocols for epilepsy vary. The protocol must be able to detect hippocampal sclerosis, as well as foreign tissue lesions (i.e., neoplasms, infections, etc and developmental abnormalities. The MR imaging of amygdala and hippocampus is best performed in a slightly oblique coronal plane, perpendicular to the long axis of hippocampus. The study requires evaluation of both morphological and signal abnormalities. High resolution FSE T2W and IR sequences are important for depiction of hippocampal signal and architectural changes. Either a coronal T1W gradient volume acquisition (e.g., SPGR or MP-RAGE sequences or inversion recovery (IR can be used to help evaluate cortical dysplasia, as well as to assess subtle hippocampal asymmetry. High-resolution T2 and axial inversion recovery FSE imaging is also routinely used. Coronal, T1-weighted, three dimensional volume, gradient echo sequences not only provide excellent gray-white matter differentiation, but also thin slices (1.0 to 1.6 mm thick, which may improve the detection of subtle malformations of cortical development. Volume loss and T2 signal changes