Treatment algorithms in refractory partial epilepsy
Barbara C. Jobst,
Barbara C. Jobst
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.
Search for more papers by this authorBarbara C. Jobst,
Barbara C. Jobst
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.
Search for more papers by this authorAddress correspondence to Barbara Jobst, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 02756, (603) 653-6118, U.S.A. E-mail: [email protected]
Summary
An algorithm is a “step-by-step procedure for solving a problem or accomplishing some end....in a finite number of steps.” (Merriam-Webster, 2009). Medical algorithms are decision trees to help with diagnostic and therapeutic decisions. For the treatment of epilepsy there is no generally accepted treatment algorithm, as individual epilepsy centers follow different diagnostic and therapeutic guidelines. This article presents two algorithms to guide decisions in the treatment of refractory partial epilepsy. The treatment algorithm describes a stepwise diagnostic and therapeutic approach to intractable medial temporal and neocortical epilepsy. The surgical algorithm guides decisions in the surgical treatment of neocortical epilepsy.
References
- Andelman F, Kipervasser S, Neufeld MY, Kramer U, Fried I. (2006) Predictive value of Wada memory scores on postoperative learning and memory abilities in patients with intractable epilepsy. J Neurosurg 104: 20–26.
- Berg AT. (2006) Defining intractable epilepsy. Adv Neurol 97: 5–10.
- Berg AT, Vickrey BG, Testa FM, Levy SR, Shinnar S, DiMario F, Smith S. (2006) How long does it take for epilepsy to become intractable? A prospective investigation. Ann Neurol 60: 73–79.
- Binder JR, Sabsevitz DS, Swanson SJ, Hammeke TA, Raghavan M, Mueller WM. (2008) Use of preoperative functional MRI to predict verbal memory decline after temporal lobe epilepsy surgery. Epilepsia 49: 1377–1394.
- Boon P, Vonck K, De Herdt V, Van Dycke A, Goethals M, Goossens L, Van Zandijcke M, De Smedt T, Dewaele I, Achten R, Wadman W, Dewaele F, Caemaert J, Van Roost D. (2007) Deep brain stimulation in patients with refractory temporal lobe epilepsy. Epilepsia 48: 1551–1560.
- Carne RP, O’Brien TJ, Kilpatrick CJ, MacGregor LR, Hicks RJ, Murphy MA, Bowden SC, Kaye AH, Cook MJ. (2004) MRI-negative PET-positive temporal lobe epilepsy: a distinct surgically remediable syndrome. Brain 127: 2276–2285.
- Dodrill CB, Ojemann GA. (1997) An exploratory comparison of three methods of memory assessment with the intracarotid amobarbital procedure. Brain Cogn 33: 210–223.
- Engel J Jr. (1987) Outcome with respect to epileptic seizures. In J Engel (Ed) Surgical treatment of the epilepsies. Raven Press, New York, pp. 553–571.
- Engel J Jr, Wiebe S, French J, Sperling M, Williamson P, Spencer D, Gumnit R, Zahn C, Westbrook E, Enos B. (2003) Practice parameter: temporal lobe and localized neocortical resections for epilepsy: report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurological Surgeons. Neurology 60: 538–547.
- Fisher RS (2008) Non-pharmacological approach: release of the “Stimulation of the Anterior Nucleus of the Thalamus in Epilepsy (SANTE)” Trial Results. American Epilepsy Society Meeting, Seattle, WA.
- Gonzalez-Martinez JA, Srikijvilaikul T, Nair D, Bingaman WE. (2007) Long-term seizure outcome in reoperation after failure of epilepsy surgery. Neurosurgery 60: 873–880. discussion 873–880.
- Haag A, Knake S, Hamer HM, Boesebeck F, Freitag H, Schulz R, Baum P, Helmstaedter C, Wellmer J, Urbach H, Hopp P, Mayer T, Hufnagel A, Jokeit H, Lerche H, Uttner I, Meencke HJ, Meierkord H, Pauli E, Runge U, Saar J, Trinka E, Benke T, Vulliemoz S, Wiegand G, Stephani U, Wieser HG, Rating D, Werhahn K, Noachtar S, Schulze-Bonhage A, Wagner K, Alpherts WC, Boas WE, Rosenow F. (2008) The Wada test in Austrian, Dutch, German, and Swiss epilepsy centers from 2000 to 2005: a review of 1421 procedures. Epilepsy Behav 13: 83–89.
- Jobst BC, Siegel AM, Thadani VM, Roberts DW, Williamson PD. (2000) Intractable seizures of frontal lobe origin. Epilepsia 41: 1139–1152.
- Jobst BC, Williamson PD. (2005) Anatomical-Clinical Localization of Ictal Behavior. In PW Kaplan, RS Fisher (Ed) Imitators of Epilepsy. Demos Medical Publishing, New York, pp. 29–44.
- Jones-Gotman M, Sziklas V, Djordjevic J, Dubeau F, Gotman J, Angle M, Tampieri D, Olivier A, Andermann F. (2005) Etomidate speech and memory test (eSAM): a new drug and improved intracarotid procedure. Neurology 65: 1723–1729.
- Jung WY, Pacia SV, Devinsky R. (1999) Neocortical temporal lobe epilepsy: intracranial EEG features and surgical outcome. J Clin Neurophysiol 16: 419–425.
