Details of a Researcher

Papers - ENATSU Rei

Division display 141 - 160 of about 228 ／ All the affair displays >>

新皮質てんかんにおける焦点同定と摘出のための検討

三國信啓, 菅野彩, 大川聡史, 江夏怜, 越智さと子

てんかん研究 ( (一社)日本てんかん学会 ) 34 ( 2 ) 484 - 484 2016.09

素因による迷走神経刺激療法治療効果の解析電位依存性Na+チャネル異常が判明した3例を含めて

越智さと子, 菅野彩, 江夏怜, 福村忍, 白石秀明, 廣瀬伸一, 横山茂, 三國信啓

てんかん研究 ( (一社)日本てんかん学会 ) 34 ( 2 ) 417 - 417 2016.09

てんかんにおけるネットワーク探索

江夏怜

てんかん研究 ( (一社)日本てんかん学会 ) 34 ( 2 ) 367 - 367 2016.09

ステレオ脳波記録法(SEEG) 北米のてんかん治療施設におけるステレオ脳波記録法(Stereoelectroencephalography(SEEG) Stereoelectroencephalography in a North American epilepsy center)

江夏怜

てんかん研究 ( (一社)日本てんかん学会 ) 34 ( 2 ) 289 - 290 2016.09

Perioperative Evaluation of Cerebral Blood Flow Using (123)I-labeled N-isopropyl-p-iodoamphetamine Single-Photon Emission Computed Tomography without Blood Sampling in Patients Who Underwent Carotid Artery Stenting.

Naoki Matsumoto, Rei Enatsu, Yasuzumi Matsui, Hiroyuki Ikeda, Norikazu Yamana, Masashi Oda, Masaaki Saiki, Osamu Narumi

Chinese medical journal 129 ( 13 ) 1616 - 8 2016.07 [International journal]

DOI PubMed

Neuromodulatory Role of Revascularization Surgery in Moyamoya Disease.

Shouhei Noshiro, Takeshi Mikami, Katsuya Komatsu, Aya Kanno, Rei Enatsu, Shogo Yazawa, Takashi Nagamine, Masao Matsuhashi, Nobuhiro Mikuni

World neurosurgery 91 473 - 82 2016.07 [International journal]

BACKGROUND: To evaluate the effectiveness of bypass surgery for moyamoya disease, electrocorticography was first evaluated. METHODS: A total of 13 hemispheres in 9 patients with moyamoya disease were included in this study. To record the spectral power of electrocorticography continuously during the bypass procedure, a 4 × 5 subdural electrode grid was placed on the middle frontal gyrus. The changes in spectral power before and after bypass surgery were evaluated and compared with those in a control group. The correlation between changes in spectral power and regional cerebral blood flow was analyzed. RESULTS: The average spectral power ratio of the beta band per total band in moyamoya disease before bypass surgery was lower than that of controls (P = 0.027), and the significance disappeared after bypass surgery (P = 0.800). The spectral power levels of the beta band and gamma band were increased in moyamoya disease after bypass surgery (P < 0.001). Changes in spectral power of the beta band correlated with changes in regional cerebral blood flow (P = 0.002). CONCLUSIONS: The spectral power of the beta band on electrocorticography was focally suppressed in patients with moyamoya disease, and the suppression was reversible by revascularization surgery. Steno-occlusive ischemic changes in moyamoya disease might cause suppression of neurophysiologic activity, and the present results provide insight into the potential neuromodulatory role of revascularization surgery.

DOI PubMed

Connectivity of the frontal and anterior insular network: a cortico-cortical evoked potential study.

Rei Enatsu, Jorge Gonzalez-Martinez, Juan Bulacio, John C Mosher, Richard C Burgess, Imad Najm, Dileep R Nair

Journal of neurosurgery 125 ( 1 ) 90 - 101 2016.07 [International journal]

