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Intractable epilepsy

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https://www.readbyqxmd.com/read/28735133/neurological-outcome-after-resection-of-parietal-lobe-including-primary-somatosensory-cortex-implications-of-additional-resection-of-posterior-parietal-cortex
#1
Young-Hoon Kim, June Sic Kim, Sang Kun Lee, Chun Kee Chung
OBJECTIVE: Postoperative neurological outcomes after primary somatosensory cortex (S1) resection have not been well-documented. This study was designed to evaluate the neurological deterioration that follows resection of the S1 areas and to assess the risk factors associated with these morbidities. METHODS: We reviewed 48 consecutive patients who suffered from medically intractable epilepsy and underwent resection of the S1 and/or the adjacent cortex. The 48 patients were categorized into 4 groups according to the resected area as seen on postoperative magnetic resonance images: Group 1 (resection of S1 only; n=4), 2 (the posterior parietal cortex (PPC) only; n=24), 3 (S1 and PPC; n=10), and 4 (S1 and precentral gyrus; n=10)...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28715338/closed-loop-neurostimulators-a-survey-and-a-seizure-predicting-design-example-for-intractable-epilepsy-treatment
#2
Hossein Kassiri, Sana Tonekaboni, M Tariqus Salam, Nima Soltani, Karim Abdelhalim, Jose Luis Perez Velazquez, Roman Genov
First, existing commercially available open-loop and closed-loop implantable neurostimulators are reviewed and compared in terms of their targeted application, physical size, system-level features, and performance as a medical device. Next, signal processing algorithms as the primary strength point of the closed-loop neurostimulators are reviewed, and various design and implementation requirements and trade-offs are discussed in details along with quantitative examples. The review results in a set of guidelines for algorithm selection and evaluation...
July 17, 2017: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/28714074/altered-metabolomic-genomic-signature-a-potential-noninvasive-biomarker-of-epilepsy
#3
Helen C Wu, Fabien Dachet, Farhad Ghoddoussi, Shruti Bagla, Darren Fuerst, Jeffrey A Stanley, Matthew P Galloway, Jeffrey A Loeb
OBJECTIVE: This study aimed to identify noninvasive biomarkers of human epilepsy that can reliably detect and localize epileptic brain regions. Having noninvasive biomarkers would greatly enhance patient diagnosis, patient monitoring, and novel therapy development. At the present time, only surgically invasive, direct brain recordings are capable of detecting these regions with precision, which severely limits the pace and scope of both clinical management and research progress in epilepsy...
July 17, 2017: Epilepsia
https://www.readbyqxmd.com/read/28710408/non-ketogenic-combination-of-nutritional-strategies-provides-robust-protection-against-seizures
#4
Glenn Dallérac, Julien Moulard, Jean-François Benoist, Stefan Rouach, Stéphane Auvin, Angèle Guilbot, Loïc Lenoir, Nathalie Rouach
Epilepsy is a neurological condition that affects 1% of the world population. Conventional treatments of epilepsy use drugs targeting neuronal excitability, inhibitory or excitatory transmission. Yet, one third of patients presents an intractable form of epilepsy and fails to respond to pharmacological anti-epileptic strategies. The ketogenic diet is a well-established non-pharmacological treatment that has been proven to be effective in reducing seizure frequency in the pharmaco-resistant patients. This dietary solution is however extremely restrictive and can be associated with complications caused by the high [fat]:[carbohydrate + protein] ratio...
July 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28705496/the-effect-of-cxcr2-inhibition-on-seizure-activity-in-the-pilocarpine-epilepsy-mouse-model
#5
Tao Xu, Xinyuan Yu, Teng Wang, Ying Liu, Xi Liu, Shu Ou, Yangmei Chen
C-X-C motif chemokine receptor 2 (CXCR2) is one of the most well characterized chemokine receptors and is a potential target for treating brain pathologies involving inflammatory processes, including epilepsy. However, the role of CXCR2 in epilepsy has not been investigated, and whether CXCR2 modulates seizure activity in temporal lobe epilepsy (TLE) remains unknown. In this study, we aimed to determine the potential role of CXCR2 in intractable TLE patients and in pilocarpine-induced epileptic mice. Here, through Western blotting and semi-quantitative immunohistochemistry, we detected that CXCR2 protein expression was up-regulated (by nearly 50%) in the temporal neocortex of TLE patients and in the hippocampus and adjacent temporal cortex of pilocarpine mice model...
