Soheyl Noachtar

Soheyl Noachtar
Ludwig-Maximilians-University of Munich | LMU · Department of Neurology

MD

About

437
Publications
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9,837
Citations
Citations since 2016
91 Research Items
4006 Citations
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20162017201820192020202120220100200300400500600700
20162017201820192020202120220100200300400500600700

Publications

Publications (437)
Article
Full-text available
Seizure semiology is a well-established method to classify epileptic seizure types, but requires a significant amount of resources as long-term Video-EEG monitoring needs to be visually analyzed. Therefore, computer vision based diagnosis support tools are a promising approach. In this article, we utilize infrared (IR) and depth (3D) videos to show...
Article
Full-text available
Background Misdiagnosis of seizure-like events (SLE) in emergency situations is common. Here, we evaluate whether a single, video-based lesson highlighting distinguishing semiological features can improve the diagnostic accuracy of emergency physicians for epileptic seizures (ES), psychogenic non-epileptic seizures (PNES) and syncopes (SY). Method...
Article
Full-text available
A hallmark of non-rapid eye movement sleep is the coordinated interplay of slow oscillations (SOs) and sleep spindles. Traditionally, a cortico-thalamo-cortical loop is suggested to coordinate these rhythms: neocortically-generated SOs trigger spindles in the thalamus that are projected back to neocortex. Here, we used intrathalamic recordings from...
Article
Full-text available
Aims To find out which variables may be associated with comfort of patients in an epilepsy monitoring unit. Design Exploratory, quantitative study design. Methods Data were collected from October 2018 to November 2019 in Austria and Southern Germany. A total of 267 patients of 10 epilepsy centres completed the Epilepsy Monitoring Unit Comfort Que...
Article
OBJECTIVE Reoperation may be an option for select patients with unsatisfactory seizure control after their first epilepsy surgery. The aim of this study was to describe the seizure-free outcome and safety of repeated epilepsy surgery in our tertiary referral center. METHODS Thirty-eight patients with focal refractory epilepsy, who underwent repeat...
Article
We describe a man in his 30s who presented with paroxysmal right-sided dyskinesias of the arm and neck, misdiagnosed with drug-resistant focal epilepsy. Two months earlier he had undergone surgery for chronic sinusitis. Immediately after this procedure, he developed hemiparesis, hemiataxia, paresthesias and disturbances in verbal fluency. Cranial M...
Preprint
Full-text available
A hallmark of non-rapid eye movement (NREM) sleep is the coordinated interplay of slow oscillations (SOs) and sleep spindles. Traditionally, a cortico-thalamo-cortical loop is suggested to coordinate these rhythms: neocortically-generated SOs trigger spindles in the thalamus that are projected back to neocortex. Here, we used direct intrathalamic r...
Article
Full-text available
To study the neuroanatomical correlate of involuntary unilateral blinking in humans, using the example of patients with focal epilepsy. Patients with drug resistant focal epilepsy undergoing presurgical evaluation with stereotactically implanted EEG-electrodes (sEEG) were recruited from the local epilepsy monitoring unit. Only patients showing icta...
Article
Objective To evaluate the safety and temporal dynamic of the antiepileptic effect of spaced transcranial direct current stimulation (tDCS) in different focal epilepsies. Methods Cathodal tDCS with individual electrode placement was performed in 15 adults with drug resistant focal epilepsy. An amplitude of 2 mA was applied twice for 9 minutes, with...
Article
Objectives: The objective of this study was to evaluate seizure remission rates in patients with benign epilepsy of childhood with centrotemporal spikes (BECTS) receiving antiepileptic drugs. Methods: PubMed and Web of Science were searched for studies on pharmacotherapy in patients with BECTS using free search terms or Medical Subject Headings....
Article
Full-text available
Zusammenfassung Epilepsiepatienten leiden überdurchschnittlich häufig unter Kopfschmerzen. Dies gilt insbesondere für Patienten mit idiopathisch generalisierten und parietookzipitalen Epilepsien. Die Häufigkeit des gemeinsamen Auftretens von Kopfschmerzen und Epilepsie überschreitet dabei die rechnerische Koinzidenz, sodass von einer Komorbidität b...
Article
Purpose The purpose of the study was to evaluate the psychometric properties of the newly developed Epilepsy Monitoring Unit Comfort Questionnaire (EMUCQ) according to the consensus-based standards for the selection of health measurements instruments (COSMIN). Moreover, we aimed to assess changes in comfort-levels. Methods From October 2018 to Nov...
Article
OBJECTIVE In the absence of a standard or guideline for the treatment of epilepsy patients with deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT), systematic single-center investigations are essential to establish effective approaches. Here, the authors report on the long-term results of one of the largest single-center ANT...