OBJECT The frontal and insular fiber network in humans remains largely unknown. This study investigated the connectivity of the frontal and anterior insular network in humans using cortico-cortical evoked potential (CCEP). METHODS This retrospective analysis included 18 patients with medically intractable focal epilepsy who underwent stereoelectroencephalography and CCEP. Alternating 1-Hz electrical stimuli were delivered to parts of the frontal lobe and anterior insula (prefrontal cortex [PFC], ventrolateral and dorsolateral premotor area [vPM and dPM, respectively], presupplementary motor area [pre-SMA], SMA, frontal operculum, and anterior insula). A total of 40-60 stimuli were averaged in each trial to obtain CCEP responses. The distribution of CCEP was evaluated by calculating the root mean square of CCEP responses. RESULTS Stimulation of the PFC elicited prominent CCEP responses in the medial PFC and PMs over the ipsilateral hemisphere. Stimulation of the vPM and dPM induced CCEP responses in the ipsilateral frontoparietal areas. Stimulation of the pre-SMA induced CCEP responses in the ipsilateral medial and lateral frontal areas and contralateral pre-SMA, whereas stimulation of the SMA induced CCEP responses in the bilateral frontoparietal areas. Stimulation of the frontal operculum induced CCEP responses in the ipsilateral insula and temporal operculum. CCEPs were observed in the ipsilateral medial, lateral frontal, and frontotemporal operculum in the anterior insular stimulation. Stimulation of the vPM and SMA led to the network in the dominant hemisphere being more developed. CONCLUSIONS Various regions within the frontal lobe and anterior insula were linked to specific ipsilateral and contralateral regions, which may reflect distinct functional roles.

DOI PubMed

Invasive Evaluations for Epilepsy Surgery: A Review of the Literature.

Rei Enatsu, Nobuhiro Mikuni

Neurologia medico-chirurgica 56 ( 5 ) 221 - 7 2016.05 [Domestic journal]

Invasive evaluations play important roles in identifying epileptogenic zones and functional areas in patients with intractable focal epilepsy. This article reviews the usefulness, methods, and limitations of invasive evaluations for epilepsy surgery. Invasive evaluations include various types of intracranial electrodes such as stereotactically implanted intracranial depth electrodes (stereo-EEG), chronic subdural electrodes, and intraoperative electrocorticography. Scalp EEG is distorted by the skull, meninges, and skin. On the other hand, intracranial electrodes provide spatial information with higher resolution than scalp electrodes, thereby enabling further delineation of epileptogenic zones and mapping of functional areas with electrical stimulation. In addition, intracranial electrodes record a wide frequency range of electrical activity, which is not possible with scalp electrodes. The very slow potentials in ictal recordings, known as ictal direct current (DC) shifts and ictal/interictal high frequency oscillations, such as ripples (100-200 Hz) and fast ripples (200-500 Hz), have been correlated with the ictal onset zone and are a sensitive and specific marker for epileptogenicity. Furthermore, several studies reported that the electrical stimulation of epileptogenic zones elicited enhanced cortical evoked potentials, abnormal delayed or repetitive responses, and fast ripples. These responses may assist in the delineation of the epileptogenic cortex as a potential new marker. There are definite risks of complications associated with the use of intracranial electrodes. However, when an invasive evaluation is selected based on careful consideration of the risks and benefits, it provides useful information for establishing a strategy for epilepsy surgery.

DOI PubMed

Etiology of Sudden Cardiac Arrest in Patients with Epilepsy: Experience of Tertiary Referral Hospital in Sapporo City, Japan.

Kei Miyata, Satoko Ochi, Rei Enatsu, Masahiko Wanibuchi, Nobuhiro Mikuni, Hiroyuki Inoue, Shuji Uemura, Katsuhiko Tanno, Eichi Narimatsu, Kunihiko Maekawa, Keiko Usui, Masahiro Mizobuchi

Neurologia medico-chirurgica 56 ( 5 ) 249 - 56 2016.05 [Domestic journal]

It has been reported that epilepsy patients had higher risk of sudden death than that of the general population. However, in Japan, there is very little literature on the observational research conducted on sudden fatal events in epilepsy. We performed a single-center, retrospective study on all the out-of-hospital cardiac arrest (OHCA) patients treated in our emergency department between 2007 and 2013. Among the OHCA patients, we extracted those with a history of epilepsy and then analyzed the characteristics of the fatal events and the background of epilepsy. From 1,823 OHCA patients, a total of 10 cases were enrolled in our study. The median age was 34 years at the time of the incident [9-52 years; interquartile range (IQR), 24-45]. We determined that half of our cases resulted from external causes of death such as drowning and suffocation and the other half were classified as sudden unexpected death in epilepsy (SUDEP). In addition, asphyxia was implicated as the cause in eight cases. Only the two near-drowning patients were immediately resuscitated, but the remaining eight patients died. The median age of first onset of epilepsy was 12 years (0.5-30; IQR, 3-21), and the median disease duration was 25 years (4-38; IQR, 6-32). Patients with active epilepsy accounted for half of our series and they were undergoing poly anti-epileptic drug therapy. The fatal events related to epilepsy tended to occur in the younger adult by external causes. An appropriate therapeutic intervention and a thorough observation were needed for its prevention.