July 10, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28704161/cardiovascular-safety-of-low-dose-fenfluramine-in-dravet-syndrome-a-review-of-its-benefit-risk-profile-in-a-new-patient-population
#6
An-Sofie Schoonjans, Fabienne Marchau, Bernard P Paelinck, Lieven Lagae, Arnold Gammaitoni, Milka Pringsheim, Martin G Keane, Berten Ceulemans
OBJECTIVE: Dravet syndrome (DS) is a rare, treatment-resistant epilepsy syndrome for which current treatment regimens are often ineffective. Fenfluramine is currently in development for treatment of DS based on reports in the 1980s and 1990s of its antiepileptic activity in pediatric patients with intractable epilepsy. However, fenfluramine was withdrawn from global markets in 1997 following reports of its association with pulmonary hypertension and heart valve disease in adult patients treated for obesity...
July 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28702333/cough-syncope-induced-by-post-nasal-drip-successfully-managed-by-gabapentin
#7
Hussein Algahtani, Bader Shirah
Syncope is a common complaint in both neurology clinic and emergency department. It is defined as transient loss of consciousness with loss of postural tone, which is usually self-limited and followed by a spontaneous recovery. Our report describes a case of cough syncope resulting from chronic intractable cough caused by post nasal drip. Although his experience was debilitating, we were able to control his symptoms significantly using a small dose of Gabapentin. This dose is much lower when compared with the already established licensed indicated higher doses used for the treatment of neuropathic pain and epilepsy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28698761/vagus-nerve-stimulation
#8
REVIEW
Hakan Ekmekçi, Hülagu Kaptan
BACKGROUND: The vagus nerve stimulation (VNS) is an approach mainly used in cases of intractable epilepsy despite all the efforts. Also, its benefits have been shown in severe cases of depression resistant to typical treatment. AIM: The aim of this study was to present current knowledge of vagus nerve stimulation. MATERIAL AND METHODS: A new value has emerged just at this stage: VNS aiming the ideal treatment with new hopes. It is based on the placement of a programmable generator on the chest wall...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28698725/plasma-pyridoxal-5%C3%A1-phosphate-level-in-children-with-intractable-and-controlled-epilepsy
#9
Zahra Pirzadeh, Mohammad Ghofrani, Mohsen Mollamohammadi
OBJECTIVE: Intractable epilepsy is a serious neurologic problem with different etiologies. Decreased levels of pyridoxal phosphate in cerebral spinal fluid of patients with intractable epilepsy due to pyridoxine dependency epilepsy are reported. The aim of this study was to compare plasma pyridoxal 5´-phosphate level in patients with intractable and controlled epilepsy. MATERIALS & METHODS: This cross- sectional analytic study included 66 epileptic children, 33 patients with controlled and 33 patients with intractable epilepsy, after neonatal period up to 15 yr old of age...
2017: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/28694041/real-time-three-dimensional-3d-visualization-of-fusion-image-for-accurate-subdural-electrodes-placement-of-epilepsy-surgery
#10
Ayataka Fujimoto, Tohru Okanishi, Sotaro Kanai, Keishiro Sato, Mitsuyo Nishimura, Hideo Enoki
INTRODUCTION: The perfect match between pre-surgical estimated seizure onset zone and subdural electrodes (SEs) position is requested for epilepsy surgery. However, post-surgical neuro images sometimes disappoint physicians due to SEs malposition. To place SEs, we used to use intraoperative photograph and fluoroscopy. With this procedure, we just recognized approximate location of SEs during surgery. The purpose of the study is to perform precise SEs location intraoperatively using intra operative computer tomography (CT) and image-guidance...
