Pratique du Shadowing: MRI-Negative Epilepsy - Apprendre l'anglais à l'oral avec la vidéo
Création de la leçon...
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This is something that I have a passion for.
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One of the things that, you know, myself and our entire epilepsy group, we really care about patients who have epilepsy.
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And as I mentioned at the beginning, if you have lesional epilepsy, those patients generally tend to have better outcomes.
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And part of the reason for that is that we know if you have a lesion that we're focusing on that area.
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We know that we're looking around that area for potentially the seizure onset zone.
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But what happens when a patient comes in and they have a completely normal MRI?
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Well, that makes it a much more difficult patient to treat.
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And we know in the literature that those patients have a much lower rate of seizure freedom.
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And so I'm going to talk a little bit about
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my own personal thoughts on that and what we've done at UCI to minimize that.
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So I like to start by doing a thought experiment.
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So if you were to imagine what the ideal patient is for epilepsy surgery, you know, what I think about when I would hear something like that,
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I would imagine a picture like this.
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I would imagine a young patient, because we know younger patients tend to do better with the surgery.
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I would think about someone who had a recent seizure onset, because if we know that if you've had a more recent seizure onset,
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you're more likely to become seizure free.
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And then I would also say that, you know, all the non -invasive tests all point to one area.
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And if I was talking about an ideal patient, I would say that area would be the right temporal lobe, because we know that the right temporal lobe is probably the safest area for us to operate in,
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generally tends to have the lowest risk for cognitive decline, some other types of neurocognitive issues that can be developed.
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And the last part would be someone who has a significant decline in their nonverbal memory already.
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The reason I put that in there is because on the right temporal lobe, that's where your nonverbal memory is.
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And so oftentimes, things like patterns, knowing directions, those things are very important for patients.
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And if you already come in and you have a significant decline, then by us doing surgery, it's very unlikely that you're going to get worse.
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And so, you know, with this type of an ideal patient, if we do surgery on this patient, our likelihood of becoming seizure -free is about 75 to 80%.
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It's really one of the best surgeries we have for patients with epilepsy.
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Now, what's happening across the country and really across the world is that our actual surgical patients are looking more like this.
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So pretty much the exact opposite of the patient I just talked about.
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They may have a normal MRI.
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They have their older patients.
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They've had a longstanding history of seizures, which we know is a risk factor for less likely to become seizure -free with our surgery.
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When we do scalp EEG, we may see bitemporal epilepsy, which is, again, a bad prognostic factor, means you're less likely to become seizure -free.
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and then you know they may have discordant non -invasive studies
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so again as I mentioned before you may have a PET
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and a MEG and other types of studies
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which all point to different parts of the brain and when
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that happens then you know we see that the seizure -free
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patients like this who we do surgery on the seizure -free
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likelihood is actually in the range of 40 to 50 percent
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so almost half of the patients you know compared to that other group can become seizure -free.
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And this was a really interesting study done a few years ago from my old program at the Cleveland Clinic,
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where they actually looked at patients who go to level four epilepsy centers like UCI, and they compared looking at the most,
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you know, the ideal patient, that mesial temporal sclerosis versus any other type of patient.
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And what we're seeing across the board, and again, across the world, is that those patients, that number of patients is steadily decreasing over time.
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So we're not seeing these mesiotemporal sclerosis patients, the patients who are easy to treat and the ones who have the highest likelihood of seizure freedom.
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We're actually seeing a lot more of this very difficult to treat patients that I just mentioned.
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So really the question becomes, how do we improve the outcomes?
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How do we take a patient with a normal MRI
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and all these difficult findings and then try and make them closer to that ideal patient that I mentioned earlier.
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So, well, the first thing you should do is basically look at what are the similarities
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and what are the differences between these two subgroups of patients.
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When you look at the MRI negative group, what you see is that they have a variety of pathologies.
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And that right there is a very difficult, that right there makes it very difficult because
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various pathologies are known to have different seizure -free outcomes depending on the surgery that you do.
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With MRI negative temporal lobe epilepsy, you also see a greater rate of secondary generalization.
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So what that means is that their brains are already wired in such a way
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that they have a seizure in one area, but that quickly generalizes to the rest of the brain.
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And so it's even more important in those patients that you accurately and definitively localize where those seizures are coming from.
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The ictal onset zone for those patients with MRI negative temporal lobe epilepsy can often be the temporal lobe plus another area, and we call that temporal plus.
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You can have neocortical epilepsy, which means like from the surface of the brain or some of the gray matter on the cortical surface,
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or you may have bilateral or contralateral onset from where you think it's coming from.
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And as I mentioned before, you see that those seizure -free rates are fairly low.
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Now, when you look at the patients who have mesial temporal sclerosis, you see that they have clear hippocampal sclerosis,
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which is a great prognostic, again, 70 to 80%.
