Handforth (UCLA) 1 Bitemporal epilepsy 50% Epilepsia 2006 1 Frontal encephalomalacia 33% 1 > 50% Neme (Santiago) 3 < 50% (VNS) see p. E23 >> (RNS) (TMS) - cortical stimulation results vary (some studies show ne efficacy). Randomized Double Blind Sham Controlled Trials Theodore (NIH) 2002 Fregni (Sao Paulo) 2006 Cantello (Multicenter Neurology Ann Neurol Italy) 2007 Epilepsia N 24 21 43 Mesial TLE 10 Sz Type Lateral TLE 10 mTLE 7 neocortical /Location Frontal 3 Neocortical 34 Parietal 1 Postraumatic 6 all malformation of MTS 5 all lesions except MS MRI cortical development Hemiatrophy 4 were excluded (MCD) Cortical dysplasia 2 Tuberous Sclerosis 1 in 17, MRI abnormality EEG identified seizure Stim Target in 4 with diffuse vertex Vertex focus MCD 1 Hz, 70% max coil Stim 1 Hz, 120% MT, 900 0.3Hz, 120% MT, output, 1,200 stim/day x Parameters stim bid x 7 days 1,000 stim/day x5 days 5 days
Handforth (UCLA) Epilepsia 2006 1 Bitemporal epilepsy 50% 1 Frontal encephalomalacia 33% Neme (Santiago) 1 > 50% 3 < 50% (VNS) see p. E23 >> (RNS) (TMS) - cortical stimulation results vary (some studies show ne efficacy). Randomized Double Blind Sham Controlled Trials Theodore (NIH) 2002 Neurology Fregni (Sao Paulo) 2006 Ann Neurol Cantello (Multicenter Italy) 2007 Epilepsia N 24 21 43 Sz Type /Location Mesial TLE 10 Lateral TLE 10 Frontal 3 Parietal 1 neocortical mTLE 7 Neocortical 34 MRI all lesions except MS were excluded all malformation of cortical development (MCD) Postraumatic 6 MTS 5 Hemiatrophy 4 Cortical dysplasia 2 Tuberous Sclerosis 1 Stim Target EEG identified seizure focus MRI abnormality in 17, vertex in 4 with diffuse MCD Vertex Stim Parameters 1 Hz, 120% MT, 900 stim bid x 7 days 1 Hz, 70% max coil output, 1,200 stim/day x 5 days 0.3Hz, 120% MT, 1,000 stim/day x5 days
E11.%20Epilepsy%20-%20Surgical%20Treatment.docx