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Intracranial antiepileptics

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https://www.readbyqxmd.com/read/28718878/deep-brain-and-cortical-stimulation-for-epilepsy
#1
REVIEW
Mathieu Sprengers, Kristl Vonck, Evelien Carrette, Anthony G Marson, Paul Boon
BACKGROUND: Despite optimal medical treatment, including epilepsy surgery, many epilepsy patients have uncontrolled seizures. Since the 1970s interest has grown in invasive intracranial neurostimulation as a treatment for these patients. Intracranial stimulation includes both deep brain stimulation (DBS) (stimulation through depth electrodes) and cortical stimulation (subdural electrodes). This is an updated version of a previous Cochrane review published in 2014. OBJECTIVES: To assess the efficacy, safety and tolerability of DBS and cortical stimulation for refractory epilepsy based on randomized controlled trials (RCTs)...
July 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28644064/frequent-vomiting-attacks-in-a-patient-with-lhermitte-duclos-disease-a-rare-pathophysiology-of-cerebellar-lesions
#2
Chika Somagawa, Tomonori Ono, Ryoko Honda, Hiroshi Baba, Takeshi Hiu, Ryujiro Ushijima, Keisuke Toda, Kei Sato, Masahiro Ito, Keisuke Tsutsumi
Lhermitte-Duclos disease (LDD) is a neurological disease caused by a hamartomatous lesion in the cerebellum. Clinically, LDD is commonly associated with progressive space-occupying lesion effects in the posterior fossa, increasing intracranial pressure, occlusive hydrocephalus, and focal neurological deficits of adjacent structures. The authors report the case of a 10-year-old boy with LDD who had been suffering from vomiting attacks (VAs). These VAs had been brief in duration but extremely frequent, and they had been resistant to antiemetic drugs since the early postnatal period...
June 23, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28615425/epilepsy-associated-long-term-mortality-after-aneurysmal-subarachnoid-hemorrhage
#3
Jukka Huttunen, Antti Lindgren, Mitja I Kurki, Terhi Huttunen, Juhana Frösen, Timo Koivisto, Mikael von Und Zu Fraunberg, Arto Immonen, Juha E Jääskeläinen, Reetta Kälviäinen
OBJECTIVE: To elucidate the epilepsy-associated causes of death and subsequent excess long-term mortality among 12-month survivors of subarachnoid hemorrhage from saccular intracranial aneurysm (SIA-SAH). METHODS: The Kuopio SIA Database (kuopioneurosurgery.fi) includes all SIA-SAH patients admitted to the Kuopio University Hospital from its defined catchment population in Eastern Finland. The study cohort consists of 779 patients, admitted from 1995 to 2007, who were alive at 12 months after SIA-SAH...
July 18, 2017: Neurology
https://www.readbyqxmd.com/read/28540130/corpora-amylacea-mimicking-low-grade-glioma-and-manifesting-as-a-seizure-case-report
#4
Seung J Lee, Minsu Kim, Carlito Lagman, Timothy T Bui, William H Yong, Isaac Yang
BACKGROUND: Corpora amylacea (CA) are accumulations of polyglucosan bodies typically found in astrocytic foot processes, and rarely, can mimic neoplasm. CA accumulation has also been associated with seizure disorders. We report the first case of a histologically confirmed intracranial, intraparenchymal CA lesion mimicking a low-grade glioma and manifesting as a seizure. CASE DESCRIPTION: A 43-year-old man presented after a general tonic-clonic (GTC) seizure. Brain magnetic resonance imaging (MRI) revealed a small lesion in the right mesial temporal lobe with radiologic features of a low-grade glioma...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28495218/effects-of-hippocampal-low-frequency-stimulation-in-idiopathic-non-human-primate-epilepsy-assessed-via-a-remote-sensing-enabled-neurostimulator
#5
Thomas A Wozny, Witold J Lipski, Ahmad Alhourani, Efstathios D Kondylis, Arun Antony, R Mark Richardson
Individuals with pharmacoresistant epilepsy remain a large and under-treated patient population. Continued technologic advancements in implantable neurostimulators have spurred considerable research efforts directed towards the development of novel antiepileptic stimulation therapies. However, the lack of adequate preclinical experimental platforms has precluded a detailed understanding of the differential effects of stimulation parameters on neuronal activity within seizure networks. In order to chronically monitor seizures and the effects of stimulation in a freely-behaving non-human primate with idiopathic epilepsy, we employed a novel simultaneous video-intracranial EEG recording platform using a state-of-the-art sensing-enabled, rechargeable clinical neurostimulator with real-time seizure detection and wireless data streaming capabilities...