DOI PubMed

[Consciousness Impairment and Left Hemiparesis due to Contrast Medium in the Coil Embolization of Unruptured Large Right Middle Cerebral Artery Aneurysm: A Case Report].

Nobuhiko Nakajima, Masaomi Koyanagi, Tamaki Kobayashi, Rei Enatsu, Masashi Oda, Masaaki Saiki

No shinkei geka. Neurological surgery 44 ( 5 ) 377 - 82 2016.05 [Domestic journal]

Neurological deficits following coil embolization of anterior circulation aneurysms due to the toxicity of contrast medium are rare. Here, we describe a patient with mild consciousness impairment and left hemiparesis following coil embolization of a large right middle cerebral artery aneurysm without evidence of ischemia or hemorrhage, who recovered completely with conservative treatment. The patient's clinical course and radiological findings led us to conclude that the neurological deficits were due to the toxic effect of contrast medium used during the coil embolization.

DOI PubMed

小児難治性てんかん外科治療に有用な画像診断と治療成績

越智さと子, 平野司, 菅野彩, 江夏怜, 三國信啓

小児の脳神経 ( (一社)日本小児神経外科学会 ) 41 ( 1 ) 84 - 84 2016.05

脳動脈瘤コイル塞栓術後に造影剤による意識障害および左片麻痺が遷延した大型右中大脳動脈瘤の1例

中島伸彦, 小柳正臣, 小林環, 江夏怜, 織田雅, 齊木雅章

Neurological Surgery ( (株)医学書院 ) 44 ( 5 ) 377 - 382 2016.05

症例は76歳男性で、ふらつきを自覚し、頭部MRI検査により偶発的に未破裂脳動脈瘤を指摘された。CTAで、右中大脳動脈に最大径17.2mm、頸部径4.6mmの外側に突出する動脈瘤を認めた。その他、左中大脳動脈に3ヶ所と内頸動脈にも1ヶ所、それぞれ3mm未満の小型動脈瘤を認めた。今回は右中大脳動脈の大型動脈瘤に対して局所麻酔下でコイル塞栓術を行った。塞栓終了時に意識障害と左片麻痺が出現していた。Cone beam CTでは右前頭葉のクモ膜下腔に高吸収域を認めた。術直後のMRIではDWIで脳実質に高信号域の出現はなく、FLAIRではクモ膜下腔に高信号を認めなかった。Cone beam CTでのクモ膜下腔の高吸収域は造影剤の漏出と考えられた。ステロイド治療も考慮したが、糖尿病があり施行しなかった。翌日のMRIでは、右前頭葉の皮質中心にDWIとFLAIRで高信号域を認めた。術後8日目にはDWIとFLAIRともに高信号域がさらに消退し、意識レベルも清明となり、神経学的脱落症状なく術後15日目に独歩で退院した。

てんかん性スパズムに対して前頭葉切除術を施行した1例

平野司, 菅野彩, 越智さと子, 江夏怜, 三國信啓

小児の脳神経 ( (一社)日本小児神経外科学会 ) 41 ( 1 ) 116 - 116 2016.05

Intraoperative Subcortical Fiber Mapping with Subcortico-Cortical Evoked Potentials.

