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High Frequency Oscillations and spikes running down after SEEG-guided thermocoagulations in the epileptogenic network of periventricular nodular heterotopia
- Source :
- Epilepsy Research, Epilepsy Research, 2019, 150, pp.27-31. ⟨10.1016/j.eplepsyres.2018.12.006⟩, Epilepsy Research, Elsevier, 2019, 150, pp.27-31. ⟨10.1016/j.eplepsyres.2018.12.006⟩
- Publication Year :
- 2019
- Publisher :
- HAL CCSD, 2019.
-
Abstract
- Objective Epilepsy associated with periventricular nodular heterotopia (PNH) is characterized by complex relationships between the heterotopic and the normotopic cortex during the interictal state and at seizure onset. High-frequency oscillations (HFO) have been proposed as a marker of epileptogenicity that might reflect disease activity. The effects of thermocoagulations on epileptogenicity in this context remain unknown. We aimed to investigate the interictal HFO- and spike profiles of different cortical structures before and after two consecutive SEEG-guided thermocoagulations, in correlation with seizure outcome, in a patient with PNH-related drug-resistant epilepsy. Methods The epileptogenic zone (EZ) was defined by SEEG analysis based on the Epileptogenicity Index. Interictal spikes, ripples (80–250 Hz) and fast ripples (FR, 250-330 Hz) were analyzed within the heterotopia, the temporal neocortex and the hippocampus. Results The SEEG recordings revealed a distributed EZ involving the heterotopia and the posterior temporal neocortex. Both structures were targeted by thermocoagulations. Background spikes, ripples and FR-rates were significantly higher in PNH compared to the normotopic cortex. A drastic reduction of spikes (by over 80%) and absence of FR were demonstrated both in the PNH and in the neocortex during the second SEEG exploration 6 months after the first thermocoagulation, whereas no significant difference was observed in the posterior hippocampus. Ripples were significantly reduced by the first and suppressed by the second thermocoagulation within the three structures. Seizures relapsed after two months but decreased in frequency after the first thermocoagulation. Sustained seizure-freedom was achieved only after the second procedure. Conclusions Our data demonstrate the running down of interictal HFO and spikes within the epileptogenic network following thermocoagulations of heterotopic and normotopic sites involved at seizure onset. This dynamics was in good correlation with significantly improved seizure control. Significance Combination of ictal and different interictal markers of epileptogenicity, including HFO and spike analysis, is important to get the full picture of the epileptogenic zone and could help to evaluate the disease activity.
- Subjects :
- 0301 basic medicine
[SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery
[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging
SEEG
Thermocoagulations
[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery
Functional Laterality
Stereoelectroencephalography
03 medical and health sciences
Epilepsy
Imaging, Three-Dimensional
0302 clinical medicine
Periventricular Nodular Heterotopia
Electrocoagulation
Seizure control
Humans
Medicine
Ictal
High Frequency Oscillations
Neocortex
business.industry
Significant difference
Brain
Electroencephalography
medicine.disease
Magnetic Resonance Imaging
[SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging
030104 developmental biology
medicine.anatomical_structure
Heterotopia (medicine)
Neurology
Epileptogenicity
Female
Neurology (clinical)
business
Neuroscience
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 09201211 and 18726844
- Database :
- OpenAIRE
- Journal :
- Epilepsy Research, Epilepsy Research, 2019, 150, pp.27-31. ⟨10.1016/j.eplepsyres.2018.12.006⟩, Epilepsy Research, Elsevier, 2019, 150, pp.27-31. ⟨10.1016/j.eplepsyres.2018.12.006⟩
- Accession number :
- edsair.doi.dedup.....06e6dc0b1e4d01077db9f2b72ad135d9