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Refractory epilepsy

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https://www.readbyqxmd.com/read/29786852/evolution-of-lobar-abnormalities-of-cerebral-glucose-metabolism-in-41-children-with-drug-resistant-epilepsy
#1
Tuhina Govil-Dalela, Ajay Kumar, Michael E Behen, Harry T Chugani, Csaba Juhász
OBJECTIVE: We analyzed long-term changes of lobar glucose metabolic abnormalities in relation to clinical seizure variables and development in a large group of children with medically refractory epilepsy. METHODS: Forty-one children (25 males) with drug-resistant epilepsy had a baseline positron emission tomography (PET) scan at a median age of 4.7 years; the scans were repeated after a median of 4.3 years. Children with progressive neurological disorders or space-occupying lesion-related epilepsy and those who had undergone epilepsy surgery were excluded...
May 22, 2018: Epilepsia
https://www.readbyqxmd.com/read/29786802/-treatment-with-neurostimulation-and-ketogenic-diet-for-people-with-medically-refractory-epilepsy
#2
Eva Kumlien, Tove Hallbook, Maria Dahlin
For some people with medically refractory epilepsy adjunct treatment with neurostimulation and ketogenic diet can be an option. Vagal nerve stimulation, VNS, consists of chronic intermittent electrical stimulation of the vagus nerve. VNS is effective and well tolerated in adolescents and adults. There is insufficient evidence on the efficacy of deep brain stimulation, DBS, and brain-responsive neurostimulation, RNS. Ketogenic diet is an established treatment in epilepsy with an increased number of indications, especially in neurometabolic diseases, where dietary therapy can completely eliminate epilepsy and improve cognitive and motor development...
May 22, 2018: Läkartidningen
https://www.readbyqxmd.com/read/29778946/mechanisms-underlying-anticonvulsant-and-proconvulsant-actions-of-norepinephrine
#3
REVIEW
Maedeh Ghasemi, Nasrin Mehranfard
Norepinephrine (NE) has been shown to exert a potent suppressant effect on seizure development. On the other hand, several lines of evidence have shown that increased NE level is proconvulsant under certain conditions. These data suggest that variations in NE levels could affect modulatory action of noradrenergic system on seizures. Less, however, is known about the mechanisms by which adrenergic pathways protect against seizures or promote seizures. Knowing the mechanisms involved in anti- or proconvulsive effects of NE may help to the development of new therapeutic candidates for patients with refractory epilepsy...
May 11, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29768988/single-cell-recordings-to-target-the-anterior-nucleus-of-the-thalamus-in-deep-brain-stimulation-for-patients-with-refractory-epilepsy
#4
Frédéric L W V J Schaper, Yan Zhao, Marcus L F Janssen, G Louis Wagner, Albert J Colon, Danny M W Hilkman, Erik Gommer, Mariëlle C G Vlooswijk, Govert Hoogland, Linda Ackermans, Lo J Bour, Richard J A Van Wezel, Paul Boon, Yasin Temel, Tjitske Heida, Vivianne H J M Van Kranen-Mastenbroek, Rob P W Rouhl
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a promising treatment for patients with refractory epilepsy. However, therapy response varies and precise positioning of the DBS lead is potentially essential for maximizing therapeutic efficacy. We investigate if single-cell recordings acquired by microelectrode recordings can aid targeting of the ANT during surgery and hypothesize that the neuronal firing properties of the target region relate to clinical outcome. We prospectively included 10 refractory epilepsy patients and performed microelectrode recordings under general anesthesia to identify the change in neuronal signals when approaching and transecting the ANT...
April 2, 2018: International Journal of Neural Systems
https://www.readbyqxmd.com/read/29768433/the-long-term-outcomes-of-epilepsy-surgery
#5
Midhun Mohan, Simon Keller, Andrew Nicolson, Shubhabrata Biswas, David Smith, Jibril Osman Farah, Paul Eldridge, Udo Wieshmann
OBJECTIVE: Despite modern anti-epileptic drug treatment, approximately 30% of epilepsies remain medically refractory and for these patients, epilepsy surgery may be a treatment option. There have been numerous studies demonstrating good outcome of epilepsy surgery in the short to median term however, there are a limited number of studies looking at the long-term outcomes. The aim of this study was to ascertain the long-term outcome of resective epilepsy surgery in a large neurosurgery hospital in the U...
