METHOD AND DEVICE FOR THE RECORDING, LOCALIZATION AND STIMULATION-BASED MAPPING OF EPILEPTIC SEIZURES AND BRAIN FUNCTION UTILIZING THE INTRACRANIAL AND EXTRACRANIAL CEREBRAL VASCULATURE AND/OR CENTRAL AND/OR PERIPHERAL NERVOUS SYSTEM

摘要

Principles from the analogous field of cardiac electrophysiology are translated to neuro electrophysiology whereby electrically competent catheters and introducing devices are threaded intravascularly through large vessel access (e.g., leg or arm) into the arterial or more typically the venous system to or within the brain tissue, possibly targeting a specific region that needs to be functionally mapped. After passive recording and mapping of important activity exactly to a 3-dimensional, high resolution brain image taken either before or during the procedure, electrical stimulation paradigms are triggered to both evoke responses to help map regions vital to the epileptic network or pathologically functioning networks in other neurological and/or psychiatric conditions, and then to map brain function in specific regions during motor, sensory, emotional, psychiatric and cognitive testing, in order to localize these functions in relation to the epileptic network. Once this pathological and functional map has been created, clinicians can then either proceed to: (1) subdural and intraparenchymal electrode placement, for chronic ictal recording, based upon the maps, (2) use of the catheter-based system to ablate regions vital to generating seizures, using either electrical stimulation or another therapy, (3) placement or chronic electrodes, effector devices, drugs, sensors, etc. to be used as part of an implantable diagnostic/therapeutic device, and/or (4) more chronic diagnostic recording by leaving behind other sensors. Principles for chronic monitoring and activating implantable devices are implemented using acutely or chronically placed sensors on, within or around tissues electrically coupled to and not in contact with the brain to work in concert with devices focused on diagnosis and/or treatment of syncope, epilepsy, and other neurological and psychiatric disorders.