August 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28446744/levetiracetam-pharmacokinetics-in-a-patient-with-intracranial-hemorrhage-undergoing-continuous-veno-venous-hemofiltration
#6
Edward T Van Matre, Scott W Mueller, Douglas N Fish, Robert MacLaren, Luis F Cava, Robert T Neumann, Tyree H Kiser
BACKGROUND Levetiracetam is an antiepileptic drug frequently used in critically ill patients. Levetiracetam is primarily eliminated as a parent compound via glomerular filtration and requires dose adjustment in renal insufficiency, but the literature on patients receiving continuous veno-venous hemofiltration (CVVH) is scant. CASE REPORT We report the levetiracetam pharmacokinetic profile of a patient being treated with levetiracetam 1000 mg intravenously every 12 h who required continuous veno-venous hemofiltration (CVVH)...
April 27, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28251589/neurostimulation-devices-used-in-treatment-of-epilepsy
#7
REVIEW
Evren Burakgazi Dalkilic
Epilepsy is a chronic neurological disorder frequently requiring lifelong treatment. In 70% of epilepsy patients, seizures are well controlled by antiepileptic medications. About 30% of epilepsy patients remain refractory to medical treatments and may need surgical interventions for better seizure control. Unfortunately and not infrequently, surgical intervention is not feasible due to various reasons such as multiple seizure foci, not resectable focus because of eloquent cortex location, or inability to tolerate surgery due to ongoing concomitant medical conditions...
February 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28199998/delayed-intraparenchymal-and-intraventricular-hemorrhage-requiring-surgical-evacuation-after-mri-guided-laser-interstitial-thermal-therapy-for-lesional-epilepsy
#8
Sean M Barber, Luke Tomycz, Timothy George, Dave F Clarke, Mark Lee
BACKGROUND: Symptomatic intracranial hemorrhage is a rare complication of laser interstitial thermal therapy (LITT). OBJECTIVES: To present a unique case of delayed symptomatic intracranial hemorrhage occurring after a LITT procedure for epilepsy in a high-volume center (68 LITT procedures for pediatric epilepsy have been performed). METHODS: An 18-year-old male with epilepsy underwent LITT to an area of heterotopia near the right lateral ventricle...
2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/27900948/prediction-of-antiepileptic-drug-treatment-outcomes-using-machine-learning
#9
Sinisa Colic, Robert G Wither, Min Lang, Liang Zhang, James H Eubanks, Berj L Bardakjian
OBJECTIVE: Antiepileptic drug (AED) treatments produce inconsistent outcomes, often necessitating patients to go through several drug trials until a successful treatment can be found. This study proposes the use of machine learning techniques to predict epilepsy treatment outcomes of commonly used AEDs. APPROACH: Machine learning algorithms were trained and evaluated using features obtained from intracranial electroencephalogram (iEEG) recordings of the epileptiform discharges observed in Mecp2-deficient mouse model of the Rett Syndrome...