Article
Full-text available
In this proof-of-concept investigation, we demonstrate a marker-free video-based method to detect nocturnal motor seizures across a spectrum of motor seizure types, in a nighttime setting with a single adult female with refractory epilepsy. In doing so, we further explore the intermediate biosignals, visually mapping seizure “fingerprints” to seizu...
Article
Background Surgery is a widely accepted treatment option for drug-resistant focal epilepsy. A detailed analysis of longitudinal postoperative seizure outcomes and use of antiepileptic drugs for different brain lesions causing epilepsy is not available. We aimed to analyse the association between histopathology and seizure outcome and drug freedom u...
Article
Full-text available
Objective: To assess hemispheric differences in the duration of focal onset seizures and its association with clinical and demographic factors. Methods: A retrospective analysis was performed on adult patients with drug-resistant unifocal epilepsy, who underwent intracranial EEG recording between 01/2006 and 06/2016. Seizure duration was determi...
Article
Full-text available
Objective To investigate the impact of clinical and demographic parameters on the duration of focal onset seizures with and without secondary generalization using precise duration measurements from intracranial electroencephalographic (iEEG) recordings. Methods Patients with unifocal epilepsy syndromes and iEEG recording were retrospectively ident...
Article
Full-text available
Purpose. To evaluate the congruence or discrepancy of the localization of magnetic resonance imaging (MRI) lesions with interictal epileptiform discharges (IEDs) or epileptic seizure patterns (ESPs) in surface EEG in lesional pediatric epilepsy patients. Methods. We retrospectively analyzed presurgical MRI and video-EEG monitoring findings of patie...
Article
Full-text available
Over the last few decades the ILAE classifications for seizures and epilepsies (ILAE-EC) have been updated repeatedly to reflect the substantial progress that has been made in diagnosis and understanding of the etiology of epilepsies and seizures and to correct some of the shortcomings of the terminology used by the original taxonomy from the 1980s...
Conference Paper
Epilepsy affects approximately 1% of the world’s population. Semiology of epileptic seizures contain major clinical signs to classify epilepsy syndromes currently evaluated by epileptologists by simple visual inspection of video. There is a necessity to create automatic and semiautomatic methods for seizure detection and classification to better su...
Article
Self-stimulation is a normal part of development and a common behaviour in children before puberty, but very rare in adults. The stereotyped semiology can sometimes raise the suspicion of epilepsy. We present a 30-year-old patient who came to our epilepsy monitoring unit for differential diagnosis of nocturnal episodes, interpreted elsewhere as hyp...
Chapter
Epilepsy is one of the most common neurological disorders, affecting up to 1% of the World population. Patients with epilepsy may suffer from severe consequences from seizures (e.g. injuries) when not monitored. Automatic seizure detection systems could mitigate this problem, improving seizure tracking and alerting a caregiver during a seizure. Exi...
Article
Full-text available
Background Refined localization of the epileptogenic zone (EZ) in patients with pharmacoresistant focal epilepsy proceeding to resective surgery might improve postoperative outcome. We here report seizure outcome after stereo EEG (sEEG) evaluation with individually planned stereotactically implanted depth electrodes and subsequent tailored resectio...
Article
Purpose: To systematically evaluate the duration of focal onset seizures under medication withdrawal as a function of drug half-life. Methods: Adults with drug resistant focal epilepsy and invasive electroencephalographic (iEEG) recording between 01/2006 and 06/2016 (n = 128) were identified. Patients with multifocal or unknown epileptic foci we...
Article
Focal cortical dysplasia is a common cause of medically refractory epilepsy in infancy and childhood. We report a neonate with seizures occurring within the first day of life. Continuous video-EEG monitoring led to detection of left motor seizures and a right frontal EEG seizure pattern. Brain MRI revealed a lesion within the right frontal lobe wit...
Article
Full-text available
This educational review describes the classification of paroxysmal events and a four-dimensional epilepsy classification system. Paroxysmal events are classified as epileptic and non-epileptic paroxysmal events. Non-epileptic events are, in turn, classified as psychogenic and organic paroxysmal events. The following four dimensions are used to clas...
Article
Pure ictal non-speech vocalisation occurs in frontal and temporal lobe epilepsies. Electrical stimulation of supplementary motor areas is reported to evoke vocalisation in selected patients. Here, we report a patient with focal epilepsy of the left anterior insula who had isolated monotonous vocalisation elicited by electrical stimulation of the le...
Article
We report a patient with frontal lobe epilepsy due to a right frontal astrocytoma (WHO Grade III) in whom two ictal SPECTs (single photon emission tomography) were performed during two seizures with different semiology and different EEG seizure patterns. Subtraction of ictal and interictal SPECT showed right lateral frontal hyperperfusion during a...
