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Bearden DJ, Ehrenberg A, Selawski R, Ono KE, Drane DL, Pedersen NP, Cernokova I, Marcus DJ, Luongo-Zink C, Chern JJ, Oliver CB, Ganote J, Al-Ramadhani R, Bhalla S, Gedela S, Zhang G, Kheder A. Four-Way Wada: SEEG-based mapping with electrical stimulation, high frequency activity, and phase amplitude coupling to complement traditional Wada and functional MRI prior to epilepsy surgery. Epilepsy Res 2023; 192:107129. [PMID: 36958107 PMCID: PMC11008564 DOI: 10.1016/j.eplepsyres.2023.107129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/29/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023]
Abstract
Presurgical evaluation of refractory epilepsy involves functional investigations to minimize postoperative deficit. Assessing language and memory is conventionally undertaken using Wada and fMRI, and occasionally supplemented by data from invasive intracranial electroencephalography, such as electrical stimulation, corticortical evoked potentials, mapping of high frequency activity and phase amplitude coupling. We describe the comparative and complementary role of these methods to inform surgical decision-making and functional prognostication. We used Wada paradigm to standardize testing across all modalities. Postoperative neuropsychological testing confirmed deficit predicted based on these methods.
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Affiliation(s)
- D J Bearden
- Children's Healthcare of Atlanta, Atlanta, GA, USA; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - R Selawski
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - K E Ono
- Children's Healthcare of Atlanta, Atlanta, GA, USA; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - D L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - N P Pedersen
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - D J Marcus
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - C Luongo-Zink
- Children's Healthcare of Atlanta, Atlanta, GA, USA; William James College, Newton, MA, USA
| | - J J Chern
- Department of Neurosurgery, Children's Healthcare of Atlanta, USA
| | - C B Oliver
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - J Ganote
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - R Al-Ramadhani
- University of Pittsburgh Medical Center Children's Hospital, Pittsburgh, PA 15224, USA
| | - S Bhalla
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - S Gedela
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - G Zhang
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - A Kheder
- Children's Healthcare of Atlanta, Atlanta, GA, USA; Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
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Luongo-Zink C, Ammons C, Al-Ramadhani R, Logan R, Ono K, Bhalla S, Kheder A, Marcus D, Drane D, Bearden D. Longitudinal neurodevelopmental profile of a pediatric patient with de novo SPTAN1, epilepsy, and left hippocampal sclerosis. Epilepsy Behav Rep 2022; 19:100550. [PMID: 35620303 PMCID: PMC9126767 DOI: 10.1016/j.ebr.2022.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/23/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022] Open
Abstract
We present the first longitudinal study of neuropsychological functioning in a pediatric patient with SPTAN1. To our knowledge we report the first case of SPTAN1 heterozygosity in a patient with MTLE due to HS. This case is the first to show that lisdexamfetamine dimesylate improved attention, behavior, and school performance in a patient with heterozygous SPTAN1 variant.
Pathogenic variants in SPTAN1 result in abnormal neurodevelopment but limited information is available on the spectrum of neurodevelopmental profiles associated with variations in this gene. We present novel data collected at two time points over a three-year period in a nine-year-old patient with heterozygous de novo SPTAN1 variant, drug-resistant epilepsy, and left hippocampal sclerosis. Across evaluations, our patient’s performance was highly variable, ranging from below age expectation to within age-expected range. The patient exhibited relative cognitive strengths at both time points on verbal-expressive tasks. Weaknesses were seen in her attention, executive function, psychomotor processing speed, fine motor, visual-motor integration, and social skills. Memory findings were consistent those associated with left hippocampal sclerosis. Evaluations resulted in diagnoses including attention deficit hyperactivity disorder and autism spectrum disorder.
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Affiliation(s)
- C. Luongo-Zink
- William James College, Newton, MA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - C. Ammons
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - R. Al-Ramadhani
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - R. Logan
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - K.E. Ono
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - S. Bhalla
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - A. Kheder
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - D.J. Marcus
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - D.L. Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - D.J. Bearden
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Corresponding author at: Center for Advanced Pediatrics, Children’s Healthcare of Atlanta, 1400 Tullie Rd. NE, Ste. 430, Atlanta, GA 30329, USA.
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