Awake Testing to Confirm Target Engagement

Neepa J. Patel, Jay R. Gavvala, Joohi Jimenez-Shahed

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

Clinical testing of the awake patient during or prior to functional neurosurgical procedures such as deep brain stimulator (DBS) placement, focused ultrasound (FUS), or epilepsy surgeries is a valuable tool to verify that the appropriate target has been engaged for purposes of improving symptoms. This testing also serves to identify potential adverse effects of surgical therapy that may limit efficacy or lead to poor outcomes. The treating clinician should be familiar with both the regional anatomy and brain circuitry involved in these diseases states, as well as the testing sequences, parameters, and interpretation of results in order to make appropriate therapeutic decisions for individual patients. This chapter reviews testing patients with movement and neuropsychiatric disorders during DBS or FUS procedures and patients with epilepsy prior to surgical intervention.

Original languageEnglish
Title of host publicationStereotactic and Functional Neurosurgery
Subtitle of host publicationPrinciples and Applications
PublisherSpringer International Publishing
Pages119-131
Number of pages13
ISBN (Electronic)9783030349066
ISBN (Print)9783030349059
DOIs
StatePublished - 1 Jan 2020

Keywords

  • Deep brain stimulation
  • Eloquent cortex
  • Epileptogenic cortex
  • Focused ultrasound
  • Globus pallidus interna
  • Movement disorders
  • Refractory epilepsy
  • Subthalamic nucleus
  • Surgical resection
  • Ventral intermediate nucleus of the thalamus

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