Article
Zusammenfassung Ziel der telemedizinischen Versorgung von Menschen mit Epilepsie ist es, eine spezialisierte Diagnostik und Therapie räumlich unabhängig zur Verfügung zu stellen. Dies spielt in Deutschland insbesondere in ländlichen, teils unterversorgten Regionen eine Rolle. In dieser Übersichtsarbeit werden aktuelle tele-epileptologische Projekte...
Article
Background: The preoperative evaluation of drug-resistant focal epilepsy patients considered for epilepsy surgery provides a unique setting to evaluate cortical function and corresponding networks. Aims: Whereas there is a wealth of data on cortical language localization using electrical stimulation with subdural electrodes, there is much less expe...
Article
Purpose: To investigate the frequency, localizing significance, and intensity characteristics of ictal vocalization in different focal epilepsy syndromes. Methods: Up to four consecutive focal seizures were evaluated in 277 patients with lesional focal epilepsy, excluding isolated auras and subclinical EEG seizure patterns. Vocalization was cons...
Article
Objective To evaluate the necessity of recording ictal electroencephalography (EEG) in patients with temporal lobe epilepsy (TLE) considered for resective surgery who have unilateral temporal interictal epileptiform discharges (IEDs) and concordant ipsitemporal magnetic resonance imaging (MRI) pathology. To calculate the necessary number of recorde...
Article
Objective: This study investigated whether there is an association between semiology of status epilepticus (SE) and response to treatment and outcome. Method: Two hundred ninety-eight consecutive adult patients (160 females, 138 males) with SE at the University of Munich Hospital were prospectively enrolled. Mean age was 63.2±17.5 (18-97) years....
Article
Full-text available
Neuroimaging is crucial for the evaluation of patients considered for resective epilepsy surgery. Multimodal image fusion is a new tool to integrate all available localizing information on the individual epileptogenic network in a three-dimensional (3D) manner to plan invasive EEG recordings and delineate the epileptogenic zone from the eloquent co...
Article
Objective Positive interictal epileptiform discharges (IEDs) are rarely recorded from surface EEG, due to the orientation of the cortex and its neurons. Their frequency and significance in adults is unknown, and has only been studied as a phenomenon of the neonatal period and childhood. We aimed to evaluate the frequency and characteristics of posi...
Article
Zusammenfassung Die EEG-Kommission der DGKN hat Richtlinien für die Durchführung und die Auswertung der EEG-Untersuchung formuliert, mit dem Ziel der Sicherung von Qualität und Vergleichbarkeit von Befunden [1]. Diese Mindestanforderungen umfassen definitionsgemäß nicht das gesamte für eine qualifizierte Ausführung erforderliche Wissen. Eine umfass...
Book
Die Elektroenzephalographie hat sich in den letzten Jahren durch die digitale Technik grundlegend geändert. Im vorliegenden Lehrbuch werden die Auswirkungen der modernen Technik auf klinische Aspekte beleuchtet und eine systematische Vorgehensweise der EEG-Auswertung vorgestellt. Reformatierungen der EEG-Abbildungen werden zum Download angeboten, d...
Article
Full-text available
Author summary In everyday life, we constantly move our eyes to sample visual information. In order to make the sampling efficient, these eye movements need to be coordinated with the intrinsic brain dynamics that constrain visual computations. The present study provides novel evidence for how this coordination is achieved at the neuronal level, fr...
Data
Pre- and postsaccade phase locking locked to saccade offset. (A) Phase-locking difference (later remembered–later forgotten) on occipital depth electrodes prior to saccade offset (time = 0 s). There was no significant difference in phase locking between later-remembered and later-forgotten trials (p > 0.21; 2-sided test, fixed-effects statistics, 1...
Data
Presaccade power. (A) Topography of magnetoencephalography (MEG) sensor-level statistics (planar gradients) for power averaged over 12–14 Hz at −0.25 s (corresponding to the phase-locking index [PLI] effect); no significant difference (cluster-based permutation statistic, no clusters found). The bar plot (error bars represent SEM; dots indicate ind...
Data
Phase locking and power after saccade onset. (A) Topography of magnetoencephalography (MEG) sensor-level statistics (planar gradients) for phase locking averaged over 12–14 Hz at 250 ms; no significant difference (cluster-based permutation statistic, all clusters p > 0.72). (B) Topography of MEG sensor-level statistics (planar gradients) for power...
Data
Presaccadic phase locking for 200-ms minimum fixation duration. Magnetoencephalography (MEG) sensor (planar gradients) analysis shows significantly higher phase locking (phase-locking index [PLI]) for later-remembered than forgotten trials at 10 Hz (corresponding to a frequency range of 7.5 to 12.5 Hz), averaged in the −0.2- to 0-s interval prior t...
