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Intractable epilepsy

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https://www.readbyqxmd.com/read/29031193/the-retention-of-lacosamide-in-patients-with-epilepsy-and-intellectual-disability-in-three-specialised-institutions
#1
J Brenner, H J M Majoie, S van Beek, J A Carpay
PURPOSE: We describe the effectiveness of lacosamide as adjunctive therapy in patients with epilepsy and an intellectual disability. This information is relevant, as few data exist pertaining to this population with a high prevalence of (intractable) epilepsy. METHODS: We performed a retrospective study in three specialised institutions. Inclusion criteria were (1) focal onset or symptomatic generalized (2) therapy-resistant epilepsy, (3) intellectual disability and (4) residence in a care-facility for people with intellectual disabilities (PWID)...
October 3, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29031192/growth-and-endocrine-function-in-children-with-dravet-syndrome
#2
Krista Eschbach, Sharon Scarbro, Elizabeth Juarez-Colunga, Victoria Allen, Stephanie Hsu, Kelly Knupp
PURPOSE: Dravet syndrome is an intractable childhood epilepsy syndrome most often associated with an SCN1A mutation. In our clinical practice, several patients with Dravet syndrome were noted to have short stature and endocrine dysfunction. This has not been reported in the literature. Our study aim was to describe growth measurements and endocrine abnormalities in children with Dravet syndrome. METHOD: A retrospective chart review was performed at a single institution...
September 29, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29027866/magnetic-resonance-imaging-guided-laser-interstitial-thermal-therapy-as-treatment-for-intractable-insular-epilepsy-in-children
#3
M Scott Perry, David J Donahue, Saleem I Malik, Cynthia G Keator, Angel Hernandez, Rohit K Reddy, Freedom F Perkins, Mark R Lee, Dave F Clarke
OBJECTIVE Seizure onset within the insula is increasingly recognized as a cause of intractable epilepsy. Surgery within the insula is difficult, with considerable risks, given the rich vascular supply and location near critical cortex. MRI-guided laser interstitial thermal therapy (LiTT) provides an attractive treatment option for insular epilepsy, allowing direct ablation of abnormal tissue while sparing nearby normal cortex. Herein, the authors describe their experience using this technique in a large cohort of children undergoing treatment of intractable localization-related epilepsy of insular onset...
October 13, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29027858/role-of-the-temporal-pole-in-temporal-lobe-epilepsy-seizure-networks-an-intracranial-electrode-investigation
#4
Taylor J Abel, Royce W Woodroffe, Kirill V Nourski, Toshio Moritani, Aristides A Capizzano, Patricia Kirby, Hiroto Kawasaki, Matthew Howard, Mary Ann Werz
OBJECTIVE A convergence of clinical research suggests that the temporal pole (TP) plays an important and potentially underappreciated role in the genesis and propagation of seizures in temporal lobe epilepsy (TLE). Understanding its role is becoming increasingly important because selective resections for medically intractable TLE spare temporopolar cortex (TPC). The purpose of this study was to characterize the role of the TPC in TLE after using dense electrocorticography (ECoG) recordings in patients undergoing invasive monitoring for medically intractable TLE...
October 13, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29026310/laser-interstitial-thermal-therapy-for-the-treatment-of-epilepsy-evidence-to-date
#5
REVIEW
Navika D Shukla, Allen L Ho, Arjun V Pendharkar, Eric S Sussman, Casey H Halpern
Medically intractable epilepsy is associated with increased morbidity and mortality. For those with focal epilepsy and correlated electrophysiological or radiographic features, open surgical resection can achieve high rates of seizure control, but can be associated with neurologic deficits and cognitive effects. Recent innovations have allowed for more minimally invasive methods of surgical seizure control such as magnetic resonance-guided laser interstitial therapy (MRgLITT). MRgLITT achieves the goal of ablating seizure foci while preserving neuropsycho-logical function and offering real-time feedback and monitoring of tissue ablation...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29023305/insights-into-the-therapeutic-effect-of-responsive-neurostimulation-assessed-with-scalp-eeg-recording-a-case-report
#6
Maria Jose Bruzzone, Naoum Issa, Sandra Rose, Peter Warnke, Vernon L Towle, James X Tao, Shasha Wu
The responsive neurostimulation system (RNS) is the first closed-loop neurostimulator approved as an adjunctive treatment for adults with medically refractory focal epilepsy from no more than two seizure foci. In addition to its therapeutic effect, it provides chronic intracranial EEG recordings, with limited storage capacity. Long-term monitoring with scalp EEG recordings can provide additional information regarding seizure patterns, the efficacy of RNS stimulation in aborting individual seizures, and the net effect of RNS on seizure control...
