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Atman Desai, Barbara C. Jobst, Vijay M. Thadani, Krzysztof A. Bujarski, Karen Gilbert, Terrance M. Darcey and David W. Roberts

neurological deficits. In the remaining 13 patients, shown to be without insular involvement in their seizures, exclusion of the insula helped support and confirm seizure onset in other regions. Previous Reports of Direct Insular SEEG Recording The role of the insula in seizure onset has received increasing interest over the past decade, 1 , 8 , 12–14 , 16 , 17 , 23 , 24 , 29 during which time several groups have published reports documenting the use of intracranial monitoring electrodes implanted into the insula using a variety of methods to investigate seizure onset

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Michael R. Levitt, Jeffrey G. Ojemann and John Kuratani

, : Neurophysiological monitoring for epilepsy surgery: the Talairach SEEG method. Stereo Electro Encephalo Graphy Indications, results, complications and therapeutic applications in a series of 100 consecutive cases . Stereotact Funct Neurosurg 77 : 29 – 32 , 2001 4 Isnard J , Guénot M , Ostrowsky K , Sindou M , Mauguière F : The role of the insular cortex in temporal lobe epilepsy . Ann Neurol 48 : 614 – 623 , 2000 5 Nguyen DK , Nguyen DB , Malak R , Leroux JM , Carmant L , Saint-Hilaire JM , : Revisiting the role of the insula in

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Zulma Tovar-Spinoza, Robert Ziechmann and Stephanie Zyck

our study is that we did not use invasive EEG monitoring to localize our surgical targets. However, intracranial EEG using stereoelectroencephalography (SEEG) may prove to be useful in the future to more accurately define seizure foci and propagation in a minimally invasive fashion. One could also consider converting a trajectory from SEEG to laser ablation in a single stage. The use of SEEG-guided thermocoagulation for epileptic foci has been described previously. 19 To our knowledge, the use of this technique for patients with tuberous sclerosis has not yet been

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Bertrand Demierre, Falko A. Stichnoth, Akira Hori and Otto Spoerri

J , Geier S , et al : E.E.G. et S.E.E.G. dans les Tumeurs Cérébrales et l'Épilepsie. Paris : Edifor , 1973 , 351 pp Bancaud J, Talairach J, Geier S, et al: E.E.G. et S.E.E.G. dans les Tumeurs Cérébrales et l'Épilepsie. Paris: Edifor, 1973,351 pp 3. Bevilacqua G , Sarnelli R : Ganglioglioma of the spinal cord. A case with a long survival Acta Neuropathol 48 : 239 – 242 , 1979 Bevilacqua G, Sarnelli R: Ganglioglioma of the spinal cord. A case with a long survival Acta Neuropathol 48: 239

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Matthew A. Howard III, Igor O. Volkov, Mark A. Granner, Hanna M. Damasio, Michael C. Ollendieck and Hans E. Bakken

. Electroencephalogr Clin Neurophysiol 40 : 225 – 243 , 1976 Babb TL, Crandall PH: Epileptogenesis of human limbic neurons in psychomotor epileptics. Electroencephalogr Clin Neurophysiol 40: 225–243, 1976 2. Babb TL , Wilson CL , Isokawa-Akesson M : Firing patterns of human limbic neurons during stereoencephalography (SEEG) and clinical temporal lobe seizures. Electroencephalogr Clin Neurophysiol 66 : 467 – 482 , 1987 Babb TL, Wilson CL, Isokawa-Akesson M: Firing patterns of human limbic neurons during

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Jean-François Hirsch, Christian Sainte Rose, Alain Pierre-Kahn, André Pfister and Elizabeth Hoppe-Hirsch

l'enfant. Arch Fr Pediatr 27: 1041–1055, 1970 3. Bancaud J , Talairach J , Geier S , et al : EEG et SEEG dans les Tumeurs Cérébrales et dans l'Épilepsie. Paris : Edifor , 1973 , p 9 Bancaud J, Talairach J, Geier S, et al: EEG et SEEG dans les Tumeurs Cérébrales et dans l'Épilepsie. Paris: Edifor, 1973, p 9 4. Bloom HJG : Intracranial tumors: response and resistance to therapeutic endeavours 1970–1980. Int J Radiat Oncol Biol Phys 8 : 1083 – 1113 , 1982 Bloom HJG: Intracranial

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Krasimir Minkin, Olivier Klein, Josette Mancini and Gabriel Lena

T, F, O, P SEEG (1 case) LE, LE & AHE 6.7 (1–16) 83.3 * AHE = amygdalohippocampectomy; ECoG = electrocorticography; F = frontal; iEEG = invasive EEG; LE = lesionectomy; NA = not available; O = occipital; P = parietal; SEEG = stereo-EEG; T = temporal; — = not specified. † Report included 27 DNTs, 3 gangliogliomas, and 1 hamartoma. Our data are consistent with the conclusion of other authors who argued that the run-down phenomenon after resection of DNTs was not significant. 1 , 4 Luyken et al. 18 reported a very stable percentage of seizure

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Jonathan Pindrik, Nguyen Hoang, Luke Smith, Mark Halverson, Mary Wojnaroski, Kelly McNally, Satyanarayana Gedela and Adam P. Ostendorf

success with ESM). 52 Newer paradigms offer the potential for less-invasive strategies in the evaluation and treatment of patients with DRE. While applied more frequently in older children and adults, stereotactic electroencephalography (SEEG) with robotic-arm assistance and stereotactic thermal coagulation or laser ablation (SLA) represent minimally invasive options. Cossu et al. performed a retrospective study of a series of young children (8/15 < 36 months of age) undergoing SEEG for DRE and reported acceptable mortality (1/15), morbidity, and success rates (80

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Koloa, Hawaii •January 27–February 1, 2019

borders, EEG-fMRI and advanced MRI post-processing with voxel-based methods were performed. Finally, if these combined methods did not provide a good definition of the EZ, intracranial recordings, preferably with stereoelectroencephalography (SEEG), was used. The goal of the current study is to examine preliminary data on how our new pre-surgical evaluation strategy has impacted post-surgical outcomes for poorly defined cases (PDCs) of pediatric focal epilepsy. Methods Chart and imaging review was performed for PDCs of focal epilepsy who followed the new pre

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Yasunori Nagahama, Alan J. Schmitt, Brian J. Dlouhy, Adam S. Vesole, Phillip E. Gander, Christopher K. Kovach, Daichi Nakagawa, Mark A. Granner, Matthew A. Howard III and Hiroto Kawasaki

temporal cortex forms the ventral bank of the sylvian fissure and immediately abuts the branches of the middle cerebral artery and peri-sylvian veins. One well-established method for obtaining electrode coverage in this area involves use of stereo-electroencephalography (SEEG). 9 , 16 Orthogonally placed depth electrodes inserted through the temporal operculum into the insula have been utilized in SEEG in suspected TLE with insular involvement. 5 , 6 The SEEG approach enables image-guided stereotactic placement of multiple depth electrodes via electrode trajectories