Pratica di Shadowing: MRI-Negative Epilepsy - Impara a parlare inglese con i video
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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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Obiettivi di parlato per questo video
Questo clip aiuta a raggiungere una tappa chiave nella fluency: la capacità di seguire e riprodurre discorsi tecnici in inglese con coerenza. Attraverso la discussione su un argomento specifico come l'epilessia MRI-negativa, impari a gestire frasi lunghe, connettere idee e mantenere il flusso anche quando si tratta di concetti complessi. È perfetto per esercitarti nel "shadowspeak", cioè nel ripetere immediatamente dopo il parlante, migliorando la pronuncia inglese e la comprensione auditiva in tempo reale.
Banca di frasi riutilizzabili
- "This is something that I have a passion for" – Espressione per indicare una passione specifica, utile in contesti professionali o personali.
- "tend to have better outcomes" – Per parlare di risultati probabili, spesso usata in discussioni scientifiche o analitiche.
- "a much more difficult patient to treat" – Struttura per descrivere situazioni complesse, valida anche al di fuori del contesto medico.
- "what's happening across the country and really across the world" – Per generalizzare un fenomeno, ideale per argomentazioni globali.
- "how do we improve the outcomes?" – Domanda chiave per avviare discussioni su soluzioni, utile in meeting o presentazioni.
Correggi i tuoi punti deboli
Il video è ottimo per lavorare sulla pronuncia inglese e sul ritmo del discorso. Molte frasi hanno una struttura complessa con congiunzioni come "and" o "but" che connettono idee: la chiave è non "spacchettare" le frasi, ma mantenere un flusso continuo. Prova a fare "shadow speech": ascolta una frase, pausa e ripetila immediatamente, cercando di imitare l'intonazione e la velocità del parlante. Questo esercizio aiuta a superare la timidezza nel pronunciare parole lunghe come "neurocognitive" o "discordant" e a gestire le pause naturali. Ricorda: il "shadowspeaks" non è solo ripetere, ma capire il senso mentre parli. Con la pratica, noterai che la tua capacità di seguire e riprodurre discorsi tecnici migliorerà drasticamente!
Cos'è la tecnica dello Shadowing?
Shadowing è una tecnica di apprendimento delle lingue supportata da studi scientifici, originariamente sviluppata per la formazione dei traduttori professionisti e resa popolare dal poliglotta Dr. Alexander Arguelles. Il metodo è semplice ma potente: ascolti un audio in inglese di madrelingua e lo ripeti immediatamente ad alta voce — come un'ombra che segue il parlante con un ritardo di solo 1–2 secondi. A differenza dell'ascolto passivo o degli esercizi di grammatica, lo shadowing costringe il tuo cervello e i muscoli della bocca a elaborare e riprodurre simultaneamente i modelli di discorso reale. La ricerca dimostra che migliora significativamente la precisione della pronuncia, l'intonazione, il ritmo, il discorso connesso, la comprensione dell'ascolto e la fluidità del parlato — rendendolo uno dei metodi più efficaci per la preparazione alla prova di speaking dell'IELTS e per la comunicazione reale in inglese.