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Drug-resistant AND epilepsy

Hongyun Liu, Zhao Yang, Fangang Meng, Yuguang Guan, Yanshan Ma, Shuli Liang, Jiuluan Lin, Longsheng Pan, Mingming Zhao, Hongwei Hao, Guoming Luan, Jianguo Zhang, Luming Li
OBJECTIVE: Epilepsy and seizures can have dramatic effects on cardiac function. The aim of the present study was to investigate deceleration capacity, acceleration capacity and their 24-h fluctuations of heart rate variability in patients with drug-resistant epilepsy. METHODS: Deceleration capacity, acceleration capacity of heart rate and their 24-h dynamics derived from the phase rectified signal averaging method as well as traditional measures were analyzed in 39 patients with drug-resistant epilepsy and 33 healthy control subjects using 24-h electrocardiogram recordings...
October 16, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Ingmar Blümcke, Roland Coras, Annika K Wefers, David Capper, Eleonora Aronica, Albert Becker, Mrinalini Honavar, Thomas J Stone, Thomas S Jacques, Hajime Miyata, Angelika Mühlebner, Jose Pimentel, Figen Söylemezoğlu, Maria Thom
Low-grade epilepsy-associated brain tumours (LEAT) are the second most common cause for drug-resistant, focal epilepsy, i.e. ganglioglioma (GG) and dysembryoplastic neuroepithelial tumours (DNT). However, molecular pathogenesis, risk factors for malignant progression, and their frequent association with drug-resistant focal seizures remain poorly understood. This contrasts recent progress in understanding the molecular-genetic basis and targeted treatment options in diffuse gliomas. The Neuropathology Task Force of the International League against Epilepsy examined available literature to identify common obstacles in diagnosis and research of LEAT...
October 16, 2018: Neuropathology and Applied Neurobiology
Katrin Augustin, Sophie Williams, Mark Cunningham, Anita M Devlin, Maximilian Friedrich, Ashan Jayasekera, Mohammed A Hussain, Damian Holliman, Patrick Mitchell, Alistair Jenkins, Philip E Chen, Matthew C Walker, Robin S B Williams
Perampanel is an adjunctive treatment for epilepsy that works through the direct inhibition of AMPA receptors. The same molecular mechanism has recently been shown for a fatty acid, decanoic acid, prescribed in the medium chain triglyceride ketogenic diet for the treatment of patients with drug-resistant epilepsy. Because each compound has been proposed to act through a distinct AMPA receptor binding site, we predicted that perampanel and decanoic acid would act synergistically against AMPA receptors and, consequently, seizures...
October 15, 2018: Epilepsia
Margarita Minou Báez-Martín, Lilia Maria Morales-Chacón, Iván García-Maeso, Bárbara Estupiñán-Díaz, María Eugenia García-Navarro, Yamila Pérez Téllez, Lourdes Lorigados-Pedre, Nelson Quintanal-Cordero, Ricardo Valdés-Llerena, Judith González González, Randis Garbey-Fernández, Ivette Cabrera-Abreu, Celia Alarcón-Calaña, Juan E Bender Del Busto, Rafael Rodríguez Rojas, Karla Batista García-Ramó, Reinaldo Galvizu Sánchez
Auditory and visual pathways may be affected as a consequence of temporal lobe epilepsy surgery because of their anatomical relationships with this structure. The purpose of this paper is to correlate the results of the auditory and visual evoked responses with the parameters of tractography of the visual pathway, and with the state of connectivity between respective thalamic nuclei and primary cortices in both systems after the surgical resection of the epileptogenic zone in drug-resistant epileptic patients...
