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Clinical Neurophysiology : Official... Mar 2021As the field of noninvasive brain stimulation (NIBS) expands, there is a growing need for comprehensive guidelines on training practitioners in the safe and effective... (Review)
Review
As the field of noninvasive brain stimulation (NIBS) expands, there is a growing need for comprehensive guidelines on training practitioners in the safe and effective administration of NIBS techniques in their various research and clinical applications. This article provides recommendations on the structure and content of this training. Three different types of practitioners are considered (Technicians, Clinicians, and Scientists), to attempt to cover the range of education and responsibilities of practitioners in NIBS from the laboratory to the clinic. Basic or core competencies and more advanced knowledge and skills are discussed, and recommendations offered regarding didactic and practical curricular components. We encourage individual licensing and governing bodies to implement these guidelines.
Topics: Brain; Clinical Competence; Humans; Practice Guidelines as Topic; Stereotaxic Techniques; Transcranial Direct Current Stimulation; Transcranial Magnetic Stimulation
PubMed: 33549501
DOI: 10.1016/j.clinph.2020.11.018 -
Neurologia Medico-chirurgica Aug 2017Stereoelectroencephalography (SEEG) is a method for invasive study of patients with refractory epilepsy. Localization of the epileptogenic zone in SEEG relied on the... (Comparative Study)
Comparative Study Review
Stereoelectroencephalography (SEEG) is a method for invasive study of patients with refractory epilepsy. Localization of the epileptogenic zone in SEEG relied on the hypothesis of anatomo-electro-clinical analysis limited by X-ray, analog electroencephalography (EEG), and seizure semiology in the 1950s. Modern neuroimaging studies and digital video-EEG have developed the hypothesis aiming at more precise localization of the epileptic network. Certain clinical scenarios favor SEEG over subdural EEG (SDEEG). SEEG can cover extensive areas of bilateral hemispheres with highly accurate sampling from sulcal areas and deep brain structures. A hybrid technique of SEEG and subdural strip electrode placement has been reported to overcome the SEEG limitations of poor functional mapping. Technological advances including acquisition of three-dimensional angiography and magnetic resonance image (MRI) in frameless conditions, advanced multimodal planning, and robot-assisted implantation have contributed to the accuracy and safety of electrode implantation in a simplified fashion. A recent meta-analysis of the safety of SEEG concluded the low value of the pooled prevalence for all complications. The complications of SEEG were significantly less than those of SDEEG. The removal of electrodes for SEEG was much simpler than for SDEEG and allowed sufficient time for data analysis, discussion, and consensus for both patients and physicians before the proceeding treatment. Furthermore, SEEG is applicable as a therapeutic alternative for deep-seated lesions, e.g., nodular heterotopia, in nonoperative epilepsies using SEEG-guided radiofrequency thermocoagulation. We review the SEEG method with technological advances for planning and implantation of electrodes. We highlight the indication and efficacy, advantages and disadvantages of SEEG compared with SDEEG.
Topics: Brain Mapping; Cerebral Cortex; Drug Resistant Epilepsy; Electrodes, Implanted; Electroencephalography; Encephalitis; Epilepsies, Partial; Humans; Intracranial Hemorrhages; Magnetic Resonance Imaging; Neuroimaging; Neuronavigation; Preoperative Care; Robotics; Stereotaxic Techniques
PubMed: 28637943
DOI: 10.2176/nmc.ra.2017-0008 -
Seizure Apr 2020Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC) consists of coupling SEEG investigation with RF-TC stereotactic lesioning... (Review)
Review
Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC) consists of coupling SEEG investigation with RF-TC stereotactic lesioning directly through the recording electrodes. In this systematic review the surgical technique, indications, and outcomes are described. Maximum accuracy is reached when a frame-based procedure with a robotic assistance and a per-operative vascular X-ray imaging are performed. Monitoring of the lesioning procedure based on the impedance, a sharp modification of which indicates that the thermocoagulation has reached its maximum volume, allows the optimization of the lesion size. The first indication concerns patients in whom a SEEG is required to determine whether surgery is feasible and in whom resection is indeed possible. Even if surgery is performed owing to insufficient efficacy of SEEG-guided RF-TC, the procedure remains interesting owing to its high positive predictive value for good outcome after surgery. The second indication concerns patients in whom phase I non-invasive investigations have concluded to surgical contraindication and who may still undergo SEEG in a purely therapeutic perspective (small deep zones inaccessible to surgery and network nodes of large epileptic networks). Lastly, SEEG-guided RF-TC can be considered as a first-line treatment for periventricular nodular heterotopia (PNH). Independently of indication, the overall seizure-free rate is 23% and the responder rate is 58%. The best results are obtained for PNH (38% seizure-free and 81% responders), while the worst results have been reported for temporal lobe-epilepsy in a dedicated study. The overall complication rate is 2.5%. More evidence is needed to help determine the exact place of SEEG-guided RF-TC in the surgical management algorithm.