July 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28688852/cdkl5-controls-postsynaptic-localization-of-glun2b-containing-nmda-receptors-in-the-hippocampus-and-regulates-seizure-susceptibility
#11
Kosuke Okuda, Shizuka Kobayashi, Masahiro Fukaya, Aya Watanabe, Takuto Murakami, Mai Hagiwara, Tempei Sato, Hiroe Ueno, Narumi Ogonuki, Sayaka Komano-Inoue, Hiroyuki Manabe, Masahiro Yamaguchi, Atsuo Ogura, Hiroshi Asahara, Hiroyuki Sakagami, Masashi Mizuguchi, Toshiya Manabe, Teruyuki Tanaka
Mutations in the Cyclin-dependent kinase-like 5 (CDKL5) gene cause severe neurodevelopmental disorders accompanied by intractable epilepsies, i.e. West syndrome or atypical Rett syndrome. Here we report generation of the Cdkl5 knockout mouse and show that CDKL5 controls postsynaptic localization of GluN2B-containing N-methyl-d-aspartate (NMDA) receptors in the hippocampus and regulates seizure susceptibility. Cdkl5 -/Y mice showed normal sensitivity to kainic acid; however, they displayed significant hyperexcitability to NMDA...
July 6, 2017: Neurobiology of Disease
https://www.readbyqxmd.com/read/28687765/reduction-of-epileptiform-activity-in-ketogenic-mice-the-role-of-monocarboxylate-transporters
#12
Linda S Forero-Quintero, Joachim W Deitmer, Holger M Becker
Epilepsy is a chronic neurological disorder that affects approximately 50 million people worldwide. Ketogenic diet (KD) can be a very effective treatment for intractable epilepsy. Potential mechanisms of action for KD have been proposed, including the re-balance among excitatory and inhibitory neurotransmission and decrease in the glycolytic rate in brain cells. KD has been shown to have an effect on the expression pattern of monocarboxylate transporters (MCT), however, it is unknown whether MCT transport activity is affected by KD and linked to the reduction of seizures during KD...
July 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28687722/a-meta-analysis-on-progressive-atrophy-in-intractable-temporal-lobe-epilepsy-time-is-brain
#13
REVIEW
Lorenzo Caciagli, Andrea Bernasconi, Samuel Wiebe, Matthias J Koepp, Neda Bernasconi, Boris C Bernhardt
OBJECTIVE: It remains unclear whether drug-resistant temporal lobe epilepsy (TLE) is associated with cumulative brain damage, with no expert consensus and no quantitative syntheses of the available evidence. METHODS: We conducted a systematic review and meta-analysis of MRI studies on progressive atrophy, searching PubMed and Ovid MEDLINE databases for cross-sectional and longitudinal quantitative MRI studies on drug-resistant TLE. RESULTS: We screened 2,976 records and assessed eligibility of 248 full-text articles...
July 7, 2017: Neurology
https://www.readbyqxmd.com/read/28669244/automated-detector-of-high-frequency-oscillations-in-epilepsy-based-on-maximum-distributed-peak-points
#14
Guo-Ping Ren, Jia-Qing Yan, Zhi-Xin Yu, Dan Wang, Xiao-Nan Li, Shan-Shan Mei, Jin-Dong Dai, Xiao-Li Li, Yun-Lin Li, Xiao-Fei Wang, Xiao-Feng Yang
High frequency oscillations (HFOs) are considered as biomarker for epileptogenicity. Reliable automation of HFOs detection is necessary for rapid and objective analysis, and is determined by accurate computation of the baseline. Although most existing automated detectors measure baseline accurately in channels with rare HFOs, they lose accuracy in channels with frequent HFOs. Here, we proposed a novel algorithm using the maximum distributed peak points method to improve baseline determination accuracy in channels with wide HFOs activity ranges and calculate a dynamic baseline...
April 17, 2017: International Journal of Neural Systems
https://www.readbyqxmd.com/read/28667864/an-acidosis-sparing-ketogenic-ask-diet-to-improve-efficacy-and-reduce-adverse-effects-in-the-treatment-of-refractory-epilepsy
#15
REVIEW
Alan W C Yuen, Isabel A Walcutt, Josemir W Sander
Diets that increase production of ketone bodies to provide alternative fuel for the brain are evolving from the classic ketogenic diet for epilepsy devised nearly a century ago. The classic ketogenic diet and its more recent variants all appear to have similar efficacy with approximately 50% of users showing a greater than 50% seizure reduction. They all require significant medical and dietetic support, and there are tolerability issues. A review suggests that low-grade chronic metabolic acidosis associated with ketosis is likely to be an important contributor to the short term and long term adverse effects of ketogenic diets...