October 12, 2018: Behavioral Sciences
A M Feyissa, T F Hasan, J F Meschia
Stroke is the cause of about 10% of all epilepsy and 55% of newly diagnosed seizures among the elderly. Although recent advances in acute stroke therapy have improved longevity, there has been a consequent rise in the prevalence of stroke-related epilepsy (STRE). Many clinical studies make a distinction between early (within 7 days of onset of stroke) and late (beyond 7 days of onset of stroke) seizures based on presumed pathophysiological differences. Although early seizures are thought to be the consequence of local metabolic disturbances without altered neuronal networks, late seizures are thought to occur when the brain has acquired a predisposition for seizures...
October 15, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Niraj K Sharma, Carlos Pedreira, Umair J Chaudhary, Maria Centeno, David W Carmichael, Tinonkorn Yadee, Teresa Murta, Beate Diehl, Louis Lemieux
OBJECTIVES: Simultaneous intracranial EEG and functional MRI (icEEG-fMRI) can be used to map the haemodynamic (BOLD) changes associated with the generation of IEDs. Unlike scalp EEG-fMRI, in most patients who undergo icEEG-fMRI, IEDs recorded intracranially are numerous and show variability in terms of field amplitude and morphology. Therefore, visual marking can be highly subjective and time consuming. In this study, we applied an automated spike classification algorithm, Wave_clus (WC), to IEDs marked visually on icEEG data acquired during simultaneous fMRI acquisition...
October 10, 2018: NeuroImage
Janna Lehnhoff, Ulf Strauss, Stephan Wierschke, Sabine Grosser, Evangelia Pollali, Ulf C Schneider, Martin Holtkamp, Christoph Dehnicke, Rudolf A Deisz
Alterations of the hyperpolarization activated nonselective cation current (Ih ) are associated with epileptogenesis. Accordingly, the second-generation antiepileptic drug lamotrigine (LTG) enhances Ih in rodent hippocampus. We directly evaluated here whether LTG fails to enhance Ih in neocortical slices from patients with pharmacoresistant epilepsy. With somatic current clamp recordings we observed that LTG depolarized the membrane potential, decreased the input resistance and increased the "sag" in human layer 2/3 neocortical pyramidal neurons when confounding IKir was blocked...
October 10, 2018: Neuropharmacology
Yanping Sun, Udaya Seneviratne, Piero Perucca, Zhibin Chen, Meng Kee Tan, Terence J O'Brien, Wendyl D'Souza, Patrick Kwan
OBJECTIVE: To identify clinical and EEG biomarkers of drug resistance in adults with idiopathic generalized epilepsy. METHODS: We conducted a case-control study consisting of a discovery cohort and a replication cohort independently assessed at 2 different centers. In each center, patients with the idiopathic generalized epilepsy phenotype and generalized spike-wave discharges on EEG were classified as drug-resistant or drug-responsive. EEG changes were classified into predefined patterns and compared between the 2 groups in the discovery cohort...
October 12, 2018: Neurology
J Kim, S Radjadurai, Z Rahman, K Hitos, S Ghattas, L Gomes, C Wong, A Bleasel, M A Dexter
INTRODUCTION: Seizures are an important cause of morbidity in patients with low grade gliomas with approximately 40% of cases drug resistant. The pathogenesis is quite complex and poorly understood. The treatment aims vary between almost purely epilepsy considerations and those that are primarily oncologic. AIM: To determine whether patients who present with seizures and are found to have a low grade glioma have better outcomes when managed through a specialized epilepsy unit compared to the general neurosurgical service...
October 9, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Irene Cano-López, Kevin G Hampel, Mercedes Garcés, Vicente Villanueva, Esperanza González-Bono
OBJECTIVE: To investigate the relative contribution of factors non-directly related to seizures such as negative affectivity, social support, somatic symptoms and memory performance on quality of life (QOL) in patients with drug-resistant epilepsy. METHODS: This is a cross-sectional study. Seventy patients with drug-resistant epilepsy were consecutively recruited from the inpatient Epilepsy Unit, Hospital Universitario y Politécnico La Fe, between April 2015 and October 2017...
