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Epilepsy, vagal nerve stimulator, aed

Firas Fahoum, Nurit Omer, Svetlana Kipervasser, Tal Bar-Adon, Miri Neufeld
The yield of monitoring patients at an epilepsy monitoring unit (EMU) depends on the recording of paroxysmal events in a timely fashion, however, increasing the risk of safety adverse events (AEs). We aimed to retrospectively study the frequency and risk factors for AE occurrences in all consecutive admissions to an adult EMU in a tertiary medical center. We also compared our findings with published data from other centers. Between January 2011 and June 2014, there were 524 consecutive admissions to the adult EMU at the Tel Aviv Sourasky Medical Center...
August 2016: Epilepsy & Behavior: E&B
Markus Gschwind, Margitta Seeck
Complete seizure control is achieved in 40-50% of all epileptic patients with drug treatment, as reported in most epidemiological studies. Many effective antiepileptic drugs with a favourable profile are available in Switzerland, allowing treatment tailored to the patient's needs. Unfortunately, up to 40-50% of all patients will eventually relapse (pharmacoresistant epilepsy). These patients run a high risk of additional morbidity and mortality. Possible pharmacoresistant epilepsy should be considered early in the disease, when there is a lack of response to the first antiepileptic drug, since only 14% of those will respond to a second drug, and only 2% to a third drug if the second fails too...
2016: Swiss Medical Weekly
Selcuk Ozdogan, Raziye Handan Nurhat, Ali Haluk Duzkalir, Deniz Yuce, Hakan Sabuncuoglu, Zeki Gokcil, Ersin Erdogan
AIM: The aim of this study was to find out if vagal nerve stimulation (VNS) affect the generalized-partial seizure count and medical treatment in adult drug resistant epilepsy patients. MATERIAL AND METHODS: Twenty adult patients who were diagnosed with drug-resistant epilepsy were investigated retrospectively for vagal nerve stimulator implantation between 2001 and 2010 at the Neurosurgery Departments of Ufuk University and Gulhane Military Medical Academy. The effects of vagal nerve stimulation on generalized-partial seizures and medical treatment was scored and if a significant difference was found, a comparison was made by Wilcoxon Signed Ranks test and Pairwise...
2016: Turkish Neurosurgery
Anand K Sarma, Nabil Khandker, Lisa Kurczewski, Gretchen M Brophy
Epilepsy is one of the most common neurologic illnesses. This condition afflicts 2.9 million adults and children in the US, leading to an economic impact amounting to $15.5 billion. Despite the significant burden epilepsy places on the population, it is not very well understood. As this understanding continues to evolve, it is important for clinicians to stay up to date with the latest advances to provide the best care for patients. In the last 20 years, the US Food and Drug Administration has approved 15 new antiepileptic drugs (AEDs), with many more currently in development...
2016: Neuropsychiatric Disease and Treatment
Michal Tzadok, Shimrit Uliel-Siboni, Ilan Linder, Uri Kramer, Orna Epstein, Shay Menascu, Andrea Nissenkorn, Omer Bar Yosef, Eli Hyman, Dorit Granot, Michael Dor, Tali Lerman-Sagie, Bruria Ben-Zeev
PURPOSE: To describe the experience of five Israeli pediatric epilepsy clinics treating children and adolescents diagnosed as having intractable epilepsy with a regimen of medical cannabis oil. METHODS: A retrospective study describing the effect of cannabidiol (CBD)-enriched medical cannabis on children with epilepsy. The cohort included 74 patients (age range 1-18 years) with intractable epilepsy resistant to >7 antiepileptic drugs. Forty-nine (66%) also failed a ketogenic diet, vagal nerve stimulator implantation, or both...
February 2016: Seizure: the Journal of the British Epilepsy Association
George Nune, Christopher DeGiorgio, Christianne Heck
Neuromodulation devices are used in the treatment of medically refractory epilepsy. This has been defined as epilepsy with persistent seizures despite adequate trials of at least two anti-epileptic drugs (AEDs). In most cases of medically refractory partial epilepsy, the first choice of treatment is resective surgery if the seizure focus can be definitively localized and if surgery can be safely performed without causing intolerable neurologic deficits. Patients with medically refractory epilepsy who are not candidates for potentially curative surgery may benefit from the implantation of a neuromodulation device...