Topics: Drug Resistant Epilepsy; Electrocoagulation; Electrocorticography; Epilepsies, Partial; Humans; Periventricular Nodular Heterotopia; Stereotaxic Techniques
PubMed: 30711397
DOI: 10.1016/j.seizure.2019.01.021 -
Neurosurgical Review Jun 2020Beginning with basic stereotactic operative methods in neurosurgery, intraoperative navigation and image guidance systems have since become the norm in that field.... (Review)
Review
Beginning with basic stereotactic operative methods in neurosurgery, intraoperative navigation and image guidance systems have since become the norm in that field. Following the introduction of image guidance into spinal surgery, there has been a dramatic increase in its utilization across disciplines and pathologies. Spine tumor surgery encompasses a wide range of complex surgical techniques and treatment strategies. Similarly to deformity correction and trauma surgery, spine navigation holds potential to improve outcomes and optimize surgical technique for spinal tumors. Recent data demonstrate the applicability of neuro-navigation in the field of spinal oncology, particularly for spinal stabilization, maximizing extent of resection and integration of minimally invasive therapies. The rapid introduction of new, less invasive, and ablative surgical techniques in spine oncology coupled with the rising incidence of spinal metastatic disease make it imperative for spine surgeons to be familiar with the indications for and limitations of imaging guidance. Herein, we provide a practical, current concepts narrative review on the use of spinal navigation in three areas of spinal oncology: (a) extent of tumor resection, (b) spinal column stabilization, and (c) focal ablation techniques.
Topics: Humans; Imaging, Three-Dimensional; Minimally Invasive Surgical Procedures; Neurosurgical Procedures; Spinal Neoplasms; Spine; Stereotaxic Techniques; Surgery, Computer-Assisted
PubMed: 31154546
DOI: 10.1007/s10143-019-01123-2 -
Seizure Jan 2017Intracranial EEG (iEEG) recordings are widely used for the work up of pharmacoresistant epilepsy. Different iEEG recording techniques namely subdural grids, strips,... (Review)
Review
Intracranial EEG (iEEG) recordings are widely used for the work up of pharmacoresistant epilepsy. Different iEEG recording techniques namely subdural grids, strips, depth electrodes and stereoencephalography (SEEG) are available with distinct limitations and advantages. Epilepsy centres mastering multiple techniques apply them in an individualised patient approach. These tools are used to map the seizure onset zone which is pivotal in approximating the epileptogenic zone, i.e. the zone which is indispensable for the generation of seizures and when resected will render the patient seizure free. Besides, the implanted electrodes can be used to define eloquent cortex through direct cortical stimulation. Different clinical scenarios exist which favour one iEEG recording technique over the other. Proximity of the presumed epileptogenic zone to eloquent cortex, for example, is a clinical scenario which may favour grid electrodes over SEEG. We here review the indication for iEEG for the work-up of patients suffering from pharmacoresistant epilepsy. In addition, we provide a description of the recording techniques focussing on the main techniques used: grid electrodes, depth electrodes and stereoencephalography. We then outline different clinical scenarios and the preferred technical approach for intracranial recordings in these scenarios. Finally, we highlight which advances have been made in the field of iEEG and which advances are in the pipeline waiting to be established for clinical use. This review provides the clinician with an update on the diagnostic use of intracranial EEG for epilepsy surgery and thus aids in understanding patient selection for this technique which may ultimately improve referral patterns.
Topics: Electroencephalography; Epilepsy; Humans; Neurologic Examination; Neurosurgical Procedures; Stereotaxic Techniques
PubMed: 27816354
DOI: 10.1016/j.seizure.2016.10.016 -
The Western Journal of Medicine 1996
Topics: Brain Neoplasms; Glioblastoma; Humans; Intracranial Arteriovenous Malformations; Neuroma, Acoustic; Radiosurgery; Retrospective Studies; Stereotaxic Techniques; Treatment Outcome
PubMed: 8855694
DOI: No ID Found -
British Medical Journal Jul 1973
Topics: Ethics, Medical; Humans; Methods; Psychosurgery; Schizophrenia; Stereotaxic Techniques
PubMed: 4577721
DOI: 10.1136/bmj.3.5870.50-a -
The New England Journal of Medicine Oct 2014
Topics: Anti-Infective Agents; Brain Abscess; Humans; Stereotaxic Techniques
PubMed: 25354114
DOI: 10.1056/NEJMc1410501 -
Journal of Neurology, Neurosurgery, and... Sep 1983The development and scope of stereotactic radiosurgery is described. The technique, which combines well with the latest diagnostic methods, has already proved a safe and...
The development and scope of stereotactic radiosurgery is described. The technique, which combines well with the latest diagnostic methods, has already proved a safe and effective way of treating inaccessible cerebral lesions and in particular small arteriovenous malformations, acoustic neuroma and the solid component of craniopharyngioma, as well as playing an increasingly useful role in the therapy of pituitary adenoma.
Topics: Adenoma; Brain Diseases; Brain Neoplasms; Craniopharyngioma; Gamma Rays; Humans; Intracranial Arteriovenous Malformations; Neuroma, Acoustic; Pituitary Neoplasms; Stereotaxic Techniques; Tomography, X-Ray Computed
PubMed: 6352865
DOI: 10.1136/jnnp.46.9.797 -
Stereotactic and Functional Neurosurgery 2021
Topics: Humans; Imaging, Three-Dimensional; Neurosurgery; Neurosurgical Procedures; Stereotaxic Techniques
PubMed: 34587613
DOI: 10.1159/000519243