2018: PloS One
https://www.readbyqxmd.com/read/29766039/beneficial-outcome-of-urethane-treatment-following-status-epilepticus-in-a-rat-organophosphorus-toxicity-model
#6
Asheebo Rojas, Wenyi Wang, Avery Glover, Zahra Manji, Yujiao Fu, Raymond Dingledine
The efficacy of benzodiazepines to terminate electrographic status epilepticus (SE) declines the longer a patient is in SE. Therefore, alternative methods for ensuring complete block of SE and refractory SE are necessary. We compared the ability of diazepam and a subanesthetic dose of urethane to terminate prolonged SE and mitigate subsequent pathologies. Adult Sprague Dawley rats were injected with diisopropylfluorophosphate (DFP) to induce SE. Rats were administered diazepam (10 mg/kg, ip) or urethane (0...
March 2018: ENeuro
https://www.readbyqxmd.com/read/29762840/the-effect-of-mir-146a-gene-silencing-on-drug-resistance-and-expression-of-protein-of-p-gp-and-mrp1-in-epilepsy
#7
H-L Zhang, Y-H Lin, Y Qu, Q Chen
OBJECTIVE: To investigate the effect of miR-146a gene silencing on brain tissue and related drug-resistance proteins in rats and explore its resistance mechanism. MATERIALS AND METHODS: A rat model of chronic refractory epilepsy was established. The rats were divided into four groups: Normal group, Model group, Negative control group and AntagomiR-146a group. Hematoxylin and eosin (HE) stain was used to detect brain histopathological changes. We examined the expression of mRNA of miR-146a, multidrug resistance (MDR1) and multidrug-resistant associated protein (MRP1) by RT-PCR...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29753047/chromosomal-microarray-analysis-of-bulgarian-patients-with-epilepsy-and-intellectual-disability
#8
Valentina Peycheva, Kunka Kamenarova, Neviana Ivanova, Dimitar Stamatov, Daniela Avdjieva-Tzavella, Iliana Alexandrova, Sashka Zhelyazkova, Iliana Pacheva, Petya Dimova, Ivan Ivanov, Ivan Litvinenko, Veneta Bozhinova, Ivailo Tournev, Emil Simeonov, Vanyo Mitev, Albena Jordanova, Radka Kaneva
High resolution chromosomal microarray analysis (CMA) has facilitated the identification of small chromosomal rearrangements throughout the genome, associated with various neurodevelopmental phenotypes, including ID/DD. Recently, it became evident that intellectual disability (ID)/developmental delay (DD) can occur with associated co-morbidities like epileptic seizures, autism and additional congenital anomalies. These observations require whole genome approach in order to detect the genetic causes of these complex disorders...
May 9, 2018: Gene
https://www.readbyqxmd.com/read/29752000/noncompliance-of-patients-with-driving-restrictions-due-to-uncontrolled-epilepsy
#9
Laurent M Willems, Philipp S Reif, Susanne Knake, Hajo M Hamer, Constantin Willems, Günter Krämer, Felix Rosenow, Adam Strzelczyk
Epilepsies are a common and chronic neurological disorder characterized by sustained risk of recurrent seizures. Because of paroxysmal and often unpredictable occurrence of seizures, patients with uncontrolled epilepsy are subject to disease-specific restrictions in daily life, such as their career choice or specific work limitations. According to German law and many other European and international guidelines, driving is strictly prohibited in patients with uncontrolled epilepsy so as to increase active and passive safety in public road traffic...
May 9, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29751371/status-epilepticus-associated-with-acute-encephalitis-long-term-follow-up-of-functional-and-cognitive-outcomes-in-72-patients
#10
Weibi Chen, Yingying Su, Mengdi Jiang, Gang Liu, Fei Tian, Guoping Ren
BACKGROUND: Continued care in patients with encephalitis and prolonged status epilepticus (SE) is controversial. Limited data is available on the functional and cognitive outcomes. METHODS: In a prospective cohort study from 2007 to 2016, patients with acute encephalitis and SE were reviewed. Long-term outcomes including motor disability (modified Rankin Scale, mRS), daily living skills (activities of daily living, ADL), cognitive ability (modified Telephone Interview for Cognitive Status, TICS-M) and epilepsy sequelae, were evaluated in those survivors at 12-month follow-up...