October 10, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29017082/temporal-lobe-surgery-for-intractable-epilepsy-in-children-what-to-do-with-the-hippocampus
#7
Mony Benifla, Odeya Bennet-Back, Zamir Shorer, Iris Noyman, Rima Bar-Yosef, Dana Ekstein
PURPOSE: Resection of the hippocampus can cause verbal memory decline, especially in the pediatric population. Thus, preservation of the hippocampus can be crucial for the quality of life of children with intractable temporal lobe epilepsy (TLE) who are candidates for epilepsy surgery. We investigated techniques that determine whether the hippocampus is part of the epileptogenic zone and the outcomes of pediatric surgery aimed to spare the hippocampus. METHODS: We accessed data of children with normal hippocampus on MRI, who underwent surgery for medically refractory TLE...
October 2, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28994113/rates-and-predictors-of-success-and-failure-in-repeat-epilepsy-surgery-a-meta-analysis-and-systematic-review
#8
Max O Krucoff, Alvin Y Chan, Stephen C Harward, Shervin Rahimpour, John D Rolston, Carrie Muh, Dario J Englot
OBJECTIVE: Medically refractory epilepsy is a debilitating disorder that is particularly challenging to treat in patients who have already failed a surgical resection. Evidence regarding outcomes of further epilepsy surgery is limited to small case series and reviews. Therefore, our group performed the first quantitative meta-analysis of the literature from the past 30 years to assess for rates and predictors of successful reoperations. METHODS: A PubMed search was conducted for studies reporting outcomes of repeat epilepsy surgery...
October 10, 2017: Epilepsia
https://www.readbyqxmd.com/read/28993242/a-distinct-microrna-expression-profile-is-associated-with-%C3%AE-11-c-methyl-l-tryptophan-amt-pet-uptake-in-epileptogenic-cortical-tubers-resected-from-patients-with-tuberous-sclerosis-complex
#9
Shruti Bagla, Daniela Cukovic, Eishi Asano, Sandeep Sood, Aimee Luat, Harry T Chugani, Diane C Chugani, Alan A Dombkowski
Tuberous sclerosis complex (TSC) is characterized by hamartomatous lesions in various organs and arises due to mutations in the TSC1 or TSC2 genes. TSC mutations lead to a range of neurological manifestations including epilepsy, cognitive impairment, autism spectrum disorders (ASD), and brain lesions that include cortical tubers. There is evidence that seizures arise at or near cortical tubers, but it is unknown why some tubers are epileptogenic while others are not. We have previously reported increased tryptophan metabolism measured with α[(11)C]-methyl-l-tryptophan (AMT) positron emission tomography (PET) in epileptogenic tubers in approximately two-thirds of patients with tuberous sclerosis and intractable epilepsy...
October 7, 2017: Neurobiology of Disease
https://www.readbyqxmd.com/read/28983902/intractable-seizures-after-a-lengthy-remission-in-childhood-onset-epilepsy
#10
Peter R Camfield, Carol S Camfield
OBJECTIVES: To establish the risk of subsequent intractable epilepsy after ≥2, ≥5, and ≥10 years of remission in childhood-onset epilepsy. METHODS: From the Nova Scotia childhood-onset epilepsy population-based cohort patients with all types of epilepsy were selected with ≥20 years follow-up from seizure onset (incidence cases). Children with childhood absence epilepsy were excluded. The rate of subsequent intractable epilepsy was then studied for patients with ≥5 years remission on or off AED treatment and compared with the rate for those with ≥2 and ≥10 years of remission...
