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191


Macro- and microelectrode recordings show complex spatiotemporal evolution of focal seizures in human epilepsy [Meeting Abstract]

Madsen, J; Bromfield, E; Wang, C; Mehta, A; Doyle, W; Devinsky, O; Ulbert, I; Melinosky, C; Meng, N; Cash, SS; Halgren, E
ISI:000241385501064
ISSN: 0013-9580
CID: 69538

Race/ethnicity, sex, and socioeconomic status as predictors of outcome after surgery for temporal lobe epilepsy

Burneo, Jorge G; Black, Lorie; Martin, Roy; Devinsky, Orrin; Pacia, Steve; Faught, Edward; Vasquez, Blanca; Knowlton, Robert C; Luciano, Daniel; Doyle, Werner; Najjar, Sohuel; Kuzniecky, Ruben I
BACKGROUND: Several risk factors have been attributed to seizure recurrence after surgery. It is unknown whether race/ethnicity plays a role in outcome. OBJECTIVE: To evaluate whether race/ethnicity plays a role in seizure recurrence after surgery. DESIGN: Cohort study. SETTING: We evaluated data obtained from the epilepsy centers at the University of Alabama at Birmingham and New York University, New York, NY. PATIENTS: All patients included had a diagnosis of mesial temporal sclerosis and underwent temporal lobectomy. MAIN OUTCOME MEASURES: Occurrence of seizure after surgery was registered 1 year after surgery. We used multiple logistic regression analysis to model the presence of seizure recurrence after surgery and generated odds ratios (ORs) for seizure recurrence after surgery for African American and Hispanic patients relative to white patients. An unadjusted model incorporated only race/ethnicity as the independent variable, and an adjusted model included socioeconomic status, age, duration of epilepsy, education, history of febrile seizures, sex, handedness, lateralization of epileptogenic focus, and number of antiepileptics as the independent variables. RESULTS: Two hundred fifty-two patients underwent surgical treatment with pathological confirmation of mesial temporal sclerosis. No differences were found between racial/ethnic groups in terms of seizure recurrence in any models. For African American patients, the ORs were 0.9 (95% confidence interval [CI], 0.4-2.1) for the unadjusted model and 0.8 (95% CI, 0.3-2.0) for the adjusted model; for Hispanic patients, the ORs were 1.6 (95% CI, 0.8-3.2) for the unadjusted model and 1.1 (95% CI, 0.5-2.6) for the adjusted model, relative to white patients. CONCLUSION: Our data suggest that although sex appears to play a role in the outcomes of surgery for temporal lobe epilepsy, race and socioeconomic status do not
PMID: 16908736
ISSN: 0003-9942
CID: 69045

Pediatric language mapping: Sensitivity of neurostimulation and Wada testing in epilepsy surgery [Meeting Abstract]

Weiner, HL; Schevon, C; Carlson, C; Doyle, W; Miles, D; LaJoie, J; Kuzniecky, R; Devinsky, O
ISI:000239763800141
ISSN: 0148-396x
CID: 104252

Subpectoral implantation of the vagus nerve stimulator

Bauman, Joel A; Ridgway, Emily B; Devinsky, Orrin; Doyle, Werner K
OBJECTIVE: To report the technique of subpectoral (SP) implantation of the vagus nerve stimulator (VNS) generator. METHODS: We retrospectively reviewed and compared demographics and complications from patients receiving either subcutaneous (SQ; n = 107) or SP (n = 138) VNS implants, performed by one surgeon (WKD) between 1999 and 2003. Selection of implant location was made during the preoperative surgeon-patient consultation on the basis of surgeon recommendation and patient preference. RESULTS: The standard VNS generator implantation is performed within a SQ pocket in the left infraclavicular region of the chest. We have modified this technique by placing the generator into a deeper pocket SP, beneath the pectoralis major muscle, while tunneling the electrodes SQ in the usual fashion. The SP group was substantially younger (median age 19 yr) compared with the SQ group (median age 29 yr). At an average follow-up of 52 months for SQ implants and 28.4 months for SP implants, there were 2.9% infections per patient in the SQ group and 2.5% infections per patient in the SP group. There were three cases of excessive generator mobility in the SQ group; no cases occurred in the SP group. CONCLUSION: The SP implantation technique provides an attractive alternative to SQ VNS implantation. With increased soft tissue coverage, we provide improved cosmesis, increased wound durability to tampering and trauma, and a comparable infection rate with the SQ group
PMID: 16582656
ISSN: 1524-4040
CID: 64237

Magnetic source imaging for pre-surgical lateralization of refractory epilepsy [Meeting Abstract]

Carlson, C; Schevon, C; Stout, J; Nadkami, S; Doyle, W; Weiner, H; Pacia, S; Devinsky, O; Kuzniecky, R
ISI:000241385500012
ISSN: 0013-9580
CID: 104248

Acute language changes following epilepsy surgery [Meeting Abstract]

Morrison, CE; Barr, WB; Doyle, W; Carlson, C; Zaroff, CM; Devinsky, O
ISI:000241385500283
ISSN: 0013-9580
CID: 104251

Spatio-temporal stages in word processing: Intracranial-recorded potentials and current source density in the human frontal, temporal and occipital cortices [Meeting Abstract]

Wang, CM; Ulbert, I; Doyle, WK; Devinsky, O; Kuzniecky, R; Halgren, A
ISI:000232540101322
ISSN: 0013-9580
CID: 98090

Lamiinar microelectrode recordings of human interictal discharges in neocortical epilepsy reveal complex high-frequency oscillation patterns [Meeting Abstract]

Cash, SS; Ulbert, I; Devinsky, O; Bromfield, E; Madsen, J; Cole, A; Halgren, E; Doyle, W
ISI:000232540100271
ISSN: 0013-9580
CID: 59585

Time-frequency analysis as an adjunct to intracranial EEG interpretation [Meeting Abstract]

Carlson, C; Schevon, C; Doyle, W; Weiner, H; Cappell, J; Emerson, R; Hirsch, A; Goodman, R; Devinsky, O; Pacia, S; Kuzniecky, R
ISI:000232540101295
ISSN: 0013-9580
CID: 59590

Local hypersynchrony in intracranial EEG recordings [Meeting Abstract]

Schevon, C; Cappell, J; Doyle, W; Weiner, H; Goodman, R; Kuzniecky, R; Emerson, R
ISI:000232540101316
ISSN: 0013-9580
CID: 59592