2020
Mesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system
Hirsch LJ, Mirro EA, Salanova V, Witt TC, Drees CN, Brown M, Lee RW, Sadler TL, Felton EA, Rutecki P, Shin HW, Hadar E, Hegde M, Rao VR, Mnatsakanyan L, Madhavan DS, Zakaria TJ, Liu AA, Heck CN, Greenwood JE, Bigelow JK, Nair DR, Alexopoulos AV, Mackow M, Edwards JC, Sotudeh N, Kuzniecky RI, Gwinn RP, Doherty MJ, Geller EB, Morrell MJ. Mesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system. Epilepsia 2020, 61: 408-420. PMID: 32072621, PMCID: PMC7154711, DOI: 10.1111/epi.16442.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnterior Temporal LobectomyDrug Resistant EpilepsyElectric Stimulation TherapyElectrocorticographyEpilepsy, Temporal LobeFemaleHumansImplantable NeurostimulatorsMaleMiddle AgedMonitoring, AmbulatoryNeurosurgical ProceduresRetrospective StudiesTemporal LobeTreatment OutcomeYoung AdultConceptsMTL resectionElectrographic seizuresTemporal lobe seizure onsetClinical seizure reductionMesial temporal resectionIntracranial EEG monitoringRNS SystemBitemporal epilepsySeizure reductionSeizure outcomeTemporal resectionPrimary outcomeRefractory epilepsyAdditional patientsEpilepsy centersUnilateral onsetBilateral onsetIcEEG recordingsSeizure onsetMTL epilepsyMedian reductionResectionPatientsEEG monitoringIcEEG data
2017
Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults
Yoo JY, Marcuse LV, Fields MC, Rosengard JL, Traversa MV, Gaspard N, Hirsch LJ. Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults. Journal Of Clinical Neurophysiology 2017, 34: 222-229. PMID: 28463933, DOI: 10.1097/wnp.0000000000000357.Peer-Reviewed Original ResearchConceptsIctal rhythmic dischargesIll adultsRhythmic dischargesSeizure onset areaAdult patientsElectrographic characteristicsStatus epilepticusAcute findingsIll patientsRefractory epilepsyClinical historySeizure onsetClinical significanceEpileptiform dischargesAmbulatory settingPatientsBenign patternControl groupEpilepsyRhythmic activityOnset areaAlpha activityAdultsBrief runsEEG recordingsPrevalence and risk factors of seizure clusters in adult patients with epilepsy
Chen B, Choi H, Hirsch LJ, Katz A, Legge A, Wong RA, Jiang A, Kato K, Buchsbaum R, Detyniecki K. Prevalence and risk factors of seizure clusters in adult patients with epilepsy. Epilepsy Research 2017, 133: 98-102. PMID: 28475999, DOI: 10.1016/j.eplepsyres.2017.04.016.Peer-Reviewed Original ResearchConceptsSymptomatic generalized epilepsyIdiopathic generalized epilepsySeizure clustersEpilepsy typeStatus epilepticusCortical dysplasiaGeneralized epilepsyFocal epilepsySeizure onsetCNS infectionSeizure freedomMore AEDsRisk factorsCentral nervous system infectionCongenital brain injuryEpilepsy risk factorsNervous system infectionPotential clinical factorsComplex partial seizuresEarly seizure onsetEpilepsy detailsRescue medicationAdult patientsPatient demographicsSystem infectionBrain‐responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas
Jobst BC, Kapur R, Barkley GL, Bazil CW, Berg MJ, Bergey GK, Boggs JG, Cash SS, Cole AJ, Duchowny MS, Duckrow RB, Edwards JC, Eisenschenk S, Fessler AJ, Fountain NB, Geller EB, Goldman AM, Goodman RR, Gross RE, Gwinn RP, Heck C, Herekar AA, Hirsch LJ, King‐Stephens D, Labar DR, Marsh WR, Meador KJ, Miller I, Mizrahi EM, Murro AM, Nair DR, Noe KH, Olejniczak PW, Park YD, Rutecki P, Salanova V, Sheth RD, Skidmore C, Smith MC, Spencer DC, Srinivasan S, Tatum W, Van Ness P, Vossler DG, Wharen RE, Worrell GA, Yoshor D, Zimmerman RS, Skarpaas TL, Morrell MJ. Brain‐responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia 2017, 58: 1005-1014. PMID: 28387951, DOI: 10.1111/epi.13739.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBrain MappingCerebral CortexDeep Brain StimulationDrug Resistant EpilepsyElectric Stimulation TherapyElectrodes, ImplantedElectroencephalographyEpilepsies, PartialEpilepsy, Complex PartialEpilepsy, Partial, MotorEpilepsy, Tonic-ClonicFeasibility StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedNeocortexYoung AdultConceptsSeizure-free periodSeizure reductionNeocortical onsetSeizure onsetNeocortical originIntractable partial-onset seizuresMedian percent seizure reductionBrain-responsive neurostimulationChronic neurologic deficitsPercent seizure reductionPrior epilepsy surgeryPartial-onset seizuresPercent of patientsProspective clinical trialsNormal MRI findingsVagus nerve stimulationEffective treatment optionEloquent cortical areasRate of infectionMagnetic resonance imagingPreimplantation baselineMRI lesionsAdverse eventsNeurologic deficitsPerioperative hemorrhage