October 6, 2017: Epilepsia
https://www.readbyqxmd.com/read/28982809/understanding-the-health-economic-burden-of-patients-with-tuberous-sclerosis-complex-tsc-with-epilepsy-a-retrospective-cohort-study-in-the-uk-clinical-practice-research-datalink-cprd
#11
Charles Shepherd, Matthias Koepp, Melissa Myland, Keyur Patel, Cristiana Miglio, Vathani Siva, Elizabeth Gray, Maureen Neary
INTRODUCTION: Epilepsy is highly prevalent in tuberous sclerosis complex (TSC), a multi-system genetic disorder. The clinical and economic burden of this condition is expected to be substantial due to treatment challenges, debilitating co-morbidities and the relationship between TSC-related manifestations. This study estimated healthcare resource utilisation (HCRU) and costs for patients with TSC with epilepsy (TSC+E) in the UK. METHODS: Patients with TSC+E in the Clinical Practice Research Datalink (CPRD) linked to Hospital Episodes Statistics were identified from April 1997 to March 2012...
October 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28981509/differential-temperature-sensitivity-of-synaptic-and-firing-processes-in-a-neural-mass-model-of-epileptic-discharges-explains-heterogeneous-response-of-experimental-epilepsy-to-focal-brain-cooling
#12
Jaymar Soriano, Takatomi Kubo, Takao Inoue, Hiroyuki Kida, Toshitaka Yamakawa, Michiyasu Suzuki, Kazushi Ikeda
Experiments with drug-induced epilepsy in rat brains and epileptic human brain region reveal that focal cooling can suppress epileptic discharges without affecting the brain's normal neurological function. Findings suggest a viable treatment for intractable epilepsy cases via an implantable cooling device. However, precise mechanisms by which cooling suppresses epileptic discharges are still not clearly understood. Cooling experiments in vitro presented evidence of reduction in neurotransmitter release from presynaptic terminals and loss of dendritic spines at post-synaptic terminals offering a possible synaptic mechanism...
October 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28971013/presurgical-thalamocortical-connectivity-is-associated-with-response-to-vagus-nerve-stimulation-in-children-with-intractable-epilepsy
#13
George M Ibrahim, Priya Sharma, Ann Hyslop, Magno R Guillen, Benjamin R Morgan, Simeon Wong, Taylor J Abel, Lior Elkaim, Iahn Cajigas, Ashish H Shah, Aria Fallah, Alexander G Weil, Nolan Altman, Byron Bernal, Santiago Medina, Elysa Widjaja, Prasanna Jayakar, John Ragheb, Sanjiv Bhatia
Although chronic vagus nerve stimulation (VNS) is an established treatment for medically-intractable childhood epilepsy, there is considerable heterogeneity in seizure response and little data are available to pre-operatively identify patients who may benefit from treatment. Since the therapeutic effect of VNS may be mediated by afferent projections to the thalamus, we tested the hypothesis that intrinsic thalamocortical connectivity is associated with seizure response following chronic VNS in children with epilepsy...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28969879/intravenous-immunoglobulin-as-a-treatment-for-intractable-epilepsy-secondary-to-focal-cortical-dysplasia-a-meta-analysis
#14
Fatema Al Amrani, Roy Dudley, Luis E Bello-Espinosa, Bernard Rosenblatt, Myriam Srour, Guillaume Sébire
BACKGROUND: The observation of a dramatic response to intravenous immunoglobulin (IVIG) by a child from our center with intractable epilepsy due to focal cortical dysplasia prompted us to perform a meta-analysis on the efficiency of IVIG in this condition. Focal cortical dysplasia is a common cause of intractable epilepsy. Microglial activation and upregulation of neuroinflammatory pathways have been documented in brain specimen from surgically treated patients with intractable epilepsy and focal cortical dysplasia...