October 2015: Current Treatment Options in Neurology
Pratima Gulati, Patricia Cannell, Twinkle Ghia, Lewis Bint, Peter Walsh, Soumya Ghosh, Lakshmi Nagarajan
AIMS: Lacosamide (LCM) is a novel anti-epileptic drug (AED) that enhances the slow inactivation of voltage-gated sodium channels. Its efficacy as adjunctive therapy for focal seizures is confirmed in adult placebo controlled trials with >50% reduction in seizure frequency in up to 50% patients. There is paucity of data on its efficacy and tolerance in treatment-resistant epilepsy in childhood (TREC). This study aims to assess efficacy and tolerance of LCM as adjunct therapy in TREC...
August 2015: Journal of Paediatrics and Child Health
Verónica Puertas-Martin, Inmaculada Carreras-Saez, Ana Marana, M Luz Ruiz-Falco Rojas, Verónica Cantarin-Extremera, M Lourdes Calleja-Gero
INTRODUCTION: Tuberous sclerosis complex (TSC) is frequently accompanied by difficult-to-treat epilepsy, which conditions these patients' quality of life and cognitive level. AIM. To describe the epidemiological and clinical characteristics, as well as the treatment of patients affected by TSC with epilepsy. PATIENTS AND METHODS: A retrospective review was carried out of the medical records of 30 patients aged under 18 registered in our database, who had been diagnosed with TSC and epilepsy...
June 16, 2014: Revista de Neurologia
Tapas Kumar Banerjee, Shyamal Kumar Das
Refractory Epilepsy (R.E.) is a condition where all antiepileptic drugs (AEDs) fail to provide adequate seizure control. To diagnose R.E., false cases of refractoriness need to be carefully excluded. There are several predictors of refractoriness. The treatment options in R.E. are resective surgery, ketogenic diet and vagal nerve stimulation. The roles of newer AEDs are also promising. The future therapeutic possibilities include deep brain stimulation, AED containing polymers, stem cells and gene therapy.
August 2013: Journal of the Association of Physicians of India
Sita Jayalakshmi, Manas Panigrahi, Subrat Kumar Nanda, Rammohan Vadapalli
Approximately 60% of all patients with epilepsy suffer from focal epilepsy syndromes. In about 15% of these patients, the seizures are not adequately controlled with antiepileptic drugs; such patients are potential candidates for surgical treatment and the major proportion is in the pediatric group (18 years old or less). Epilepsy surgery in children who have been carefully chosen can result in either seizure freedom or a marked (>90%) reduction in seizures in approximately two-thirds of children with intractable seizures...
March 2014: Annals of Indian Academy of Neurology
Shay Menascu, Uri Kremer, Yitzhak Schiller, Ilan Blatt, Nathan Watemberg, Marina Boxer, Hadasa Goldberg, Isabella Korn-Lubetzki, Moshe Steinberg, Bruria Ben-Zeev
BACKGROUND: The management of intractable epilepsy in children and adults is challenging. For patients who do not respond to anti-epileptic drugs and are not suitable candidates for epilepsy surgery, vagal nerve stimulation (VNS) is a viable alternative for reducing seizure frequency. METHODS: In this retrospective multicenter open-label study we examined the efficacy and tolerability of VNS in patients in five adult and pediatric epilepsy centers in Israel. All patients had drug-resistant epilepsy and after VNS implantation in 2006-2007 were followed for a minimum of 18 months...
November 2013: Israel Medical Association Journal: IMAJ
Vera C Terra, Ricardo Amorim, Carlos Silvado, Andrea Julião de Oliveira, Carmen Lisa Jorge, Eduardo Faveret, Paulo Ragazzo, Luciano De Paola
Epilepsy comprises a set of neurologic and systemic disorders characterized by recurrent spontaneous seizures, and is the most frequent chronic neurologic disorder. In patients with medically refractory epilepsy, therapeutic options are limited to ablative brain surgery, trials of experimental antiepileptic drugs, or palliative surgery. Vagal nerve stimulation is an available palliative procedure of which the mechanism of action is not understood, but with established efficacy for medically refractory epilepsy and low incidence of side-effects...
November 2013: Arquivos de Neuro-psiquiatria
Vera C Terra, Luciano L Furlanetti, Altacílio Aparecido Nunes, Ursula Thomé, Meire Akico Nisyiama, Américo C Sakamoto, Helio R Machado
Vagus nerve stimulation (VNS) seems to be effective in the management of selected cases of pharmacoresistant epilepsy in children. This was a case-control prospective study of children with refractory epilepsy submitted to vagal nerve stimulator implantation and a control group with epilepsy treated with antiepileptic drugs. Patients under 18years of age who underwent clinical or surgical treatment because of pharmacoresistant epilepsy from January 2009 to January 2012 were followed and compared with an age-matched control group at final evaluation...