November 2018: Journal of Psychosomatic Research
Xian-Jin Ke, Yong-Fei Cheng, Nian Yu, Qing Di
Drug-resistant epilepsy (DRE) is present in 20-30% of all patients who develop epilepsy. Growing evidences demonstrated that glutamate released during seizures to increase the brain P-glycoprotein (P-gp) expression. Carbamazepine (CBZ) is known to influence the P-gp and cytochrome P450 (CYP) expression. However, the exact molecular mechanism is still unknown. We investigated that the effects of NF-κB and pregnane X receptor (PXR) activity on P-gp and CYP3A expression in mouse brain endothelial (bEnd.3) cells treated with l-glutamate (mimicking the seizure conditions), CBZ (mimicking the AED treating conditions) or both (l-glutamate plus CBZ) through qPCR and Western blotting assay...
October 9, 2018: Neuroscience Letters
Vaclav Kremen, Benjamin H Brinkmann, Inyong Kim, Hari Guragain, Mona Nasseri, Abigail L Magee, Tal Pal Attia, Petr Nejedly, Vladimir Sladky, Nathanial Nelson, Su-Youne Chang, Jeffrey A Herron, Tom Adamski, Steven Baldassano, Jan Cimbalnik, Vince Vasoli, Elizabeth Fehrmann, Tom Chouinard, Edward E Patterson, Brian Litt, Matt Stead, Jamie Van Gompel, Beverly K Sturges, Hang Joon Jo, Chelsea M Crowe, Timothy Denison, Gregory A Worrell
Brain stimulation has emerged as an effective treatment for a wide range of neurological and psychiatric diseases. Parkinson's disease, epilepsy, and essential tremor have FDA indications for electrical brain stimulation using intracranially implanted electrodes. Interfacing implantable brain devices with local and cloud computing resources have the potential to improve electrical stimulation efficacy, disease tracking, and management. Epilepsy, in particular, is a neurological disease that might benefit from the integration of brain implants with off-the-body computing for tracking disease and therapy...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Francesca Conte, Benjamin Legros, Wim Van Paesschen, Andreja Avbersek, Pierandrea Muglia, Chantal Depondt
PURPOSE: Despite the availability of a broad range of treatments for epilepsy, a significant proportion of patients have ongoing seizures. This study aims to characterize the drug resistant population and to report long-term outcomes of patients undergoing different types of pharmacological and surgical treatment. METHODS: Adult patients with drug resistant epilepsy (DRE) were identified from a largely retrospective database of 900 consecutive patients with epilepsy, recruited from two reference centers for DRE in Belgium...
October 1, 2018: Seizure: the Journal of the British Epilepsy Association
Andrea Arena, Till S Zimmer, Jackelien van Scheppingen, Anatoly Korotkov, Jasper J Anink, Angelika Mühlebner, Floor E Jansen, Wim van Hecke, Wim G Spliet, Peter C van Rijen, Annamaria Vezzani, Johannes C Baayen, Sander Idema, Anand M Iyer, Marzia Perluigi, James D Mills, Erwin A van Vliet, Eleonora Aronica
Oxidative stress (OS) occurs in brains of patients with epilepsy and coincides with brain inflammation, and both phenomena contribute to seizure generation in animal models. We investigated whether expression of OS and brain inflammation markers co-occurred also in resected brain tissue of patients with epileptogenic cortical malformations: hemimegalencephaly (HME), focal cortical dysplasia (FCD) and cortical tubers in tuberous sclerosis complex (TSC). Moreover, we studied molecular mechanisms linking OS and inflammation in an in vitro model of neuronal function...
October 10, 2018: Brain Pathology
S Lakshmikanthcharan, Mohamed Hisham, S K Chaitanya Juluri, Sivakumar Mundilipayalam Nandakumar
Almost one-third of the people suffering from epilepsy continue to have seizures in spite of using appropriate antiepileptics. Pharmacoresistance is defined as the failure to achieve seizure control with two or more anticonvulsant medications at appropriate daily dosage. Here, we discuss one such gentleman whose seizures had been intractable despite multiple antiepileptic drugs in maximum tolerable doses. Verapamil, a calcium channel blocker, was used for its P-glycoprotein inhibition properties to overcome the pharmacoresistance in this patient with satisfactory seizure control...
