シャドーイング練習: MRI-Negative Epilepsy - 動画で英語スピーキングを学ぶ
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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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この動画で英語スピーキング練習する理由
医療分野の専門用語や論理的な話し方を練習したい方には最適な動画です。「MRI - negative epilepsy」のような専門的なトピックを使って、shadow speak（シャドースピーク）の練習をすることで、リアルな会話のリズムや専門用語の発音、論理的な説明の仕方を身につけることができます。日常会話だけでなく、ビジネスや専門的な場面での英語スピーキング能力も向上します。また、話者が問題を提示して解決策を探る過程を追うことで、議論の展開方法も学べます。
文脈の中の文法と表現
動画の中には、英語学習に役立ついくつかの表現があります。
- 「if you were to imagine...」：仮定法の一種で、「もし...を想像するなら」という意味。例えば、「If you were to imagine the ideal patient, what would you think?」のように使います。仮定的な場面を表すのに便利です。
- 「tend to have better outcomes」：「傾向がある」という意味の「tend to」と「outcomes」（結果）の組み合わせ。「Patients with lesional epilepsy tend to have better outcomes.」のように、傾向を説明するのによく使われます。
- 「compared to that other group」：「...と比較して」という表現。「The seizure - free likelihood is 40 - 50% compared to that other group.」のように、データの比較をする際に使います。
発音の難しい箇所
動画の中には、発音が難しい単語やアクセントがあります。
- 「epilepsy」：/ˈepɪlepsi/ と発音します。「エピレプシー」と日本語でも言いますが、英語の発音では「ep」の部分を強く発音します。
- 「temporal lobe」：「temporal」は/ˈtempərəl/、「lobe」は/loʊb/ です。「テンポラルローブ」という意味で、脳の部分を指します。「temporal」の発音が難しいので、繰り返し練習しましょう。
- 「prognostic」：/prɑːɡˈnɑːstɪk/ と発音します。「予後の」という意味で、医療用語でよく使われます。「pro」の部分を強く発音し、「gn」の部分は鼻濁音になります。
これらの発音をshadowspeakの練習で覚えることで、自然な英語の発音が身につきます。動画を何度も繰り返し聞き、真似して話すことが大切です。
シャドーイングとは？英語上達に効果的な理由
シャドーイング（Shadowing）は、もともとプロの通訳者養成プログラムで開発された言語学習法で、多言語習得者として知られるDr. Alexander Arguelles によって広く普及されました。方法はシンプルですが非常に効果的：ネイティブスピーカーの英語を聞きながら、1〜2秒の遅延で声に出してすぐに繰り返す——まるで「影（shadow）」のように話者を追いかけます。文法ドリルや受動的なリスニングと異なり、シャドーイングは脳と口の筋肉が同時にリアルタイムで英語を処理・再現することを強制します。研究により、発音精度、抑揚、リズム、連音、リスニング力、そして会話の流暢さが大幅に向上することが確認されています。IELTSスピーキング対策や自然な英語コミュニケーションを目指す方に特におすすめです。