June 28, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28666289/intractable-epilepsy-due-to-mtr-deficiency-importance-of-homocysteine-analysis
#16
Jonna Komulainen-Ebrahim, Eemeli Saastamoinen, Elisa Rahikkala, Heli Helander, Reetta Hinttala, Leila Risteli, Heikki Rantala, Johanna Uusimaa
No abstract text is available yet for this article.
June 30, 2017: Neuropediatrics
https://www.readbyqxmd.com/read/28666193/efficacy-of-adjunctive-vagus-nerve-stimulation-in-patients-with-dravet-syndrome-a-meta-analysis-of-68-patients
#17
REVIEW
Maxine Dibué-Adjei, Igor Fischer, Hans-Jakob Steiger, Marcel Alexander Kamp
RATIONALE: Dravet Syndrome (DS) is a severe epileptic encephalopathy of childhood involving intractable seizures, recurrent status epilepticus and cognitive decline. Because DS is a rare disease, available data is limited and evidence-based treatment guidelines are lacking. Vagus nerve stimulation (VNS) is an established neurostimulation treatment for intractable epilepsy, however little evidence is published on its efficacy in patients with DS. METHODS: We performed a meta-analysis of all peer-reviewed English language studies reporting seizure outcomes of patients with DS treated with adjunctive vagus nerve stimulation...
June 17, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28659857/a-new-rat-model-of-epileptic-spasms-based-on-methylazoxymethanol-induced-malformations-of-cortical-development
#18
Eun-Hee Kim, Mi-Sun Yum, Minyoung Lee, Eun-Jin Kim, Woo-Hyun Shim, Tae-Sung Ko
Malformations of cortical development (MCDs) can cause medically intractable epilepsies and cognitive disabilities in children. We developed a new model of MCD-associated epileptic spasms by treating rats prenatally with methylazoxymethanol acetate (MAM) to induce cortical malformations and postnatally with N-methyl-d-aspartate (NMDA) to induce spasms. To produce cortical malformations to infant rats, two dosages of MAM (15 mg/kg, intraperitoneally) were injected to pregnant rats at gestational day 15. In prenatally MAM-exposed rats and the controls, spasms were triggered by single (6 mg/kg on postnatal day 12 (P12) or 10 mg/kg on P13 or 15 mg/kg on P15) or multiple doses (P12, P13, and P15) of NMDA...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28658617/reliable-and-elastic-propagation-of-cortical-seizures-in%C3%A2-vivo
#19
Michael Wenzel, Jordan P Hamm, Darcy S Peterka, Rafael Yuste
Mapping the fine-scale neural activity that underlies epilepsy is key to identifying potential control targets of this frequently intractable disease. Yet, the detailed in vivo dynamics of seizure progression in cortical microcircuits remain poorly understood. We combine fast (30-Hz) two-photon calcium imaging with local field potential (LFP) recordings to map, cell by cell, the spread of locally induced (4-AP or picrotoxin) seizures in anesthetized and awake mice. Using single-layer and microprism-assisted multilayer imaging in different cortical areas, we uncover reliable recruitment of local neural populations within and across cortical layers, and we find layer-specific temporal delays, suggesting an initial supra-granular invasion followed by deep-layer recruitment during lateral seizure spread...
June 27, 2017: Cell Reports
https://www.readbyqxmd.com/read/28655938/significance-of-high-frequency-electrical-brain-activity
#20
REVIEW
Katsuhiro Kobayashi, Tomoyuki Akiyama, Takashi Agari, Tatsuya Sasaki, Takashi Shibata, Yoshiyuki Hanaoka, Mari Akiyama, Fumika Endoh, Makio Oka, Isao Date
 Electroencephalogram (EEG) data include broadband electrical brain activity ranging from infra-slow bands (< 0.1 Hz) to traditional frequency bands (e.g., the approx. 10 Hz alpha rhythm) to high-frequency bands of up to 500 Hz. High-frequency oscillations (HFOs) including ripple and fast ripple oscillations (80-200 Hz and>200 / 250 Hz, respectively) are particularly of note due to their very close relationship to epileptogenicity, with the possibility that they could function as a surrogate biomarker of epileptogenicity...
June 2017: Acta Medica Okayama
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