September 2018: Indian Journal of Critical Care Medicine
Anjiao Peng, Xiangmiao Qiu, Wanlin Lai, Wanling Li, Lin Zhang, Xi Zhu, Shixu He, Jianan Duan, Lei Chen
OBJECTIVE: The relationship between the gut microbiota and the central nervous system has been gradually recognized while whether microbiome plays a role in the pathogenesis of drug-resistant epilepsy is still unknown. The aim of our work was to explore whether dysbiosis is involved in the mechanism of drug-resistant epilepsy. METHODS: Patients with epilepsy attending West China Hospital of Sichuan University were enrolled from March to May 2017. Patients were grouped into drug-resistant (n = 42) and drug-sensitive (n = 49) groups, another 65 healthy controls were from the same families of the patients...
November 2018: Epilepsy Research
Soila Järvenpää, Jukka Peltola, Sirpa Rainesalo, Esa Leinonen, Kai Lehtimäki, Kaija Järventausta
OBJECTIVE: Anterior nucleus of thalamus (ANT) deep brain stimulation (DBS) is becoming a more common treatment for drug-resistant epilepsy. Epilepsy and depression display a bidirectional association. Anterior nucleus of thalamus has connections to anterior cingulate cortex and orbitomedial prefrontal cortex, hence, a possible role in emotional and executive functions, and thus, ANT DBS might exert psychiatric adverse effects. Our aim was to evaluate previous and current psychiatric symptoms in patients with epilepsy undergoing ANT DBS surgery and assess the predictability of psychiatric adverse effects...
October 2, 2018: Epilepsy & Behavior: E&B
Juan Pablo Orozco-Hernández, Juan Felipe Quintero-Moreno, Daniel Stiven Marín-Medina, Aníbal Valencia-Vásquez, Hans Carmona Villada, Angélica Lizcano, José William Martínez
INTRODUCTION: Patients with drug-resistant epilepsy (DRE) account for most of the burden of epilepsy, and they have poor prognosis in seizure control, higher morbidity, and mortality. OBJECTIVES: The objective of the study was to develop a prognostic model of drug resistance in adult patients with generalized epilepsy from Colombia. METHODS: In this case-control study of patients with generalized epilepsy, patients were separated into two groups: one group with DRE (cases) according to the new International League Against Epilepsy (ILAE) definition after a complete evaluation performed by an epileptologist and the other group without DRE (control)...
October 2, 2018: Epilepsy & Behavior: E&B
Eiju Watanabe
Surgery is considered a therapeutic option for drug-resistant epilepsies. As a first step, the epileptic focus is carefully examined using extra- and intra-cranial EEG and various neurodiagnostic imaging techniques, such as magnetic resonance imaging, intra-ictal single photon emission computed tomography, magnetoencephalography, and functional near-infrared spectoroscopy. Only when the epileptogenic focus can not be identified, callosotomy is considered as a palliative surgical method. It is indicated especially in cases with drop attacks, which severely exacerbate the patient's quality of life...
October 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Liliana Czornyj, Paulo Cáceres Guido, Guillermo Bramuglia, Alejandra Rodiño, Iris Feria-Romero, Alberto Lazarowski
BACKGROUND: Low levels of AEDs can be secondary drug-drug interactions or related to irregular intake due to poor treatment adherence. This latter behavior is highly suspected in ambulatory pediatric epileptic patients when controls of AEDs are subtherapeutic. However, it cannot be considered for inpatients during long periods of hospitalization. A few isolated case reports have documented persistent low levels (PLL) of AEDs in hospitalized epileptic children, but no population study has currently been reported...
September 22, 2018: Epilepsy Research
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