2014
The spatial and signal characteristics of physiologic high frequency oscillations
Alkawadri R, Gaspard N, Goncharova II, Spencer DD, Gerrard JL, Zaveri H, Duckrow RB, Blumenfeld H, Hirsch LJ. The spatial and signal characteristics of physiologic high frequency oscillations. Epilepsia 2014, 55: 1986-1995. PMID: 25470216, PMCID: PMC5123742, DOI: 10.1111/epi.12851.Peer-Reviewed Original ResearchConceptsPhysiologic high-frequency oscillationsSeizure onsetEpileptic networkNon-rapid eye movement sleepComprehensive Epilepsy CenterMesial temporal structuresEye movement sleepHigh-frequency oscillationsHighest HFO ratesFirst seizureInvasive evaluationEpilepsy centersIntracranial evaluationMovement sleepPerirolandic regionEpileptiform dischargesParietooccipital regionOccipital lobeEpileptic sitesPatientsNonepileptic regionsPhysiologic eventsFast ripplesHFO ratesLonger duration
2013
Seizure localization using three-dimensional surface projections of intracranial EEG power
Lee HW, Youngblood MW, Farooque P, Han X, Jhun S, Chen WC, Goncharova I, Vives K, Spencer DD, Zaveri H, Hirsch LJ, Blumenfeld H. Seizure localization using three-dimensional surface projections of intracranial EEG power. NeuroImage 2013, 83: 616-626. PMID: 23850575, PMCID: PMC3815983, DOI: 10.1016/j.neuroimage.2013.07.010.Peer-Reviewed Original ResearchConceptsEpilepsy surgerySeizure localizationGood surgical outcomeEEG powerIntractable epilepsy patientsAgreement rateNormal brain functionOverall agreement ratePoor outcomeSurgical outcomesIntractable epilepsyIcEEG recordingsSeizure onsetSublobar localizationEpilepsy patientsIndependent reviewersClinical informationIcEEG dataPatientsBrain functionSurgeryImproved diagnostic methodIntracranial EEGDiagnostic methodsOutcomesNonconvulsive seizures after subarachnoid hemorrhage: Multimodal detection and outcomes
Claassen J, Perotte A, Albers D, Kleinberg S, Schmidt JM, Tu B, Badjatia N, Lantigua H, Hirsch LJ, Mayer SA, Connolly ES, Hripcsak G. Nonconvulsive seizures after subarachnoid hemorrhage: Multimodal detection and outcomes. Annals Of Neurology 2013, 74: 53-64. PMID: 23813945, PMCID: PMC3775941, DOI: 10.1002/ana.23859.Peer-Reviewed Original ResearchConceptsRegional cerebral blood flowAcute brain injuryBrain injuryCerebral physiologic effectsCerebral perfusion pressureSecondary brain injuryBrain tissue oxygenationSubarachnoid hemorrhage patientsCerebral blood flowGlobal brain metabolismElevated heart rateComplex physiologic processBlood pressureNonconvulsive seizuresHemorrhage patientsPerfusion pressureSubarachnoid hemorrhageBrain metabolismFunctional outcomeIntracranial pressureSeizure onsetPhysiologic effectsHeart rateOnly seizuresBlood flow
2009
Cortical and subcortical networks in human secondarily generalized tonic–clonic seizures
Blumenfeld H, Varghese GI, Purcaro MJ, Motelow JE, Enev M, McNally KA, Levin AR, Hirsch LJ, Tikofsky R, Zubal IG, Paige AL, Spencer SS. Cortical and subcortical networks in human secondarily generalized tonic–clonic seizures. Brain 2009, 132: 999-1012. PMID: 19339252, PMCID: PMC2724910, DOI: 10.1093/brain/awp028.Peer-Reviewed Original ResearchConceptsGeneralized tonic-clonic seizuresTonic-clonic seizuresFocal CBF increasesCBF increaseAssociation cortexImpaired consciousnessBasal gangliaSubcortical structuresCerebral blood flow changesBlood flow changesPartial seizure onsetLateral cerebellar hemispheresSingle photon emissionStatistical parametric mappingSecondary generalizationCBF decreasePartial seizuresCerebral cortexMotor manifestationsUpper brainstemSeizure onsetCerebellar hemisphereIndividual patientsTemporal lobeSeizure phaseClinical use of ictal SPECT in secondarily generalized tonic–clonic seizures
Varghese GI, Purcaro MJ, Motelow JE, Enev M, McNally KA, Levin AR, Hirsch LJ, Tikofsky R, Paige AL, Zubal IG, Spencer SS, Blumenfeld H. Clinical use of ictal SPECT in secondarily generalized tonic–clonic seizures. Brain 2009, 132: 2102-2113. PMID: 19339251, PMCID: PMC2714057, DOI: 10.1093/brain/awp027.Peer-Reviewed Original ResearchConceptsCerebral blood flow increasesBlood flow increasesGeneralized tonic-clonic seizuresIctal SPECTTonic-clonic seizuresPartial seizuresPost-ictal periodSeizure onsetGeneralized seizuresSecondary generalizationCerebral blood flow decreasesRegional cerebral blood flow increasesPropagation of seizuresBlood flow decreaseCerebral blood flowEpilepsy surgery evaluationUseful clinical toolSingle photon emissionFlow increasesSeizure localizationSurgery evaluationBlood flowSeizuresClinical toolClinical use