- Knowlton RC. (2006) The role of FDG-PET, ictal SPECT, and MEG in the epilepsy surgery evaluation. Epilepsy Behav 8: 91–101.
- Knowlton RC, Elgavish RA, Bartolucci A, Oiha B, Limdi N, Blount J, Bureo J, Ver Hoef L, Paige L, Faught E, Kankirawatana P, Riley K, Kuzniecky R. (2008) Functional imaging II. Precidtion of epilepsy surgery outcome. Ann Neurol 64: 35–41.
- Kossoff EH, Rowley H, Sinha SR, Vining EP. (2008) A prospective study of the modified Atkins diet for intractable epilepsy in adults. Epilepsia 49: 316–319.
- Markand ON, Salanova V, Whelihan E, Emsley CL. (2000) Health-related quality of life outcome in medically refractory epilepsy treated with anterior temporal lobectomy. Epilpesia 41: 749–759.
- Merriam-Webster D. (2009) http://www.merriam-webster.com/dictionary/algorithm .
- Natsume J, Bernasconi N, Aghakhani Y, Kumakura Y, Nishikawa M, Fedi M, Soualmi L, Dubeau F, Andermann F, Bernasconi A, Diksic M. (2008) Alpha-[11C]methyl-L-tryptophan uptake in patients with periventricular nodular heterotopia and epilepsy. Epilepsia 49: 826–831.
- O’Brien TJ, So EL, Mullan BP, Hauser MF, Brinkmann BH, Jack CR Jr, Cascino GD, Meyer FB, Sharbrough FW. (1999) Subtraction SPECT co-registered to MRI improves postictal SPECT localization of seizure foci. Neurology 52: 137–146.
- Ojemann JG, Kelley WM. (2002) The frontal lobe role in memory: a review of convergent evidence and implications for the Wada memory test. Epilepsy Behav 3: 309–315.
- Salanova V, Markand O, Worth R. (2005) Temporal lobe epilepsy: analysis of failures and the role of reoperation. Acta Neurol Scand 111: 126–133.
- Siegel AM, Roberts DW, Thadani VM, Jobst BC, Williamson PD. (2001) The role of intracranial electrode re-evaluation in epilepsy patients following failed initial invasive monitoring. Epilepsia 42: 883–888.
- Siegel AM, Cascino GD, Meyer FB, McClelland RL, So EL, Marsh WR, Scheithauer BW, Sharbrough FW. (2004) Resective reoperation for failed epilepsy surgery: seizure outcome in 64 patients. Neurology 63: 2298–2302.
- Spencer SS, Schramm J, Wyler A, O’Connor M, Orbach D, Krauss G, Sperling M, Devinsky O, Elger C, Lesser R, Mulligan L, Westerveld M. (2002) Multiple subpial transection for intractable partial epilepsy: an international meta-analysis. Epilepsia 43: 141–145.
- Thadani VM, Siegel A, Lewis P, Siegel AM, Jobst BC, Gilbert KL, Darcey TM, Roberts DW, Williamson PD. (2004) Validation of ictal single photon emission computed tomography with depth encephalography and epilepsy surgery. Neurosurg Rev 27: 27–33.
- Velasco F, Velasco M, Jimenez F, Velasco AL, Marquez I. (2001) Stimulation of the central median thalamic nucleus for epilepsy. Stereotact Funct Neurosurg 77: 228–232.
- Vining EP, Freeman JM, Ballaban-Gil K, Camfield CS, Camfield PR, Holmes GL, Shinnar S, Shuman R, Trevathan E, Wheless JW. (1998) A multicenter study of the efficacy of the ketogenic diet. Arch Neurol 55: 1433–1437.
- Vonck K, Thadani V, Gilbert K, Dedeurwaerdere S, De Groote L, De Herdt V, Goossens L, Gossiaux F, Achten E, Thiery E, Vingerhoets G, Van Roost D, Caemaert J, De Reuck J, Roberts D, Williamson P, Boon P. (2004) Vagus nerve stimulation for refractory epilepsy: a transatlantic experience. J Clin Neurophysiol 21: 283–289.
- Wiebe S, Blume WT, Girvin JP, Eliasziw M. (2001) A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med 345: 311–318.
- Wieser HG, Blume WT, Fish D, Goldensohn E, Hufnagel A, King D, Sperling MR, Luders H, Pedley TA. (2001) ILAE Commission Report. Proposal for a new classification of outcome with respect to epileptic seizures following epilepsy surgery. Epilepsia 42: 282–286.
- Williamson PD, Thadani VM, French JA, Darcey TM, Spencer SS, Spencer DD, Mattson RH. (1998) Medial temporal lobe epilepsy III. Videotape analysis of objective seizure characteristics. Epilepsia 39: 1182–1188.
- Yang T, Roberts DW, Gilbert KL, Thadani VM, Darcey TM, Holmes GL, Morse RP, Duhaime AC, Williamson PD, Jobst BC. (2008) Long term seizure prognosis after intracranial EEG evaluation. Epilepsia 49: 308.
- Yun CH, Lee SK, Lee SY, Kim KK, Jeong SW, Chung CK. (2006) Prognostic factors in neocortical epilepsy surgery: multivariate analysis. Epilepsia 47: 574–579.
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