May 11, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29751140/nanoparticle-based-delivery-of-carbamazepine-a-promising-approach-for-the-treatment-of-refractory-epilepsy
#11
Anna Zybina, Anastasiya Anshakova, Julia Malinovskaya, Pavel Melnikov, Vladimir Baklaushev, Vladimir Chekhonin, Olga Maksimenko, Sergey Titov, Vadim Balabanyan, Jörg Kreuter, Svetlana Gelperina, Kenul Abbasova
Resistance to antiepileptic drugs (AEDs) is a major clinical problem. The overexpression of P-glycoprotein (Pgp), one of the main transporters limiting the entry of xenobiotics into the brain, is among the factors contributing to the AED resistance. Presently, there is no consensus on the interaction of carbamazepine (CBZ) with the Pgp. This study investigates the effect of the Pgp inhibitor verapamil on the anticonvulsant effect of CBZ and its nanoparticulate formulation in the rat model of isoniazid-induced epilepsy...
May 8, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29749462/immunotherapy-by-targeting-of-vgkc-complex-for-seizure-control-and-prevention-of-cognitive-impairment-in-a-mouse-model-of-epilepsy
#12
Zhiliang Fan, Xiaojuan Feng, Zhigang Fan, Xingyuan Zhu, Shaohua Yin
Epilepsy is a type of refractory neurologic disorder mental disease, which is associated with cognitive impairments and memory dysfunction. However, the potential mechanisms of epilepsy are not well understood. Previous evidence has identified the voltage gated potassium channel complex (VGKC) as a target in various cohorts of patients with epilepsy. In the present study, the efficacy of an antibody against VGKC (anti‑VGKC) for the treatment of epilepsy in mice was investigated. A mouse model of lithium‑pilocarpine temporal lobe epilepsy was established and anti‑VGKC treatment was administered for 30 days...
May 9, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29747241/stiripentol-add-on-therapy-for-focal-refractory-epilepsy
#13
REVIEW
Francesco Brigo, Stanley C Igwe, Nicola Luigi Bragazzi
BACKGROUND: This is an updated version of the Cochrane review last published in 2015 (Issue 10). For nearly 30% of people with epilepsy, seizures are not controlled by current treatments. Stiripentol is a new antiepileptic drug (AED) that was developed in France and was approved by the European Medicines Agency (EMA) in 2007 for the treatment of Dravet syndrome as an adjunctive therapy with valproate and clobazam, with promising effects. OBJECTIVES: To evaluate the efficacy and tolerability of stiripentol as add-on treatment for people with focal refractory epilepsy who are taking AEDs...
May 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29745347/febrile-infection-related-epilepsy-syndrome-fires-an-overview-of-treatment-and-recent-patents
#14
Kam Lun E Lun Hon, Alexander K C Leung, Alcy R Torres
BACKGROUND: New-onset refractory status epilepticus (NORSE) refers to a clinical presentation in a patient without active epilepsy or other existing relevant neurological disorder, with new onset of refractory status epilepticus in the absence of a clear acute or active structural, metabolic, or toxic cause. Febrile infection-related epilepsy syndrome (FIRES) is a subset of NORSE that requires a febrile infection between 24 hours and 2 weeks prior to the onset of refractory status epilepticus, with or without fever at the onset of status epilepticus, and with no restriction to the age of the patient...