February 2014: Epilepsy & Behavior: E&B
Pascal Vrielynck
In this report, we review the pharmacological and non-pharmacological treatments of the different absence seizure types as recently recognized by the International League Against Epilepsy: typical absences, atypical absences, myoclonic absences, and eyelid myoclonia with absences. Overall, valproate and ethosuximide remain the principal anti-absence drugs. Typical absence seizures exhibit a specific electroclinical semiology, pathophysiology, and pharmacological response profile. A large-scale comparative study has recently confirmed the key role of ethosuximide in the treatment of childhood absence epilepsy, more than 50 years after its introduction...
2013: Neuropsychiatric Disease and Treatment
S Healy, J Lang, J Te Water Naude, F Gibbon, P Leach
OBJECTIVE: This study aims to assess the efficacy and safety of vagal nerve stimulation (VNS) in children less than 12 years old operated on at the University Hospital Wales. METHOD: Retrospective review of patients undergoing VNS insertion, over a 3-year period, was undertaken. All children had a minimum follow-up period of 2 years. Sixteen patients were identified via the paediatric epilepsy surgery database. A case note review and telephone evaluation was conducted...
November 2013: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Gregory L Krauss, Michael R Sperling
Recent evidence suggests that medically resistant epilepsy can be identified if seizures persist despite adequate doses of 2 appropriate first-line antiepileptic drugs (AEDs). Patients with medically resistant epilepsy should have their seizures carefully characterized in order to confirm their diagnosis, select treatment, and assist in determining prognosis. Patients should be counseled about factors that aggravate epilepsy and the importance of adhering to treatments. Physicians should carefully inquire about side effects and alter therapy to eliminate or minimize these symptoms...
December 2011: Neurology. Clinical Practice
Samira Yadegari, Parviz Bahrami
Idiopathic generalized epilepsies (IGE) are genetic based seizures with normal neurologic exam, intelligence, and imaging studies. Based on the age of onset and prominent seizure type, different syndromes were identified. The purpose of this study is to summarize the characteristics, prognosis, and choices of antiepileptic drugs (AED) in common syndromes of IGE. In addition, we review the updated role of new AEDs in specific syndromes of IGE. The first choice AED is usually valproate. Most drug trials on the effects of new AEDs compared them with placebo and not valproate...
April 2013: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Luisa Rocha
In spite of the high success rate of many surgical procedures for pharmacoresistant epilepsy, a substantial number of patients do not become seizure-free. Different strategies for electrical modulation of the brain such as Deep Brain Stimulation, Vagal Nerve Stimulation and Transcraneal Magnetic Stimulation have gained considerable interest in the last decade as alternative therapies for patients with medically refractory epilepsy. Research into the mechanism of action of the strategies for electrical modulation of the brain suggests a crucial role of different molecules and channels such as glutamate, γ-aminobutyric acid, adenosine, brain-derived neurotrophic factor, calcium channels, sodium channels as well as extracellular potassium...
May 2013: Pharmacology & Therapeutics
Mohamad A Mikati, Nour Ataya, Jessica El-Ferezli, Alhan Shamseddine, Amal Rahi, Aline Herlopian, Rana Kurdi, Saleh Bhar, Abeer Hani, Youssef G Comair
We present our 10-year experience and preoperative predictors of outcome in 93 adults and children who underwent epilepsy surgery at the American University of Beirut. Presurgical evaluation included video-EEG monitoring, MRI, neuropsychological assessment with invasive monitoring, and other tests (PET, SPECT, Wada). Surgeries included temporal (54%), extratemporal (22%), and multilobar resections (13%), hemispherectomy (4%), vagal nerve stimulation (6%), and corpus callosotomy (1%). Mesial temporal sclerosis was the most common aetiology (37%)...
September 2012: Epileptic Disorders: International Epilepsy Journal with Videotape
Andrea O Rossetti, Serge Vulliémoz
Antiepileptic drugs allow controlling seizures in 70% of patients. For the others, a presurgical work-up should be undertaken, especially if a focal seizure origin is suspected; however, only a fraction of pharmacoresistant patients will be offered resective (curative) surgery. In the last 15 years, several palliative therapies using extra- or intracranial electrical stimulations have been developed. This article presents the vagal nerve stimulation, the deep brain stimulation (targeting the mesiotemporal region or the thalamus), and the cortical stimulation "on demand"...
May 2, 2012: Revue Médicale Suisse
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