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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with an early onset of temporal lobe epilepsy (TLE) are at an increased risk for language reorganization. It is unknown whether this reorganization involves a full shift of all language skills to the contralateral hemisphere, or whether it can be partial and involve only a subset of language skills. In this study we report dominance concordance patterns for five separate language skills measured during the Intracarotid Amobarbital Procedure (IAP) for 124 TLE patients. We examined whether the language skills show similar or independent lateralization patterns. We compare these patterns in early versus late seizure onset groups with either a left or right temporal lobe seizure focus. The data showed that the rates of atypical representation ranged from 25.8% for reading to 14.5% of the sample for speech. A majority of patients (60%) showing atypical language representation do so on more than one skill. While multiple atypicalities were common, the proportion of patients showing atypical representation on all five skills was strikingly low (5.6% of the total sample). Our data suggest that language systems are not independent and do not shift and reorganize in isolation, and no pairs of skills seem more likely to reorganize than others. There was also evidence that language is not monolithic with all language skills reorganizing together. The latter suggests that the pressures compelling atypical representation may not work equally on all language skills.
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PMID:Hemispheric lateralization and language skill coherence in temporal lobe epilepsy. 1928 72

Pediatric cerebral angiography is a commonly performed procedure and its performance has many similarities to the technique used in adults. However, some notable differences exist, especially in the nuances of arterial access, catheter manipulation, patient sedation, and fluid/radiocontrast load. A thorough understanding of cerebral angiography and its application to pediatric patients is imperative to ensure appropriate selection of patients requiring cerebral angiography and to minimize risk while obtaining the desired information. The intracarotid sodium Amytal injection (Wada) test is a specialized procedure performed in the workup of patients with seizure disorders who are being considered for surgical resective therapy. However, Wada testing in children poses unique challenges, as will be discussed in this paper. Specific aspects of performing the Wada test in the pediatric setting, anatomic considerations and contraindications, and the relevance of the Wada test in comparison with noninvasive tools, such as functional magnetic resonance imaging, will be discussed.
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PMID:Diagnostic cerebral angiography and the Wada test in pediatric patients. 2133 92

During the author's clinical activity at three institutes : Kyoto University Hospital (Kyoto 1965-1969, 1977-1985), National Cardiovascular Center NCVC (Osaka 1986-1992) and Zurich University Hospital (Zurich 1970-1976, 1993-2007), He has experienced (underlined periods) working with PET scan and SPECT in relation to microsurgical treatment. The following describes how and for what the author has been engaged in this regard. 1. As preparation for the work with PET, SPECT with a rotating gamma camera was used to know blood distribution with the use of Kr-81m infusion from a selectively located catheter in the ICA, ECA or VA, e.g. to know the flow distribution of a newly constructed EC-IC bypass, which was quite separated from and not mixed up with that of already functioning inherent collaterals (Fig. 1). 2. With the use of inhalation PET scan (15O labelled CO2 and O2 inhalation and 15O CO inhalation) basic knowledge of hemodynamics of MMD was acquired (Fig. 2) 3. With the use of H215 O-PET scan with DiamoxR loading, indication for and effectiveness of EC-IC bypass surgery for occlusive cerebrovascular disease (atherosclerosis (anterior circulation (Fig. 5), posterior circulation (Fig. 6, 7)), MMD (Fig. 9), congenital disease (Fig. 8) have been settled or demonstrated. 4. In epileptic seizures, interictally or intraictally, the active locus has been identified by the use of FDG-PET, flumazenil-PET, H 2 15 O or 13 NH 3-PET respectively (Fig. 12). In this relation, selective Wada test with the use of Tc-99 m-ECD selective infusion together with Amytal R through a catheter inserted selectively into the anterior choroidal artery is an important preoperative test for the SAHE (Fig. 13). 5. FDG-PET and/or tyrosine PET supply important clues concerning appropriate surgical treatment strategy, and also for intractable glioblastoma or high grade glioma, so that in combination with radiotherapy and chemotherapy one may expect more excellent long term outcome with good quality of life (Fig. 16, 17). Furthermore, there must be cases with dementia in which some revascularization procedure might be of help, for which FDG-and H 2 15O-PET could be helpful for differential diagnosis and indication of surgery (Fig. 18).
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PMID:[Operative neurosurgery: Personal view and historical backgrounds. (10) Microneurosurgery and PET scan: clinical experience of a neurosurgeon]. 2291 4


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