May 8, 2018: Recent Patents on Inflammation & Allergy Drug Discovery
https://www.readbyqxmd.com/read/29743978/clarified-a%C3%A3-a%C3%A3-euterpe-oleracea-juice-as-an-anticonvulsant-agent-in-vitro-mechanistic-study-of-gabaergic-targets
#15
Gabriela P F Arrifano, Mathieu P Lichtenstein, José Rogério Souza-Monteiro, Marcelo Farina, Hervé Rogez, José Carlos Tavares Carvalho, Cristina Suñol, Maria Elena Crespo-López
Seizures affect about 50 million people around the world. Approximately 30% of seizures are refractory to the current pharmacological arsenal, so, the pursuit of new therapeutic alternatives is essential. Clarified Euterpe oleracea (EO) juice showed anticonvulsant properties similar to diazepam in an in vivo model with pentylenetetrazol, a GABAA receptor blocker. This study investigated the effects of EO on the main GABAergic targets for anticonvulsant drugs, analyzing the effect on the GABA receptor's benzodiazepine and picrotoxinin binding sites and the GABA uptake...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29740975/similarities-between-the-responses-to-ant-dbs-and-prior-vns-in-refractory-epilepsy
#16
Toni Kulju, Joonas Haapasalo, Kai Lehtimäki, Sirpa Rainesalo, Jukka Peltola
OBJECTIVES: Neurostimulation has offered new treatment options in refractory epilepsy, first with vagus nerve stimulation (VNS) and more recently with deep brain stimulation (DBS). There is a lack of previous detailed data assessing the relationship between VNS and ANT-DBS. The aim of this study was to investigate the potential correlation between therapeutic responses to VNS and ANT-DBS. MATERIALS AND METHODS: A total of 11 patients with previous VNS therapy underwent ANT-DBS implantation...
May 8, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29736224/prognostic-value-of-ictal-onset-patterns-in-postsurgical-outcome-of-temporal-lobe-epilepsy
#17
Jafar Mehvari-Habibabadi, Reza Basiratnia, Houshang Moein, Mohamad Zare, Majid Barakatain, Yahya Aghakhani, Nasim Tabrizi
Background: To investigate ictal onset patterns (IOP) in scalp electroencephalography (EEG) of patients with temporal lobe epilepsy (TLE) and their prognostic effect on the postoperative outcome. Methods: We conducted a retrospective cohort study between 2011 and 2015 in our referral Epilepsy Surgery Center enrolling adult patients with refractory TLE and a visible epileptogenic lesion in magnetic resonance imaging (MRI), who underwent epilepsy surgery. Demographic, clinical and MRI findings were collected and ictal findings during video-EEG monitoring were reviewed in detail...
October 7, 2017: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/29733410/perioperative-multimodal-evaluation-and-surgical-tactics-of-tumor-related-epilepsy-2-dimensional-operative-video
#18
Chengxin Ma, Rui Feng, N U Farrukh Hameed, Jie Zhang, Dongxiao Zhuang, Jinsong Wu
Treatment of tumor-related epilepsy (TRE), especially for tumors near critical areas, requires surgeons to strike a balance between the epileptic benefit and functional outcome after surgery. Here, we present a case in which multimodal evaluation facilitated the achievement of such surgical balance. Informed patient consent was obtained. A 17-yr-old female presented with seizure attacks for 2 yr. Magnetic resonance imaging (MRI) revealed a right parietal mass lesion with hypointense signal on T1W imaging, hyperintense signal on T2W imaging, and homogeneous enhancement...
May 4, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29728228/detection-of-structural-abnormalities-of-cortical-and-subcortical-gray-matter-in-patients-with-mri-negative-refractory-epilepsy-using-neurite-orientation-dispersion-and-density-imaging
#19
Masoumeh Rostampour, Hassan Hashemi, Seyed Morteza Najibi, Mohammad Ali Oghabian
PURPOSE: NODDI (Neurite Orientation Dispersion and Density Imaging) and DTI (Diffusion tensor imaging) may be useful in identifying abnormal regions in patients with MRI-negative refractory epilepsy. The aim of this study was to determine whether NODDI and DTI maps including neurite density (ND), orientation dispersion index (ODI), mean diffusivity (MD) and fractional anisotropy (FA) can detect structural abnormalities in cortical and subcortical gray matter (GM) in these patients. The correlation between these parameters and clinical characteristics of the disease was also investigated...
April 2018: Physica Medica: PM
https://www.readbyqxmd.com/read/29718083/neuropsychology-within-a-tertiary-care-epilepsy-center
#20
Chris E Morrison, William S MacAllister, William B Barr
Epilepsy is a prevalent condition characterized by variations in its clinical presentation, etiology, and amenability to treatment. Through history, neuropsychologists have played a significant role in performing research studies on changes in language, memory, and executive functioning in patients with epilepsy, including those undergoing surgical treatment for medically refractory seizures. These studies provided a foundation for establishing neuropsychologists as critical members of interdisciplinary clinical teams specializing in evaluation and treatment of epilepsy...
May 1, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
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