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Printable Handouts
Navigable Slide Index
- Introduction
- Epidemiology
- "The falling sickness"
- Hippocrates (400 BC) (1)
- Hippocrates: “On the Sacred Disease” (1)
- Hippocrates: “On the Sacred Disease” (2)
- Hippocrates (400 BC) (2)
- History of epilepsy - Christianity
- St. Valentine - patron of epilepsy (1)
- St. Valentine - patron of epilepsy (2)
- J Hughlings Jackson (1835-1911) (1)
- J Hughlings Jackson (1835-1911) (2)
- Dr. Victor Horsley
- J Hughlings Jackson - 1880’s
- Institute of Medicine - Consensus report
- Economic burden
- Co-morbidity
- Improvement in quality of life
- Adverse effects
- Epilepsy in resource-poor countries (1)
- 40% in China are untreated
- Epilepsy in resource-poor countries (2)
- Focal (partial) epilepsy
- Video: focal epilepsy
- Right temporal spikes
- Right frontal spikes
- Recorded right temporal lobe seizure
- Right frontal seizure discharge
- Focal seizure disorder
- MRI image: focal seizure disorder (1)
- MRI image: focal seizure disorder (2)
- Reasons for seizures
- Substrate-directed pathology
- MRI image: left temporal lobe seizure
- MRI image: patient with glioma
- MRI image: patient with glial neoplasm
- MRI image: patient with cavernous hemangioma
- Malformations
- Types of focal cortical dysplasia
- Focal cortical dysplasia in MRI
- MRI image: malformations (1)
- MRI image: malformations (2)
- MRI image: malformations (3)
- MRI image: subtle alterations (1)
- MRI image: subtle alterations (2)
- Mesial temporal sclerosis
- MRI image: mesial temporal sclerosis (1)
- MRI image: mesial temporal sclerosis (2)
- MRI and mesial temporal sclerosis
- Focal epilepsy: PET and glucose metabolism
- Inter-ictal PET study
- Imaging and MTLE
- Goals of therapy (1)
- Goals of therapy (2)
- Efficacy of treatment (1)
- Efficacy of treatment (2)
- Treatment strategies
- Surgical candidates
- Epilepsy surgery
- Comparative study
- Long-term outcome
- Seizure-free outcome
- MRI image: epilepsy surgery (1)
- MRI image: epilepsy surgery (2)
- MRI image: epilepsy surgery (3)
- Temporal lobe epilepsy - “normal MRI”
- Surgery: normal MRI (1)
- Surgery: normal MRI (2)
- Non-lesional surgery
- PET + and MRI -
- Trends in epilepsy surgery 1993-2009
- Non-lesional epilepsy - neocortical onset
- Intracranial monitoring (1)
- Intracranial monitoring (2)
- Intracranial monitoring (3)
- Partial epilepsy - SPECT
- SISCOM - Mayo protocol
- SISCOM
- Statistical SPECT processing
- Images: statistical SPECT processing (1)
- Images: statistical SPECT processing (2)
- Images: statistical SPECT processing (3)
- Extratemporal - “normal MRI”
- Extratemporal epilepsy - non-lesional surgery (1)
- Extratemporal epilepsy - non-lesional surgery (2)
- Extratemporal epilepsy - non-lesional surgery (3)
- Extratemporal epilepsy - non-lesional surgery (4)
- Intractable epilepsy - cavernous hemangiomas
- Temporal lobe low grade neoplasms
- Surgical outcome - focal cortical dysplasia (1)
- Surgical outcome - focal cortical dysplasia (2)
- FDG-PET improves outcome
- Epilepsy surgery - “Time Means Neurons!”
- Early surgical treatment
- Trends in epilepsy surgery 1990-2008
- Image-guided laser thermal ablation
- Images: image-guided laser thermal ablation (1)
- Images: image-guided laser thermal ablation (2)
- Electronic stimulation
- Neuro Pace Responsive Neurostimulator System
- Intractable epilepsy - RNS study
- Images: RNS (1)
- Images: RNS (2)
- SANTE (1)
- SANTE (2)
- SANTE (3)
- Summary
Topics Covered
- Epilepsy overview (Epidemiology, History, Economic burden, Co-morbidity, Improvement in quality of life, Adverse effects)
- Reasons for epileptic seizures
- MRI images and recordings of epileptic seizures
- Epilepsy in resource-poor countries
- Focal (partial) epilepsy
- Substrate-directed pathology (Tumors, Vascular anomalies, Malformations of cortical anomalies, Mesial temporal sclerosis)
- PET and glucose metabolism in focal epilepsy
- MRI & Inter-ictal PET study
- Treatment (Goals, strategies & Efficacy)
- Epilepsy surgery
- Long-term and seizure-free surgical outcomes
- Intractable epilepsy
- Temporal & Extratemporal lobe epilepsy
- Non-lesional epilepsy
- SPECT & SISCOM imaging
- Usage of FDG-PET
- Image-guided laser thermal ablation
- Electronic stimulation (Neuro Pace Responsive Neurostimulator System & SANTE)
- Update interview: Stereoelectroencephalography (SEEG)
- Update interview: Laser ablation
- Update interview: Radiofrequency ablation
- Update interview: Plan the operative strategy for resective surgery
- Update interview: The expanded role of intracranial neuromodulation therapy
- Update interview: Magnetoencephalography (MEG) in the preoperative assessment
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Cascino, G.D. (2020, September 22). Epilepsy [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 26, 2024, from https://doi.org/10.69645/KMUU2005.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Gregory D. Cascino has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Update Available
The speaker addresses developments since the publication of the original talk. We recommend listening to the associated update as well as the lecture.
- Full lecture Duration: 45:54 min
- Update Interview Duration: 12:30 min
A selection of talks on Neurology
Transcript
Please wait while the transcript is being prepared...
0:00
My name is Dr. Gregory Cascino.
I'm the Professor of
Neuroscience at the Mayo
Clinic College of Medicine.
I'm Chair of the
Division of Epilepsy
at Mayo Clinic in
Rochester, Minnesota.
My remarks will be restricted
to the evaluation and treatment
of patients with drug
resistant focal epilepsy
who may be candidates
for epilepsy surgery.
0:22
Epilepsy is one of the most common
chronic neurologic disorders.
The present definition
includes patients
with recurrent and
unprovoked seizures.
These often include patients with
two or more seizure episodes.
However, recent reevaluation of
the classification of patients
with seizures indicates even those
with a single seizure who have
significant risk
factor for recurrence
are considered to have
epilepsy or a seizure disorder.
In the community, the prevalence of
epilepsy may be as high as 3% to 4%
and the fastest growing group are
those of 80 years of age or older.
The incidents in the United States
is 180,000 patients per year.
The peaks for the development of
epilepsy are very early in life
and later in life.
The cost of epilepsy in the United
States is 12.5 billion US dollars,
and most of this is indirect
costs, such as unemployment,
underemployment,
need for a caregiver,
unable to live independently.
1:26
We know that epilepsy
has been well described,
and it's probably one
of the most frequently
identified diseases
in historic medicine.
"The Falling Sickness"
is a beautiful treaties
on the history of
epilepsy from the Greeks
to the beginning of
modern neurology.