July 19, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28954709/visual-field-defects-following-different-resective-procedures-for-mesiotemporal-lobe-epilepsy
#15
Barbara Schmeiser, Moritz Daniel, Evangelos Kogias, Daniel Böhringer, Karl Egger, Shan Yang, Niels Alexander Foit, Andreas Schulze-Bonhage, Bernhard Jochen Steinhoff, Josef Zentner, Wolf Alexander Lagrèze, Nikolai Johannes Gross
INTRODUCTION: One of the most common side effects of mesiotemporal lobe resection in patients with medically intractable epilepsy are visual field defects (VFD). While peripheral defects usually remain unnoticed by patients, extended VFD influence daily life activities and can, in particular, affect driving regulations. This study had been designed to evaluate frequency and extent of VFD following different surgical approaches to the mesiotemporal area with respect to the ability to drive...
September 24, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28950998/polymicrogyria-and-intractable-epilepsy-in-siblings-with-knobloch-syndrome-and-homozygous-mutation-of-col18a1
#16
Brittany A Charsar, Ethan M Goldberg
No abstract text is available yet for this article.
August 15, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28946181/localization-of-musicogenic-epilepsy-to-heschl-s-gyrus-and-superior-temporal-plane-case-report
#17
Yasunori Nagahama, Christopher K Kovach, Michael Ciliberto, Charuta Joshi, Ariane E Rhone, Adam Vesole, Phillip E Gander, Kirill V Nourski, Hiroyuki Oya, Matthew A Howard, Hiroto Kawasaki, Brian J Dlouhy
Musicogenic epilepsy (ME) is an extremely rare form of the disorder that is provoked by listening to or playing music, and it has been localized to the temporal lobe. The number of reported cases of ME in which intracranial electroencephalography (iEEG) has been used for seizure focus localization is extremely small, especially with coverage of the superior temporal plane (STP) and specifically, Heschl's gyrus (HG). The authors describe the case of a 17-year-old boy with a history of medically intractable ME who underwent iEEG monitoring that involved significant frontotemporal coverage as well as coverage of the STP with an HG depth electrode anteriorly and a planum temporale depth electrode posteriorly...
September 15, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28941760/bilateral-cingulum-fiber-reductions-in-temporal-lobe-epilepsy-with-unilateral-hippocampal-sclerosis
#18
H Urbach, K Egger, K Rutkowski, J M Nakagawa, B Schmeiser, M Reisert, A Brandt, B J Steinhoff, A Schulze-Bonhage, T Hammen
PURPOSE: To evaluate whether white matter tracts within the Papez circuit are altered in patients with unilateral hippocampal sclerosis (HS). METHODS: Twenty patients with histologically proven unilateral HS and 20 age-matched controls were studied with a 3T Epilepsy-dedicated MRI protocol including a MPRAGE sequence for hippocampus volumetry and a diffusion tensor imaging (DTI) sequence (61 diffusion-encoding directions, 2×2×2mm(3) voxels) for diffusion tensor tractography (DTT)...
September 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28941398/the-mechanisms-mediating-the-antiepileptic-effects-of-the-ketogenic-diet-and-potential-opportunities-for-improvement-with-metabolism-altering-drugs
#19
REVIEW
Neil A Youngson, Margaret J Morris, J William O Ballard
The ketogenic diet (KD) is increasingly being used to treat patients with intractable epilepsy. Despite decades of research, the reason for its success, when anticonvulsants have failed, is still not completely understood. There are, however, many candidate mechanisms which can be grouped into those that alter neuronal excitability at the synapse, and those that confer neuroprotection. The molecular underpinning of these mechanisms centres on the shift from glucose- to lipid-based energy generation that accompanies a high fat/low carbohydrate diet...
September 13, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28938499/postherpetic-anti-n-methyl-d-aspartate-receptor-encephalitis-after-hemispherotomy-in-a-patient-with-intractable-startle-epilepsy
#20
Irem Erkent, Rahsan Gocmen, F Irsel Tezer, Kader K Oguz, Nalan Kucuksahin, Figen Soylemezoglu, Burcak Bilginer, Serap Saygi
No abstract text is available yet for this article.
September 22, 2017: Neuropediatrics
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