November 30, 2016: Journal of Neural Engineering
https://www.readbyqxmd.com/read/27857926/intracerebral-hemorrhagic-infarction-after-cranioplasty-in-a-patient-with-sinking-skin-flap-syndrome
#10
Jai-Hyuck Han, Mou-Seop Lee
The sinking skin flap syndrome (SSFS) is a rare complication after a large craniectomy. Hemorrhage infarction after a cranioplasty is a very rare complication with only 4 cases to date. We report a case of the patient who underwent an autologous cranioplasty to treat SSFS that developed intracerebral hemorrhage infarction. A 20-year-old male was admitted to our emergency department with stuporous mentality. Emergent decompressive craniectomy (DC) have done. He had suffered from SSFS and fever of unknown origin (FUO) since DC...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27842769/drug-induced-acute-liver-failure
#11
REVIEW
Shahid Habib, Obaid S Shaikh
Drug-induced acute liver failure (ALF) disproportionately affects women and nonwhites. It is most frequently caused by antimicrobials and to a lesser extent by complementary and alternative medications, antiepileptics, antimetabolites, nonsteroidals, and statins. Most drug-induced liver injury ALF patients have hepatocellular injury pattern. Cerebral edema and intracranial hypertension are the most serious complications of ALF. Other complications include coagulopathy, sepsis, metabolic derangements, and renal, circulatory, and respiratory dysfunction...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27703674/correlation-between-secondary-thrombosis-in-epileptic-patients-and-serum-levels-of-folate-and-vitamin-b12
#12
Hao Zhou, Hong-Li Huang, Nuan Wang, Xiao-Hu Pang
Epilepsy is a chronic brain dysfunction syndrome and nervous system disease whose pathogenesis remains to be determined. The aim of the present study was to analyze the correlation between secondary thrombosis and the serum levels of folate and vitamin B12 in epileptic patients, as well as to determine whether the supplementation of folate and vitamin B12 was associated with a decreased incidence of thrombosis, and provide the basis for novel clinical treatment. A total of 37 patients, diagnosed as epileptic with secondary thrombosis between April 2012 and April 2014, were included in the treatment group...
October 2016: Biomedical Reports
https://www.readbyqxmd.com/read/27703637/intracranial-hemorrhage-induced-uncontrolled-seizure-in-a-deceased-donor-liver-transplant-patient-a-case-report
#13
Seung-Young Oh, Hannah Lee, Yang-Hyo Park, Ho Geol Ryu
Seizure is the second most common neurologic complication after liver transplantation and may be caused by metabolic abnormalities, electrolyte imbalance, infection, and immunosuppressant toxicity. A 61-year-old male patient underwent liver transplantation due to hepatitis B virus-related liver cirrhosis with portal systemic encephalopathy. The immediate postoperative course of the patient was uncomplicated. However, on postoperative day (POD) 6, weakness developed in both lower extremities. No abnormal findings were detected on a brain computed tomography (CT) scan on POD 8, but a generalized tonic clonic seizure developed which was difficult to control even with multiple antiepileptic drugs...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27471595/neurocysticercosis-in-pregnancy-maternal-and-fetal-outcomes
#14
Rebecca F D'Cruz, Sher M Ng, Pooja Dassan
Neurocysticercosis (NCC) is a parasitic infection with the larvae of Taenia solium from contaminated pork. It is a leading cause of seizures in the developing world. Symptoms may be secondary to live or degenerating cysts, or previous infection causing calcification or gliosis. Diagnosis is based on clinical presentation, radiological confirmation of intracranial lesions and immunological testing. Management involves symptom control with antiepileptics and antiparasitic agents. Few cases have been described of maternal NCC during pregnancy...
July 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27396544/circadian-and-ultradian-patterns-of-epileptiform-discharges-differ-by-seizure-onset-location-during-long-term-ambulatory-intracranial-monitoring
#15
David C Spencer, Felice T Sun, Sarah N Brown, Barbara C Jobst, Nathan B Fountain, Victoria S S Wong, Emily A Mirro, Mark Quigg
OBJECTIVE: Previous studies reporting circadian patterns of epileptiform activity and seizures are limited by (1) short-term recording in an epilepsy monitoring unit (EMU) with altered antiepileptic drugs (AEDs) and sleep, or (2) subjective seizure diary reports. We studied circadian patterns using long-term ambulatory intracranial recordings captured by the NeuroPace RNS System. METHODS: Retrospective study of RNS System trial participants with stable detection parameters over a continuous 84-day period...