Rei Enatsu, Aya Kanno, Shunya Ohtaki, Yukinori Akiyama, Satoko Ochi, Nobuhiro Mikuni

World neurosurgery 86 478 - 83 2016.02 [International journal]

OBJECTIVE: During brain surgery, there are difficulties associated with identifying subcortical fibers with no clear landmarks. We evaluated the usefulness of cortical evoked potentials with subcortical stimuli (subcortico-cortical evoked potential [SCEP]) in identifying subcortical fibers intraoperatively. METHODS: We used SCEP to identify the pyramidal tract in 4 patients, arcuate fasciculus in 1 patient, and both in 2 patients during surgical procedures. After resection, a 1 × 4-electrode plate was placed on the floor of the removal cavity and 1-Hz alternating electrical stimuli were delivered to this electrode. A 4 × 5 recording electrode plate was placed on the central cortical areas to map the pyramidal tract and temporoparietal cortical areas for the arcuate fasciculus. SCEPs were obtained by averaging electrocorticograms time locked to the stimulus onset. RESULTS: The subcortical stimulation within 15 mm of the target fiber induced cortical evoked potentials in the corresponding areas, whereas the stimulation apart from 20 mm did not. Five patients showed transient worsening of neurologic symptoms after surgery. However, all patients recovered. CONCLUSIONS: SCEP was useful for identifying subcortical fibers and confirmed the preservation of these fibers. This technique is expected to contribute to the effectiveness and safety of resective surgery in patients with lesions close to eloquent areas.

DOI PubMed

PCASに対する神経集中治療軽度低体温施行症例における異常脳波所見

宮田圭, 喜屋武玲子, 成松英智, 江夏怜, 三國信啓, 臼井桂子, 長峯隆, 西田絢一, 國分宣明

Neurosurgical Emergency ( (NPO)日本脳神経外科救急学会 ) 20 ( 3 ) 445 - 445 2016.01

悪性リンパ腫との鑑別を要した胸腰髄椎間板ヘルニアの一例

中島伸彦, 宮本至, 小林環, 五百蔵義彦, 江夏怜, 小柳正臣, 織田雅, 齊木雅章, 鳴海治

姫路医療センター紀要 ( (独)国立病院機構姫路医療センター ) 14 19 - 21 2015.12

悪性リンパ腫との鑑別を要した胸腰髄椎間板ヘルニアの一例を経験したので報告する。症例は81歳、男性。約2ヵ月の経過で下肢筋力低下が進行し、起立歩行不能となり近医神経内科を受診した。Magnetic Resonance Imaging(MRI)でT12/L1右腹側より脊髄を圧迫する腫瘤が認められ、造影MRIでは造影効果を有していた。soluble InterLeukin-2 Recepter(sIL-2R)は1300U/mlと高値を認め、悪性リンパ腫が疑われたため当科紹介受診となり、手術による生検と摘出の方針となった。腫瘤の病理結果は椎間板ヘルニアであった。入院中にPositron Emission Tomography(PET)撮影を行ったが他部位に悪性リンパ腫の存在も認めなかった。術後下肢の筋力は改善を示した。椎間板ヘルニアはMRIで造影を受けることがあり、腫瘍性疾患との判別が困難となる場合がある。また、sIL-2Rは悪性リンパ腫だけでなく様々な疾患での上昇が確認されており、T細胞が活性化する椎間板ヘルニアでもsIL-2Rが上昇する可能性がある。我々は造影MRIでの造影効果ならびにsIL-2R高値となったため診断に難渋した椎間板ヘルニアの一例に対し文献的考察を踏まえて報告する。(著者抄録)

ガイドラインポイント解説「てんかん外科の適応に関する指針」の解説

江夏怜, 三國信啓

脳神経外科速報 ( (株)メディカ出版 ) 25 ( 11 ) 1179 - 1183 2015.11

皮質・皮質間誘発電位(CCEP) 頭蓋内電極を用いた脳機能・発作ネットワークの探索

江夏怜, 菅野彩, 大瀧隼也, 能代将平, 鈴木健吾, 越智さと子, 三國信啓

臨床神経生理学 ( (一社)日本臨床神経生理学会 ) 43 ( 5 ) 383 - 383 2015.10

【プライマリーケアにおける救急患者の診断と初期治療】神経症状けいれん

江夏怜, 三國信啓

臨牀と研究 ( 大道学館出版部 ) 92 ( 10 ) 1251 - 1254 2015.10

血中PRL値測定は、術後発作コントロールの指標となりうるか? 治療関与前後での対比

越智さと子, 菅野彩, 江夏怜, 秋山幸功, 三上毅, 三國信啓

てんかん研究 ( (一社)日本てんかん学会 ) 33 ( 2 ) 628 - 628 2015.09

　 PREV - NEXT 　

<ENATSU Rei>

Papers - ENATSU Rei