Data
Presaccade phase locking on parahippocampal leads of depth electrodes. (A) Electrode locations of parahippocampal depth electrodes in 3 participants (color coded). (B) Phase-locking difference (later remembered–later forgotten) on parahippocampal depth electrodes prior to saccade onset (time = 0). Significantly higher phase locking in later-remembe...
Data
Condition-specific phase-locking index (PLI) contrasts. (A) Difference between later-remembered trials and surrogate data at 12–14 Hz, −250 ms. (B) Difference between later-forgotten trials and surrogate data at 12–14 Hz, −250 ms. Significant sensors are highlighted (p < 0.05, 2-sided). The data set used to generate the analyses shown in this figur...
Data
Phase locking and power after stimulus onset. (A) Cluster-based permutation statistics showed no significant differences in phase locking between later-remembered and later-forgotten scenes at 12–14 Hz, controlling for multiple comparisons over time (0 to 4 s) and sensors (p cluster > 0.9). There were also no significant differences after averaging...
Article
Full-text available
Background Detailed neuropathological information on the structural brain lesions underlying seizures is valuable for understanding drug-resistant focal epilepsy. Methods We report the diagnoses made on the basis of resected brain specimens from 9523 patients who underwent epilepsy surgery for drug-resistant seizures in 36 centers from 12 European...
Article
Zusammenfassung Epilepsien zählen zu den häufigsten neurologischen Erkrankungen mit etwa 600 000 Betroffenen in Deutschland. Symptome epileptischer Anfälle, die Vielzahl möglicher Epilepsieursachen und die unterschiedlichen Krankheitsverläufe erschweren sowohl die korrekte Diagnosestellung als auch die Auswahl einer geeigneten Therapie (Antikonvuls...
Article
Background Resective surgery is an effective and safe treatment option for medically refractory focal epilepsy. Patients who require prior invasive EEG evaluation with intracranial electrodes are usually considered difficult candidates. The absence of an MRI-visible structural lesion and extratemporal seizure onset are also considered disadvantageo...
Article
Epileptische Anfälle und Status epilepticus können bei Palliativpatienten eine Herausforderung darstellen — Diagnostik und Therapie müssen der palliativen Situation angepasst werden. Im folgenden Artikel wird auf pragmatische Lösungen eingegangen.
Article
Electroencephalography (EEG) and neuroimaging are the two most crucial diagnostic methods for epilepsy. The EEG represents the only specific method to detect epileptogenicity of a brain lesion. The EEG shows some syndrome-specific alterations, helps to make therapeutic decisions and allows prognosis about the disease. Neuroimaging in epilepsy inclu...
Article
Nichtepileptische paroxysmale Störungen werden leicht mit epileptischen Anfällen verwechselt und bilden daher im Alltag wichtige Differenzialdiagnosen der Epilepsie. Im Wesentlichen handelt es sich um Synkopen, nichtepileptische Anfälle im Rahmen dissoziativer Störungen, paroxysmale Bewegungsstörungen, Migräne, transitorische ischämische Attacken u...
Article
Objective: To investigate the occurrence of ictal and postictal aphasia in different focal epilepsy syndromes. Methods: We retrospectively analyzed the video-electroencephalographic monitoring data of 1,118 patients with focal epilepsy for seizure-associated aphasia (SAA). Statistical analysis included chi-square analysis and Fisher's exact test...
Preprint
Efficient sampling of visual information requires a coordination of eye movements and ongoing brain oscillations. Using intracranial and MEG recordings, we show that saccades are locked to the phase of visual alpha oscillations, and that this coordination supports mnemonic encoding of visual scenes. Furthermore, parahippocampal and retrosplenial co...
Article
Objective: To evaluate the characteristics of visual auras (VA) in epilepsy and migraine. Background: Both disorders are usually diagnosed on clinical grounds, but differentiation might be challenging in isolated auras or because of the similar presentation in migraine and epilepsy. Methods: A retrospective study of two cohorts was performed t...
Article
Epileptische Anfälle und Status epilepticus können bei Palliativpatienten eine Herausforderung darstellen — Diagnostik und Therapie müssen der palliativen Situation angepasst werden. Im folgenden Artikel wird auf pragmatische Lösungen eingegangen.
Article
Ein 19-jähriger Mann wird nach einem erstmals aufgetretenen „Krampfanfall“ vorgestellt. Nach einer Party sei er plötzlich nicht mehr kontaktfähig gewesen und habe für ein bis zwei Minuten am ganzen Körper gekrampft. In der Nothilfe ist er fokal-neurologisch unauffällig.