September 2016: Epilepsia
https://www.readbyqxmd.com/read/27341061/comparative-surgical-outcome-associated-with-the-management-of-brain-arteriovenous-malformation-in-a-regional-neurosurgical-centre
#16
COMPARATIVE STUDY
Mario K Teo, Adam M H Young, Edward J St George
OBJECTIVES: Microsurgical resection of brain arteriovenous malformation (AVMs) is challenging, however, expert surgical series from large volume centres, have reported over 95% occlusion rates with 2 to 8% risk of morbidity & mortality. Data from a regional neurosurgical unit was analysed and compared with published series for the purposes of quality control. We also compared our surgical result with other treatment modalities from the whole AVM cohort managed over the same study period...
December 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27292227/the-relationship-between-seizures-interictal-spikes-and-antiepileptic-drugs
#17
Irina I Goncharova, Rafeed Alkawadri, Nicolas Gaspard, Robert B Duckrow, Dennis D Spencer, Lawrence J Hirsch, Susan S Spencer, Hitten P Zaveri
OBJECTIVE: A considerable decrease in spike rate accompanies antiepileptic drug (AED) taper during intracranial EEG (icEEG) monitoring. Since spike rate during icEEG monitoring can be influenced by surgery to place intracranial electrodes, we studied spike rate during long-term scalp EEG monitoring to further test this observation. METHODS: We analyzed spike rate, seizure occurrence and AED taper in 130 consecutive patients over an average of 8.9days (range 5-17days)...
September 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27281943/-intracranial-tumors-and-epileptic-seizures-treatment-principles
#18
Andrea O Rossetti, Serge Vulliémoz
Epileptic seizures represent a relatively frequent issue in patients with intracranial neoplasms, and very frequently imply the start of an antiepileptic treatment as secondary prophylaxis. Even if the current level of evidence is relatively low, compounds with a limited risk of pharmacokinetic interactions are clearly preferred. Levetiracetam is probably the most prescribed agent in this setting, while pregabalin, valproate, lacosamide and lamotrigine are valuable alternatives. The treatment choice has to consider the different profiles of side effects and should be tailored to each patient...
April 27, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/27176609/survival-following-decompressive-hemicraniectomy-for-hemiconvulsion-hemiplegia-epilepsy-syndrome-case-report
#19
Alexandra D Beier, Gemi E Jannotta, E Dayan Sandler, Harry S Abram, Raj D Sheth, Philipp R Aldana
Hemiconvulsion-hemiplegia-epilepsy (HHE) is an uncommon epileptic syndrome that affects young children. Typical management includes early initiation of benzodiazepines to abate the initial seizure activity quickly. Patients in whom epilepsy develops require prolonged use of antiepileptic agents. Herniation due to diffuse cerebral edema from HHE is rare; however, decompressive craniectomy has been described as a lifesaving measure. The authors present the case of a patient in whom a decompressive craniectomy was performed...
September 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27162608/simple-partial-status-epilepticus-manifested-as-homonymous-hemianopsia-a-rare-intracranial-recording
#20
Anna Siatouni, Stylianos Gatzonis, Andreas Alexopoulos, Nikos Georgakoulias, Mathildi Papathanassiou, Stefanos Korfias, Vaso Zisimopoulou, Damianos Sakas
A 30-year-old woman with intractable seizures evaluated as surgical candidate. During presurgical evaluation an invasive electroencephalogram was recommended to define the location and extent of epileptogenic zone and relationship to epileptogenic lesion. On third monitoring night the patient complained of persistent homonymous hemianopsia following a habitual seizure. Concurrently, persistent epileptic activity was evident in a small, restricted area around the right calcarine fissure. The ictal discharges persisted for the next 30 h despite high-dose administration of intravenous antiepileptic drugs, until patient was taken to operating room...
March 25, 2016: Clinics and Practice
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