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They have classic semiology, their EEG correlates with the MRI, their ictal onset is coming from that hippocampus or the mesial temporal lobe.
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And so pretty much no matter what you do, you can do laser ablation you can do open surgery you
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have very good seizure free rates like i said 70 to 80
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so when i look at this and when you
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when you think about where these seizures what you know what the differences are
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and what the main you know similarities are i really focus on
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that ictal onset zone that's really the most important area for us in terms of how we localize these seizures
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and how we can treat these patients hey everyone ryan rad here from neurosurgery training .org
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Vocabulaire et conseils d’expression pour cette leçon
Cette leçon d’expression orale de niveau C1 s’appuie sur la vidéo « MRI-Negative Epilepsy ». Les mots qui reviennent le plus souvent : patient, seizure, epilepsy, temporal, surgery. Cette vidéo contient 72 phrases et 1192 mots à répéter en shadowing. La partie parlée dure 6:53. Le locuteur parle à un rythme naturel d’environ 173 mots par minute, proche d’une conversation courante. 83 % des mots font partie des 3 000 mots les plus courants en anglais ; le reste mérite d’être vu avant de commencer.
Vocabulaire clé de cette vidéo
Les 15 mots les plus avancés de la vidéo, avec leur prononciation et leur sens :
| Mot | Prononciation | Sens |
|---|---|---|
| seizure nom | /ˈsi.ʒɚ/ | saisie |
| epilepsy nom | /ˈɛpɪˌlɛpsi/ | épilepsie, mal caduc |
| temporal adjectif | /ˈtɛm.pə.ɹəl/ | temporel |
| lobe nom | /ləʊb/ | lobe |
| onset nom | /ˈɒnˌsɛt/ | début, apparition |
| sclerosis nom | /skləˈɹəʊ.sɪs/ | sclérose |
| likelihood nom | /ˈlaɪklihʊd/ | vraisemblance |
| prognostic adjectif | /pɹɑɡˈnɑs.tɪk/ | pronostique |
| pathology nom | /pəˈθɒləd͡ʒi/ | pathologie |
| similarity nom | /ˌsɪm.ɪˈlæɹ.ɪ.ti/ | similarité, similitude |
| invasive adjectif | /ɪnˈveɪsɪv/ | d'invasion |
| ablation nom | /əˈbleɪ.ʃn̩/ | ablation |
| bitemporal adjectif | bitemporal | |
| correlate verbe | /ˈkɔɹəleɪt/ | corréler |
| definitively adverbe | /dɪˈfɪnɪtɪvli/ | définitivement |
Les verbes à particule que vous entendrez
| Mot | Sens |
|---|---|
| look around verbe | regarder autour de soi |
La grammaire de cette vidéo
Les structures que le locuteur utilise le plus, avec les mots exacts de la vidéo :
| Structure | Dans la vidéo |
|---|---|
| Propositions relatives who / which + proposition — une précision sur une personne ou une chose | someone who had · someone who has · epilepsy, which is |
| Voix passive be + participe passé — l’accent est mis sur ce qui arrive, pas sur qui le fait | can be developed · are known · are already wired |
Prononciation à surveiller
Le locuteur utilise 12 contractions et formes réduites, comme we're, you're, I'm. Prononcez-les sous leur forme courte, telles que vous les entendez.
- Les sons « sh » et « zh »: seizure /ˈsi.ʒɚ/, ablation /əˈbleɪ.ʃn̩/, lesion /ˈliːʒən/, lesional /ˈliːʒən.əl/
- Mots longs — placez bien l’accent: epilepsy /ˈɛpɪˌlɛpsi/, pathology /pəˈθɒləd͡ʒi/, similarity /ˌsɪm.ɪˈlæɹ.ɪ.ti/, contralateral /ˌkɑntɹəˈlætəɹəl/, definitively /dɪˈfɪnɪtɪvli/
Comment s’entraîner avec cette vidéo
- Écoutez la vidéo en entier une fois sans parler et notez les mots que vous ne connaissez pas.
- Commencez à la vitesse 0,75×, répétez phrase par phrase, puis revenez à la vitesse normale quand cela devient facile.
- Enregistrez-vous et comparez avec l’original, en faisant attention à des mots comme seizure, epilepsy, temporal.
Qu'est-ce que la technique du Shadowing ?
Le Shadowing est une technique d'apprentissage des langues fondée sur la science, développée à l'origine pour la formation des interprètes professionnels. Le principe est simple mais puissant : vous écoutez de l'anglais natif et le répétez immédiatement à voix haute — comme une ombre suivant le locuteur avec un décalage de 1 à 2 secondes. Les recherches montrent une amélioration significative de la précision de la prononciation, de l'intonation, du rythme, des liaisons, de la compréhension orale et de la fluidité.