Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2016
The Correlation between Intraoperative Microelectrode Recording and 3-Tesla MRI in Patients Undergoing ANT-DBS for Refractory Epilepsy.
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus) (ANT) has been suggested as a treatment option in refractory epilepsy. The targeting of ANT is especially challenging due to its poor visualization in commonly used MRI sequences, lack of easily observable symptom relief during surgery and high degree of anatomical variation between individuals. ⋯ Our data suggest that MER provides clinically relevant information during implantation surgery by demonstrating both nucleus-specific neuronal firing patterns and white matter laminae between different nuclear groups.
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Stereotact Funct Neurosurg · Jan 2016
Continuous Intraoperative Monitoring of Temporal Lobe Epilepsy Surgery.
The monitoring of interictal epileptiform discharge rates (IEDRs) all along anterior temporal lobe resections (ATLRs) has never been reported. Here the effect of ATLR on continuous IEDR monitoring is described. ⋯ IEDR monitoring was possible with depth, but not with scalp electrodes. IEDR decreases started with resection of the superior temporal gyrus. A larger patient cohort is necessary to confirm the high predictive values of IEDR monitoring that could become a tool for surgery customization.
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Stereotact Funct Neurosurg · Jan 2015
Long-term results of motor cortex stimulation in the treatment of chronic, intractable neuropathic pain.
Although motor cortex stimulation (MCS) has been used for more than 20 years in the treatment of chronic neuropathic pain, there is still a debate about the efficacy of MCS. ⋯ MCS was more effective in the treatment of chronic neuropathic pain of central poststroke pain and peripheral neuropathic pain types than in the treatment of SCI pain in the long-term follow-up.
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Stereotact Funct Neurosurg · Jan 2015
The Influence of Positioning and Muscle Activity on Motor Threshold during Motor Cortex Stimulation Programming.
Background: Stimulation parameters are crucial for the efficacy and safety of motor cortex stimulation (MCS). Motor threshold (MT) can be defined as the lowest voltage that produces motor contraction. The final stimulation parameters are always a smaller percentage of MT in order to avoid seizures. ⋯ Conclusion: When selecting final stimulation parameters for MCS, clinicians should be aware that the lowest MT is elicited while patients are seated upright and actively contracting the target muscle. Using this method of determining the MT when calculating the final stimulation parameters could reduce the chance of MCS-induced seizures. © 2015 S. Karger AG, Basel.