1. Click to edit Master subtitle style Epilepsy Surgery & Neuroimaging Techniques By Morgan Hammick BME 281, Section 2

2. The Brain Often compared to an organic computer There are 6 major divisions of the adult brain Contains roughly 20 billion neurons Contains almost 95% of the body’s neural tissue Averagely weights 1.4 kg (3 lbs) Male brains are ~10% larger than females

3. Epilepsy A medical condition that produces seizures affecting a variety of mental and physical functions 1 in 10 adults will have a seizure in their life time Seizures are classified into 2 groups Symptomatic & Cryptogenic Causes of seizures are further divided into 2 groups Acute & Remote 1990- 70% cryptogenic and 30% remote

4. What Happens? 1. Non-invasive diagnostics 2. Electrode Implantation 1. Based off suspected epileptogenic zone 3. Brain Mapping 1. Using electrodes, MRI, EEG, and CT 2. Gives a better assessment of the risks and benefits of the resection surgery 4. Resection Surgery

5. Materials Types of electrodes Microwire electrodes Wires made of conducting metal coated with a non-cytotoxic insulator material. One array can consist of anywhere from 4 to over 100 wires Silicon-based electrodes Allow a more complex design and greater control over the electrode placement Unreliable for chronic recording in the CNS

6. Benefits Neuroimaging has revolutionized the care of patients More accurate diagnosis Reduced morbidity

7. Risks There is always a risk with invasive EEGs Nonreversible brain damage About 1% craniotomies Infection Memory Loss Partial Paralysis Surgery is only considered for patients who have no other options

8. Costs About 2 million people in the US have epilepsy $15.5 billion in direct & indirect costs $50,000 - $200,00 There are insurance companies that partially cover associated costs with epilepsy

9. Sources Martini, Frederic H., Michael J. Timmons, and Robert B. Tallitsch. "The Nervous System: The Brain and Cranial Nerves." Human Anatomy. 7th ed. Boston: Pearson Benjamin Cummings, 2012. 406. Print. "What Is Epilepsy." Epilepsy Foundation. Epilepsy Foundation of America, 2012. Web. 19 Oct. 2013.. “Causes of Epilepsy”. Epilepsy Foundation. Epilepsy Foundation of America, 2012. Web. 19 Oct. 2013.. Taimouri, V., A. Akhondi-Asl, X. Tomas- Fernandez, J. M. Peters, S. P. Prabhu, A. Poduri, M. Takeoka, T. Loddenkemper, A. M. Bergin, C. Harini, J. R. Madsen, and S. K. Warfield. "Electrode Localization for Planning Surgical Resection of the Epileptogenic Zone in Pediatric Epilepsy." International Journal of Computer Assisted Radiology and Surgery (2013): n. pag. Abstract. PubMed (n.d.): n. pag. Print. Polikov, V., P. Tresco, and W. Reichert. "Response of Brain Tissue to Chronically Implanted Neural Electrodes." Journal of Neuroscience Methods 148.1 (2005): 1-18. Print. Passaro, Erasmo A. "Neuroimaging in Epilepsy." Neuroimaging in Epilepsy. Ed. Selim R. Benbadis. Medscape, 11 July 2013. Web. 20 Oct. 2013.. "Comprehensive Epilepsy Center." Risks of Epilepsy Surgery. NYU Langone Medical Center, n.d. Web. 21 Oct. 2013.. "Epilepsy Surgery for Adults." Epilepsy Action. Epilepsy Action, n.d. Web. 20 Oct. 2013.. "Targeting Epilepsy." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 06 June 2011. Web. 21 Oct. 2013.. "Epilepsy Surgery Facts." One Fact One Fight For Epilepsy. N.p., 21 June 2010. Web. 20 Oct. 2013.. Morace, Roberta, Giancarlo Di Gennaro, Angelo Picardi, Addolorata Macia, Giulio Meldolesi, Liliana Grammaldo, Pier Quarato, Vincenzo Esposito, Antonio Sparano, and Marco Risi. "Surgery after Intracranial Investigation with Subdural Electrodes in Patients with Drug-resistant Focal Epilepsy: Outcome and Complications." Neurosurgical Review (2012): n. pag. Springer Link. Web. 21 Oct. 2013..